bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracardiac fibroma in an asymptomatic infant
Authors: Tahernia A. C. , Bricker J. T. , Ott D. A. 
Published: February 2009

AbstractPrimary tumors of the heart are rare in infancy and childhood. A one‐year‐old, asymptomatic, male infant with unimpressive physical findings in whom an echocardiogram demonstrated a large, encapsulated, solid fibroma filling the right ventricle without obstruction of either the inflow or outflow tract is presented. Successful complete surgical excision of the tumor was accomplished. The histological examination was compatible with a benign fibroma. The infant has remained asymptomatic postoperatively with subsidence of the heart murmur. He has not shown any evidence of recurrence of the tumor during a follow‐up period of 29 months. This represents an unusual case of a huge right ventricular fibroma and only the fifth youngest patient, to our knowledge, to undergo successful surgical removal.
Management of the patient with a low HDL‐cholesterol
Authors: Leighton R. F. 
Published: February 2009

AbstractWhile there is epidemiologic evidence linking a low high‐density lipoprotein (HDL) cholesterol level with coronary disease events, and interventions that raise HDL while lowering low‐density lipoprotein (LDL) cholesterol levels have been shown to reduce subsequent coronary events, there are no studies showing benefit from raising HDL when a low HDL level is the sole lipid abnormality. HDL is thought to play a key role in reverse cholesterol transport, removing lipids from peripheral cells, but the precise role of HDL in cholesterol metabolism is not understood. The measurement of HDL levels has not been well standardized. Reliance on ratios relating HDL to LDL or to total cholesterol may be misleading in the management of patients. It has not been shown that measuring HDL subfractions or apolipoprotein levels is superior to measuring total HDL levels in predicting coronary risk. HDL levels may be raised by hygienic measures such as smoking cessation and exercise, but a considerable amount of exercise over a long period of time is required. Alcohol consumption and weight loss through dieting inconsistently raise HDL. Estrogen therapy raises and progestational agents lower HDL. Certain beta‐blocking drugs lower HDL levels. For the patient with an isolated low HDL level the hygienic measures may be advised, but drug therapy such as nicotinic acid or gemfibrozil should be prescribed only when low HDL is accompanied by elevated LDL levels that are unresponsive to diet and hygienic measures.
The value of transesophageal echocardiography in the investigation of acute prosthetic valve dysfunction
Authors: Scorr P. J. , Ettles D. F. , Wharton G. A. , Williams G. J. 
Published: February 2009

AbstractWhen patients present with suspected prosthetic valve dysfunction, investigation is usually instituted to delineate the site and cause thereof. Precordial cross‐sectional echocardiography is often helpful in this respect, but in the patient with acute pulmonary edema, imaging may be impaired because of discomfort and respiratory distress. The information obtained may also be suboptimal as a result of concomitant obesity, chest wall deformity, and pulmonary disease.1 In addition, further difficulties may relate to the acoustic shadowing produced by the metallic portion of the valve and its sewing ring, especially with valves in the mitral position.2 In such patients, cardiac catheterization may cause further decompensation and is associated with a recognized increase in morbidity and mortality.3 Angiography does not accurately site regurgitant jets in relation to the prosthetic valve concerned and will not detect the presence of vegetations. Transesophageal echocardiography circumvents many of these imaging difficulties and we evaluated its use in five patients with prosthetic heart valves who presented acutely ill, in severe pulmonary edema and suspected prosthetic heart valve failure. In each case, the diagnosis of valve dysfunction was established, and precise information regarding the site and cause of the failure was obtained. No complications or deterioration in patient condition resulted from the procedure and the findings were confirmed at surgery performed within 24 hours in all five patients. Transesophageal echocardiography should be included in the assessment of acute prosthetic heart valve failure.
Recreational swimming in CHD patients and healthy control subjects in relation to left heart function
Authors: Lehman Samek M. N. L. 
Published: February 2009

