bluuebunny/crossref_metadata_2025_split huggingface dataset:
The long‐term outcome of patients who suffered and survived an acute myocardial infarction in the midst of recurrent attacks of variant angina
Authors: Madias J. E. 
Published: February 2009

AbstractTwenty‐one patients, ranging in age between 28 and 59 years, who survived hospitalization for an acute myocardial infarction in association with repetitive attacks of variant angina, were followed prospectively for 59.1±5.1 (SEM) (range 17–120) months. Four patients died, one of sudden death 17 months after admission, one of congestive heart failure at 33 months, and two of cancer at 43 and 45 months of follow‐up. Three patients had four new myocardial infarctions at 22, 32, 33, and 61 months of follow‐up. Six patients were readmitted for angina or other cardiac reasons. Twelve patients remained asymptomatic throughout the follow‐up and one more patient was asymptomatic before and after his recurrent myocardial infarction. No relapse of variant angina was documented. Thus, the long‐term course of patients with variant angina culminating in acute myocardial infarction is relatively benign, despite the highly unstable features of their initial presentation.
Effect of nifedipine on dipyridamole thallium‐201 myocardial scintigraphy
Authors: Bonaduce D. , Morgano G. , Canonico V. , Breglio R. , Condorelli M. , Salvatore M. , Muto P. 
Published: February 2009

AbstractThe effect of a calcium antagonist drug, nifedipine, on dipyridamole thallium‐201 images was assessed in 10 angina patients with positive dipyridamole test. Two dipyridamole thallium‐201 tests were performed, the first in basal conditions, the second after administration of 20 mg nifedipine. After dipyridamole, heart rate and double product increased respectively from 68.0±8.2 to 94.7±11.5 beats/min (p<0.01) and from 9459.5±1800.2 to 12,770.0±1864.7 mmHg x beats/min (p<0.01). Dipyridamole when infused after nifedipine induced an increase in heart rate from 74.2±7.16 to 88.8±5.6 beats/min (p<0.01) and in double product from 9650.5±1348.0 to 11,399.0±1146 mmHg x beats/min (p<0.05). Systolic and diastolic blood pressures were unmodified during the two studies. Segment scores were comparable before and after nifedipine. Thus, nifedipine does not worsen thallium‐201 myocardial images obtained during dipyridamole infusion, therefore, this test could provide an alternative to exercise thallium‐201 in patients receiving calcium antagonist drugs.
An evaluation of the avionics pressurometer iii 1978 at home and in hospital
Authors: Gould B. A. , Hornung R. S. , Cashman P. M. M. , Altman D. , Raftery E. B. 
Published: February 2009

AbstractThe Avionics Pressurometer III is the only noninvasive indirect ambulatory blood pressure system which provides 24‐h blood pressure measurements, but it has been subjected to limited evaluation. We report a critical evaluation comparing it to simultaneous intra‐arterial blood pressures both at home and at hospital as well as during standardized exercise. Comparisons with simultaneous indirect methods were also made. Twenty‐two hypertensives undergoing intra‐arterial ambulatory blood pressure monitoring wore the two recorders for one day. The mean difference (standard deviation SD) for intra‐arterial blood pressure—Avionics blood pressure was 2 (SD 8.6) /‐14 (SD 10.3)mmHg at home and ‐3 (SD 15.4)/‐11 (SD 12.3) mmHg at hospital. At the end of exercise the figures for the same comparison were ‐7 (SD 16)/0 (SD 15.6) mmHg. In general the agreement between intra‐arterial and Avionics pressurometer recordings was closer for systolic than for diastolic blood pressures but there was wide variation for individuals as shown by the standard deviations about the mean difference. We did not use the recorder at night as patients complained that the noise kept them awake and so night‐time blood pressures were not attainable. We do not think the recorder performed satisfactorily during physical exertion, and in view of its expense, this recorderis of limited potential value in supplying accurate information.
Deficiency of apolipoproteins a‐i and c‐iii and severe coronary heart disease
Authors: Hiasa Y. , Maeda T. , Mori H. 
Published: February 2009