AbstractWe examined the influence on heart rate, blood pressure, lactate, glucose, and catecholamine levels of moderate recreational swimming at a mean time of 5.2 to 9 minutes with mean speed of 0.33 to 0.49 m/s in 25 CHD patients and 8 healthy control subjects. During swimming, changes in these exercise‐related parameters were observed such as were only found in seated ergometry trials at levels above 100 to 175 W. We consider these changes tolerable for patients with mild left heart damage (n= 13; ejection fraction 54±7%; exercise capacity 2.1±0.4 W/kg). They may indicate overexertion in patients with marked damage to the left heart (n=12; ejection fraction 44±5%; exercise capacity 1.3±0.4 W/kg). Six of the 12 patients with marked left heart damage stopped swimming before the planned time had elapsed for subjective (overexertion) or objective (arrhythmia) reasons.
Comparison of atrial contribution to cardiac hemodynamics in patients with normal and severely compromised cardiac function
Authors: Mukharji J , Rehr R. B. , Hastillo A. , Thompson J. A. , Hess M. L. , Paulsen W. J. , Vetrovec G. W. 
Published: February 2009

AbstractThe importance of atrial contribution to cardiac function in patients with congestive heart failure is controversial. Ten patients with severe congestive failure (Group A) and 10 patients with normal ventricular function (Group B) were studied during atrial and ventricular pacing. Left ventricular ejection fraction, baseline pulmonary capillary wedge pressure, and baseline cardiac index were different between Group A and Group B patients: 22±10 vs. 65±11 (p<0.01); 21±5 vs. 8±4, (p<0.01); and 2.8±0.5 vs. 3.5±1.0 (p=0.05). Compared with atrial pacing, cardiac index decreased from 2.8±0.6 to 2.2±0.5 (p<O.01) in Group A and from 3.6±0.7 to 2.9±0.5 (p<0.01) in Group B, during ventricular pacing. Pulmonary capillary wedge pressure increased by similar amounts in both groups during ventricular pacing. The change in cardiac index, % change in cardiac index, and change in pulmonary capillary wedge pressure from atrial to ventricular pacing, were not different between Group A and Group B patients. By logistic regression analysis, no association was found between the % change in cardiac index and the following variables: left ventricular ejection fraction, left ventricular end‐diastolic volume, baseline pulmonary capillary wedge pressure, change in pulmonary capillary wedge pressure, and baseline cardiac index. The atrial contribution to resting steady‐state cardiac function is similar between patients with severe congestive failure and those with preserved ventricular function.
Myocardial energetics in dilated cardiomyopathy
Authors: Thierfelder L. , Holubarsch CH. , Hasenfuss G. , Just H. J. 
Published: February 2009

AbstractTo assess hemodynamic and energetic effects of different drug interventions on idiopathic dilated cardiomyopathy (IDCM), we determined hemodynamic variables of myocardial oxygen consumption (MVO2) in 37 patients with IDCM. Hemodynamics were measured during routine left and right heart catheterization. MVO2 was analyzed from myocardial blood flow (measured by the argon method) and aortocoronary sinus blood oxygen difference. The hemodynamic variable which correlated best with MVO2 was shown to be the systolic stress time integral (STI). Four different representative compounds were tested with respect to their acute effects on myocardial energetics (MVO2/STI) in patients with IDCM who were in compensated heart failure (NYHA class II–III). The drug interventions were performed at rest. Intravenous injection of the vasodilator nitroprusside yielded a 35% reduction in STI and a 30% reduction in MVO2; in other words, the ratio MVO2/STI was not altered. Injection of the calcium sensitizer and phosphodiesterase inhibitor pimobendan also did not alter this ratio, as both STI (36%) and MVO2 (33%) were lowered. The profound reduction in STI (60%) seen with the phosphodiesterase inhibitor enoximone was accompanied by a much smaller decrease in MVO2 (19%); therefore, the ratio of MVO2/STI increased significantly. An increase of this ratio was also seen with the partial beta‐, receptor agonist xamoterol. However, in this case STI did not change, whereas MVO2 increased by 26%. In summary, vasodilation has energy‐saving effects, whereas positive inotropism is an energy‐consuming process. We conclude that the overall effect on myocardial energetics of a drug which possesses both positive inotropic and vasodilating properties depends on the balance of the two properties.
Anatomic basis for and morphologic results from catheter balloon valvuloplasty of stenotic mitral valves
Authors: Waller B. F. , Vantassel J. W. , Mckay C. 
Published: February 2009