AbstractA 55‐year‐old woman with severe coronary arteriosclerosis and skin xanthomas is described. The patient had a normal total cholesterol level of 168 mg/dl. Her level of high‐density lipoprotein cholesterol was markedly reduced (3 mg/dl). On apolipoprotein analysis, apolipoproteins A‐I and C‐III were not detectable, and the level of apolipoprotein A‐II was found to be at a low level (3.5 mg/dl). This case may possibly belong to a distinct new disease entity of deficiencies of apolipoprotein A‐I and C‐III in which coronary arteriosclerosis appears prematurely and severely.
Clinical studies on diabetic myocardial disease using exercise testing with myocardial scintigraphy and endomyocardial biopsy
Authors: Gend A. , Mizuno S. , Nunoda S. , Nakayama A. , Igarashi Y. , Sugihara N. , Namura M. , Takeda R. , Bunko H. , Hisada K. 
Published: February 2009

AbstractNine diabetics without significant coronary stenosis participated in an exercise testing protocol with thallium‐201 myocardial scintigraphy. Endomyocardial biopsy of right ventricle was also obtained. There were 4 patients with abnormal perfusion (positive group) and 5 patients with normal perfusion (negative group). All cases of the positive group were familial diabetics and there was only one case of dietary treatment, whereas in the negative group, there were only 2 cases of familial diabetics and 3 cases receiving dietary treatment. No statistical differences between the positive and negative groups were observed for the data of exercise performance and hemodynamic parameters in cardiac catheterization at rest. However, the mean ejection fraction in the positive group (62 ± 13%) was significantly lower than in the negative group (77±4%). In both groups, the mean diameter of myocardial cells and the mean percent fibrosis of biopsy specimens showed significant increases compared with the control group. The mean percent fibrosis in the positive group (24.1±8.5%) compared with that in the negative group (16.5±5.9%) showed a tendency to increase. It is suggested that the abnormal perfusion of thallium‐201 in the positive group indicates subclinically a pathological change of microcirculation caused by diabetes mellitus.
The ear lobe crease sign and coronary artery disease in aortic stenosis
Authors: Gibson T. C. , Ashikaga T. 
Published: February 2009

AbstractEar lobe creases have been proposed as useful indirect markers of coronary artery disease. To test such a hypothesis, this physical sign was evaluated in 100 patients with symptomatic aortic stenosis undergoing cardiac catheterization to establish the hemodynamic severity of the obstruction and the degree of coronary artery involvement. This is a disorder where the coexistence of cardiac ischemia may play an important part in diagnosis and management. Criteria were established for the degree of ear lobe involvement with a grading of mild (Grade 1), moderate (Grade 2), and severe (Grade 3). Significant coronary artery disease was defined as narrowing ≥50% and a coronary score was established. Sensitivity, specificity, positive and negative predictive values were calculated, using Bayesian analysis for three levels of assumed coronary artery disease prevalence. An ear lobe crease score was correlated with a coronary artery disease score, taking into account the variables of age, sex, and body mass index. No useful statistical correlations were found and it is concluded that this physical sign is of little practical value in this clinical setting.
Acute and chronic pulmonary thromboembolism: current perspectives. part i: glossary of terms, historic evolution and prevalence
Authors: Ansari A. 
Published: February 2009

AbstractDespite considerable medical as well as surgical advances, the problem of pulmonary thromboem‐bolism, both acute and chronic, continues to plague clinicians of all medical disciplines. Approximately 650,000 to 700,000 patients per year suffer from acute pulmonary thromboembolism in the United States. Of these, approximately 60,000–70,000 die as a direct result of it. Our knowledge of the etiology, pathology, pathogenesis of pulmonary infarction, pathophysiology, accurate diagnosis, proper management (including both primary and secondary prophylaxis) of deep vein thrombi and pulmonary thromboemboli has advanced considerably during the past 15 years. These advances, which have now been adopted in the clinical practice, have already begun to indicate that not only more cases of acute and chronic pulmonary thromboembolism are being recognized than before, but also the morbidity and mortality of this disease process is declining. This is likely to improve further as our quest for safe, accurate, noninvasive and inexpensive diagnostic methods continues. Medical thromboembolectomy using thrombolytic therapy is fast replacing the surgical thromboembolectomy for patients with acute massive pulmonary thromboembolism. Better thrombolytic agents, such as tissue plasminogen activator, which selectively lyses the thromboemboli without producing significant systemic lytic state and now undergoing clinical investigation, is likely to revolutionize the management of both acute and chronic pulmonary thromboembolism because of its propensity to dissolve plasminogen‐bound thrombi of any age. The majority of the patients who suffer from acute pulmonary thromboembolism recover most of their lost lung function unless cardiopulmonary reserve was compromised prior to the onset of the acute episode. Conversely, patients with chronic pulmonary thromboembolism usually have relentless progression of their disease with progressive increase in mean pulmonary artery pressure, ultimately resulting in chronic cor pulmonale and death. However, recently pulmonary thromboembolectomy for those patients who have chronic pulmonary thromboembolism resulting from thromboemboli located in the main pulmonary artery or its main branches has been performed with success and acceptable mortality. This paper reviews the subject of pulmonary thromboembolism, both acute and chronic, from the days of Virchow to the present.
Prospective comparison of exercise digital subtraction and exercise first pass radionuclide ventriculography
Authors: Detrano R. , Yiannikas J. , Simpfendorfer C. , Underwood D. A. , Salcedo E. E. , Rollins M. 
Published: February 2009