AbstractThis report provides the anatomic basis for catheter balloon valvuloplasty procedures. The morphologic hallmark of mitral stenosis is commissural fusion and the major mechanism of successful balloon valvuloplasty is commissural splitting. Single and double dilating balloons are used to increase the cross‐sectional orifice area of stenotic mitral valves. Double balloons appear to improve the luminal diameter and cross‐sectional area compared with single balloons. This report also illustrates the anatomic basis for single and double balloon catheter placement and position using the transseptal approach.
Embolic mononeuropathy in subacute bacterial endocarditis
Authors: Andreas S. , Tebbe U. , Kreuzer H. , Holzgraefe M. 
Published: February 2009

AbstractA 49‐year‐old man presented with temperature up to 39.5°C, a sudden peroneal nerve lesion, and a cardiac murmur. The peroneal nerve lesion was likely caused by an embolic occlusion of an artery supplying the nerve. Until now, six cases of embolic mononeuropathy in endocarditis have been reported in the literature. Embolic mononeuropathy is a very rare manifestation of subacute bacterial endocarditis and quite often complicates, as do other more common embolic manifestations, the correct diagnosis.
“Pseudo reinfarction”: A consequence of electrocardiogram lead transposition following myocardial infarction
Authors: Chanarin N. , Caplin J. , Peacock A. 
Published: February 2009

AbstractUnexpected or bizarre new electrocardiographic changes should alert the physician to the possibility of lead transposition and, if in doubt, the electrocardiogram should be repeated. The classic form of limb lead transposition leading to the appearance of dextrocardia is well recognized. We report a patient with myocardial infarction where lead transposition led to a diagnosis of reinfarction and to the inappropriate use of thrombolytic therapy.
Tomographic views of normal and abnormal hearts: The anatomic basis for various cardiac imaging techniques. Part II
Authors: Waller B. F. , Taliercio C. P. , Slack J. D. , Orr C. M. , Howard J. , Smith M. L. 
Published: February 2009

AbstractRecent developments have enhanced the diagnosis of cardiovascular disorders in the area of cardiac imaging techniques. From an era of imaging by silhouettes (chest roentgenography, fluoroscopy, angiocardiography), we have emerged into an era of imaging by tomographic scanning (echocardiography, radionuclide tomography, computed tomography, magnetic resonance). A basic understanding of tomographic cardiac anatomy is the foundation for proper use and interpretation of these new imaging modalities. The present report provides a description of the techniques of tomographic cutting of necropsy cardiac specimens and illustrates some of the pathologic cardiac abnormalities cut in these tomographic planes. Part II of this report describes the long‐axis method, methods using the body rather than the heart as the reference axis, and includes transverse, frontal, and parasagittal methods of imaging the heart.
Management of acute myocardial infarction 1990: A perspective
Authors: Vogel John H. K. 
Published: February 2009

AbstractRising costs have reached a point at which physicians must assume a major role in dealing with the cost of medicine. Little information is available regarding actual practice at the community hospital level. In order to develop some insight on this issue, a survey of cardiovascular specialists was conducted regarding management of acute myocardial infarction in 1990. The results indicate a major lack of correlation between efficacy, cost, and practice patterns in terms of current knowledge. Perhaps legal concerns have contributed to these current practice patterns. Clearly, aside from choice of thrombolytic agent and/or PTCA, early treatment of acute myocardial infarction has emerged as a most important factor in reducing mortality.
Detection of coronary artery disease by vasodilator thallium imaging of the heart with amyl nitrite inhalation: A pilot study
Authors: Rifkin R. D. , Sharma S. C. , Spraragen S. , Claunch B. , Shackford H. , Patton R. 
Published: February 2009

AbstractThallium imaging of the heart using dipyridamole‐induced coronary arteriolar vasodilation has proven to be an effective means of detecting significant coronary stenosis. However, intravenous dipyridamole has not yet been made available for general use. We therefore examined the feasibility of substituting amyl nitrite inhalation as an arteriolar vasodilator prior to thallium imaging. Seventeen patients, all of whom had catheterization‐proven coronary stenosis, inhaled amyl nitrite for 2–5 min. Thallium was injected after 45–60 s of inhalation. Completion of inhalation was followed immediately by planar imaging. Of 6 patients who inhaled amyl nitrite for at least 4 min, 5 had moderate or severe image defects on immediate scans which completely resolved on delayed scans. Only 3 of 11 who inhaled amyl nitrite for 2 min or less prior to scanning had similarly positive tests. Overall sensitivity for significant stenosis was 8 of 17 (47%). Inhalation was well tolerated with only one episode of angina and hypotension. We conclude that amyl nitrite inhalation for at least 4 min may offer an effective and readily available alternative to intravenous dipyridamole for vasodilator imaging of the heart.
Efficacy and safety of clentiazem in patients with essential hypertension: Results of an early pilot test
Authors: Kawakita S. , Kinoshita M. , Ishikawa H. , Kagoshima T. , Katori R. , Ishikawa K. , Hirota Y. 
Published: February 2009

AbstractThe purpose of this study was to evaluate the antihypertensive effect of a new calcium antagonist, clentiazem, on inpatients or outpatients with essential hypertension. After blood pressure was stable and > 160/95 mmHg with placebo for at least a 2‐week observation period, oral clentiazem was administered once daily and dosage was increased stepwise from 10 to 40 mg over 10 weeks. Blood pressure significantly decreased by the second week of the study, and this hypotensive effect was maintained until the eighth week. Cumulative effective rate (percent of patients whose blood pressure decreased in 20/10 mmHg) in 62 outpatients were as follows; 10.3% at 10 mg, 39.6% at 20 mg, 70.2% at 30 mg, 76.6% at 40 mg. There was no significant postural change observed in the blood pressure from supine to standing position. Side effects such as dizziness, general malaise and gait disturbances were observed in 3 (3.9%) of 76 patients. No abnormal changes in clinical laboratory examinations or electrocardiograms were caused by clentiazem. Thus these data demonstrated that clentiazem produces certain antihypertensive effects with sufficient safety.
Effects of dibutyryl cyclic AMP on ventricular vulnerability during atrioventricular block in dog
Authors: Kumagai K. , Tashiro E. , Tashiro N. , Moroe K. , Hiroki T. , Arakawa K. 
Published: February 2009

AbstractThe effects of dibutyryl cyclic AMP (DBcAMP) on ventricular vulnerability during complete atrioventricular block (CA VB) were studied one week after transarterial electrical ablation of the AV junction in 18 closed‐chest dogs. All dogs exhibited CAVB and a stable ventricular escape rhythm with a mean cycle length of 1812 ± 638 ms. After the administration of DBcAMP at a rate of 0.1 mg/kg/min for 30 min, the ventricular cycle length was significantly shortened, and the QTc interval was slightly prolonged, although the QT interval did not change. The ventricular fibrillation threshold after the administration of DBcAMP was significantly increased (from 12.2 ± 3 84 to 18.4 ± 5.08 mA, p<0.01). Thus, it was demonstrated that DBcAMP exhibited suppressive effects on the ventricular vulnerability in the experimentally induced CAVB.
Unusual form of coronary artery fistula of left anterior descending and right coronary artery in an adult patient
Authors: Sionis D. G. , Margaris N. G. , Mandellou A. I. , Tavernarakis A. G. 
Published: February 2009

AbstractAn unusual morphologically tortuous, common fistulous communication of the left anterior descending and right coronary artery with the right ventricle was found in a 55‐year‐old male patient with severe aortic and mild mitral regurgitation. The angiographic features of this lesion are discussed because of the rarity of this doubly rare coronary artery fistula.
Letters to the Editor
Authors: Diethrich Edward B. , Abela George S. 
Published: February 2009

AbstractTemperature Monitoring during Peripheral Thermo‐Optical Laser Recanalization in Humans Barbeau GR, Abela GS, Seeger JM, Friedl SE, Tomaru T, Giacomino PP: Clin Cardiol 13, 690–697 (1990)
Quantitative assessment of transient left ventricular asynergy in coronary artery disease
Authors: Laucevi A. , Beruk E. , Kosinskas E. , JablonskienE D. , Iva L. 
Published: February 2009