AbstractIn order to test the comparative sensitivities of first‐pass radionuclide and digital subtraction ventriculography in detecting wall motion abnormalities during exercise, 29 patients referred for coronary angiography were submitted to both types of stress ventriculograms. Resting and exercise ventriculograms by both techniques were reviewed by independent observers and the five equal ventricular wall segments were graded as normal, mildly, moderately, severely hypokinetic, akinetic, or dyskinetic. Of the 29 patients, 24 had arteriographically defined ischemic potential (at least >50% obstruction of a major coronary artery supplying viable myocardium). Exercise digital subtraction ventriculography correctly identified 17 (71%) of these by a worsening of wall motion during exercise, while radionuclide ventriculography identified only eight (33%) by the wall motion response. When either a worsening of wall motion or the failure to increase ejection fraction by at least 5 points were used as criteria for an abnormal test, the sensitivities of digital and radionuclide ventriculographies were 96% and 79%, respectively. Though the number of patients without ischemic potential (5 patients) was too small to judge the relative specificities, digital subtraction ventriculography appears to be more sensitive than radionuclide ventriculography in identifying exercise‐induced wall motion abnormalities and in predicting coronary occlusions.
Echocardiographic evidence of intrathoracic masses due to localized blast crisis in a patient affected by chronic granulocytic leukemia
Authors: Mancuso L. , Bondi F. , Marchì S. , Marceno R. , Malleo C. 
Published: February 2009

AbstractWe report a case of intrathoracic blast crisis in a patient affected by chronic granulocytic leukemia. Two‐dimensional echocardiography performed to exclude pericardial effusion showed tumor masses in area of the atrioventricular groove and by the side of the left ventricular wall, which were confirmed by computed tomography.
Embolization complicating coronary angioplasty in the presence of an intracoronary thrombus
Authors: Weyne A. E. , Heyndrickx G. R. , Vandekerckhove Y. R. , Clement D. L. 
Published: February 2009

AbstractTwo cases of coronary occlusion and subsequent embolization during percutaneous coronary angioplasty (PTCA) are described. Prior to PTCA, angiographic evidence of intracoronary thrombus was present. Abrupt reclosure after dilation was treated by successful redilation. However, coronary embolization of thrombus debris occurred downstream in one patient and into an adjacent coronary branch in the second patient.
Effects of alcohol on systemic and pulmonary hemodynamics in normal humans
Authors: Koskinen P. , Kupari M. , Nieminen M. S. , Suokas A. , Tötterman K. , Pajari R. , Heikkilä J. 
Published: February 2009