AbstractThe purpose of this study was to determine the diagnostic value of quantitative two‐dimensional echocardiography during transesophageal atrial pacing in assessing the presence and severity of coronary artery disease. Apical four‐ and two‐chamber views were registered at rest and at different pacing rates. Computerized quantitative evaluation of left ventricle wall motion was performed. On the basis of left ventricle wall motion analysis data of 22 individuals with no coronary pathology, as assessed by angiography and with negative exercise ECG and transesophageal atrial pacing ECG test, nomograms for assessment of wall motion abnormalities and for calculation of asynergy area as a measure of wall motion abnormality extent were obtained. The method revealed new transient wall motion abnormalities during pacing or exacerbation of old ones present at rest in 83 of the 89 patients with angiographically proven coronary artery stenosis ⩾70% and in 3 of the 32 controls with no changes in their coronary angiograms. Thus, it showed high sensitivity (93%), specificity (91%), predictive value of positive result (96%), predictive value of negative result (83%), and efficiency of the test (93%). These values appeared to be higher than those calculated for transesophageal atrial pacing ECG, recorded simultaneously with echocardiographic images (81, 87, 95, 62, and 83%, respectively) and for exercise ECG test which was performed in 66 coronary patients and in 29 controls (68, 86, 92, 54, and 74%, respectively). The extent of pacing‐induced left ventricular regional wall motion abnormalities appeared to be directly correlated to the extent of coronary artery disease. Thus, transesophageal atrial pacing two‐dimensional echo stress testing seems to be a valuable method for the evaluation of coronary artery disease and for the assessment of its extent.
Left ventricular muscle mass and diastolic function in patients with essential hypertension under long‐term clonidine monotherapy
Authors: Hüting Jürgen , Mitrovic Veselin , Thormann Jochen , Bahavar Hassan , Schlepper Martin 
Published: February 2009

AbstractTo determine whether alterations of left ventricular (LV) structure are associated with improved LV function under chronic clonidine monotherapy (300–450 g/day) of essential hypertension, 11 male patients (age range 47–61 years) were followed for 5.4 ± 0.9 months using echocardiography and Doppler echocardiography. Blood pressure decreased from a mean of 168/105 to 150/96 mmHg (p<0.01), heart rate remained unchanged (73 ± 10 vs. 71 ± 10 beats/min). LV muscle mass decreased from 350 ± 73 to 297 ± 56 g (p<0.02), LV volume/muscle mass ratio increased from 0.58 ± 0.13 to 0.69 ± 0.12 ml/g (p<0.005). Ejection time increased from 276 ± 17 to 296 ± 17 ms (p<0.01), whereas no significant change was found for pre‐ejection period, ejection fraction, cardiac index and LV dimensions. Doppler analysis revealed improved isovolumic relaxation time (116 ± 17 vs. 84 ± 28 ms; p<0.05), but no change in isovolumic contraction duration, maximal inflow velocities, time‐velocity integrals and their duration, rate of acceleration and deceleration of early and atrial filling, and of their ratios. It is concluded that no reliable improvement in diastolic or systolic LV function is observed in chronic clonidine monotherapy of essential hypertension despite a normalization of blood pressure and a regression of LV hypertrophy.
Prediction of degree of residual stenosis in coronary thrombolysis
Authors: Fujoo Banyo , Matsuda Yasuo , Hamada Yoshio , Takashiba Kiyoshi , Ohno Hiroshi , Ebihara Hironori , Hyakuna Eiji , Iwamoto Susumu 
Published: February 2009

AbstractIn order to predict the residual stenosis in coronary thrombolysis, the factors easily obtained from clinical history—age, gender, history of angina before acute myocardial infarction (AMI), family history, hypertension, diabetes, hypercholesterolemia, smoking, and interval between onset of AMI and recanalization—were observed in 114 patients with successful coronary thrombolysis. In 55 patients with angina before AMI, 29 patients had residual stenosis ≥75% and 26 patients had residual stenosis <75%. In 59 patients without angina before AMI, 15 patients had residual stenosis ≥75%, and 44 patients had residual stenosis <75 %. The presence or absence of angina before AMI was the main variable that discriminated the groups of residual stenosis of more or less than 75 %, which was the only significant independent variable to predict the residual stenosis. These data suggest that the presence of angina pectoris before AMI is likely to be associated with a significant degree of residual stenosis after thrombolysis.