AbstractEven at low doses, alcohol has been reported to impair left ventricular pump function. To characterize further the effects of alcohol on the normal cardiovascular system, using the Swan‐Ganz thermodilution catheter, we studied 6 healthy physicians, aged 27–36 years, while they were lightly intoxicated. Within a period of 30 min the subjects ingested 0.5 g/kg of ethanol diluted to 15% (w/v) in fruit juice. Hemodynamic measurements were obtained before the first ingestion and every half‐hour thereafter for 2 hours. A peak blood ethanol concentration (mean ± SE) of 13.3 ± 1.6 mmol/l (0.61 mg/dl) was recorded at 60 min. Unexpectedly, pulmonary artery pressure rose during the early part of the increasing blood ethanol phase, probably due to pulmonary vascular constriction. At 30 min, the systolic pulmonary artery pressure had increased by 10% (p<0.05) and the diastolic pressure by 14% (p<0.001); both returned to baseline levels by the end of the experiment. Calculated pulmonary vascular resistance rose from a baseline value of 0.50±0.30 to 0.85±0.34 units (p<0.01) at 30 min. Left ventricular preload decreased significantly during the declining blood ethanol phase: mean pulmonary capillary wedge pressure decreased from 12 ± 3 to 10 ± 2 mmHg (p<0.01), and mean right atrial pressure decreased significantly. This study suggests that alcohol causes changes in cardiac function by altering its loading conditions. The combined diuretic and systemic venodilatory actions of alcohol provide the most probable explanation for the decrease in preload.
Are anti‐platelet drugs of value in the management of patients with chronic stable angina? A study with ticlopidine
Authors: Khurmi N. S. , Bowles M. J. , Raftery E. B. 
Published: February 2009

AbstractThirty patients (28 males and 2 females) aged 46–68 years with established chronic stable angina were studied in a placebo‐controlled double‐blind crossover trial to examine the efficacy of oral ticlopidine (an antiplatelet agent) 250 mg twice daily. The baseline mean ± SEM exercise time of 7.5±0.5 min rose to 8.1 ±0.6 min after 2 weeks of placebo run‐in, 8.8±0.7 min after 4 weeks of double‐blind placebo, and to 9.2±0.6 min with ticlopidine therapy; none of these changes achieved statistical significance. Similarly, time to the development of 1 mm ST‐segment depression, maximal ST‐segment depression, heart rate, and rate‐pressure product failed to show any statistically significant changes during ticlopidine therapy. Ambulatory electrocardiographic monitoring showed that the mean number of episodes of ST‐segment depression > 1 mm remained unaltered during ticlopidine therapy. Four patients (3 during placebo, 1 during ticlopidine) stopped treatment prematurely because of unstable angina and two because of adverse effects. Our data suggest that ticlopidine has no significant effect on objective indices of myocardial ischemia in patients with chronic stable angina, that placebo has no effect on the objective in dices of myocardial ischemia derived from exercise testing and ambulatory electrocardiographic monitoring, and that exercise testing and ambulatory electrocardiographic monitoring in patients with chronic stable angina pectoris are reproducible.
Spontaneous closure of congenital ventricular septal defect in an adult
Authors: Hu D. C. K. , Giuliani E. R. , Downing T. P. , Danielson G. K. 
Published: February 2009

AbstractSpontaneous closure of congenital ventricular septal defect occurs commonly in infants and young adults. Occurrence in adults—patients older than 21 years— however, is rare. For this reason, we report on spontaneous closure of a congenital ventricular septal defect in a patient older than 26 years. This case was documented by catheterization before and after spontaneous closure. The proposed mechanisms of spontaneous closure are briefly reviewed.
Prognostic value of ventricular arrhythmias and transient st‐t changes after myocardial infarction: A two‐year follow‐up with ambulatory ECG recording
Authors: Mazzocca G. , Piacenti M. , Marchesi C. , Contini C. 
Published: February 2009

AbstractThe aim of this study is to evaluate the frequency and prognostic significance of ventricular arrhythmias (VA) and of ST‐T changes found during 24‐h ECG recording in patients who survived an acute myocardial infarction. Eighty‐nine patients (2 females and 87 males) discharged from hospital after acute myocardial infarction were studied. Mean age was 52.2 years (SD±10) with a range of 26–68. Serial observations were carried out at 1, 2, 3, 6, and 12 months after the acute event. Eight patients died during the first two years of follow‐up, of these, 2 deaths were of noncardiac origin: one was due to gastric carcinoma and the other to pulmonary neoplasm. Of the 6 cardiac deaths, 4 were sudden and unexpected and 2 were due to reinfarction. Statistical analysis of the results obtained in the first three months of follow‐up has not shown any significant correlation between pathologic patterns and cardiac death. In the second period we found a statistically significant relationship between cardiac death and multiform VPBs (p<0.05), CVA (p<0.05), and ST‐T changes (p<0.05). More significant was the correlation between cardiac death and the presence at the same time of ST‐T changes and multiform VPBs (p<0.01).
Reversed septal motion in right ventricular volume overload: False negative sign in the presence of increased septal thickness
Authors: Ballester M. , Pons G. , Carreras F. , Cladellas M. 
Published: February 2009

AbstractParadoxical septal motion of the interventricular septum and right ventricular enlargement constitute diagnostic features of right ventricular volume overload. A diastolic septal displacement toward the left ventricle and its systolic normalization explain this phenomenon. A thick septum would, theoretically, impede such movement. One patient with a cardiac allograft and gross tricuspid regurgitation is described who, in the context of a rejection episode and in a very short interval, showed two septal motion patterns related to two different septal thicknesses. It is concluded that in a patient with large right ventricular dimension and increased septal thickness, lack of paradoxical septal motion does not rule out severe right ventricular volume overload.
Myocardial infarction in young adults under 30 years: Risk factors and clinical course
Authors: Weinberger I. , Rotenberg Z. , Fuchs J. , Sagy A. , Friedmann J. , Agmon J. 
Published: February 2009

AbstractThe clinical features and course of 30 patients (26 men and 4 women) under 30 years of age (mean age 27.3 years) with an acute myocardial infarction (MI) are described. The most common risk factor among this group of patients was smoking in 20 patients (66%). The prevalence of the other risk factors was low: hyperlipidemia in four patients and family history of ischemic disease in another four patients, diabetes mellitus, hypertension, and obesity each in one patient. Seven patients (23%) had none of the conventional risk factors. Three patients were exerting themselves prior to the onset of their MI pain; all of them had normal coronaries. Five patients experienced chest pain prior to MI, among them only two experienced classical angina pectoris. Eighteen patients underwent uncomplicated MI. The complications in the other 12 during the acute MI were rhythm disturbances in eight and congestive heart failure in four. Cardiac catheterization was performed in 25 patients. The occurrence of zero, one, or multivessel disease was equal. The 30 patients were followed up from six months to 15 years (mean 7 years). In 18 patients circulating aggregated platelets were measured one year after the MI. Elevated values were found in all of them (mean ±SD34.9±9.1%). In 6 of the 18, all heavy smokers, extreme values were found in the range of 39–55%. Three out of the 30 patients died within five years after their first MI. The other 15 patients developed complications, most of them angina pectoris. Five patients were hospitalized for reinfarction. None of the 30 underwent aortocoronary bypass operation. According to our study the following conclusions could be drawn in MI patients under 30: (I) The main risk factor in this group of patients was smoking, the prevalence of the other conventional coronary risks factors being low. (2) Exertion and chest pain are not prerequisite conditions preceding MI in these patients. (3) The probability of finding zero, one, or multivessel disease on coronary angiography in this group of young MI patients is equal. (4) In MI patients under 30, increased circulating aggregated platelets may play a pathogenetic role in the development of MI.
Comparative effects of calcium‐channel blockers and beta‐adrenergic blocker on early diastolic time intervals and a‐wave ratio in patients with hypertrophic cardiomyopathy
Authors: Doiuchi J. , Hamada M. , Kokubu T. , Ito T. 
Published: February 2009

AbstractTo compare the effects of calcium‐channel blockers with those of beta‐adrenergic blockers in patients with hypertrophic cardiomyopathy (HCM), diastolic time intervals (IIA‐O time, from the second heart sound to the O point of apexcardiogram, IIA‐MVO time, from IIA to the mitral valve opening, and MVO‐O time, from the MVO to the O point of apexcardiogram), and A‐wave ratio measured from apexcardiogram were evaluated before and after more than three months of treatment. In both groups, heart rate significantly decreased after treatment. The IIA‐MVO time was not affected by either drug. The IIA‐O and the MVO‐O times were significantly shortened by calcium‐channel blockers (from 234.6±77.4 ms to 204.6±39.2 ms; p<0.01, and from 133.1±66.4 ms to 100.3±34.0 ms; p<0.01, respectively). However, they were not affected by beta‐adrenergic blocker. A‐wave ratio significantly decreased after calcium‐channel blockers (from 18.0±9.8% to 13.7±7.3%; p<0.01) and beta‐adrenergic blocker (from 21.7±12.6% to 17.2±8.0%; p<0.01). From these observations, it is suggested that calcium‐channel blockers improved the early diastolic filling rate, whereas beta‐adrenergic blocker did not affect it. It is concluded that the effects of calcium‐channel blockers and beta‐adrengergic blocker on early diastolic time intervals were different in patients with HCM.