bluuebunny/crossref_metadata_2025_split huggingface dataset:
Difference in the response to isoproterenol between asymmetric septal hypertrophy and symmetric hypertrophy in patients with hypertrophic cardiomyopathy
Authors: Iida K. , Sugishita Y. , Matsuda M. , Yamaguchi T. , Ajisaka R. , Matsumoto R. , Fujita T. , Yukisada K. , Ito I. 
Published: February 2009

AbstractThe response to isoproterenol was studied in 9 patients with hypertrophic cardiomyopathy (HCM) and asymmetric septal hypertrophy (ASH), 9 patients with HCM and symmetric hypertrophy (SH), and 9 normal controls (NC), using digitized M‐mode echocardiography. There was no significant difference in fractional shortening (FS) between ASH and SH, nor between SH and NC before isoproterenol infusion. During isoproterenol infusion, however, FS was significantly greater in ASH (60±6%) than in SH (53±7%) and NC (49±5%) (p<0.05, p<0.01, respectively), and normalized peak rate of change of left ventricular dimension during systole (pVs) was greater in ASH (7.7 ± 1.5/s) than in SH (5.2±0.8/s) and in NC (4.9±0.8/s) (p<0.001, p<0.001, respectively). This study shows that the response to isoproterenol of ASH differs from those of SH and of NC and suggests hypersensitivity of the beta‐adrenergic receptor system in ASH and the possibility that ASH is a different clinical entity than SH.
Malignant schwannoma of the heart
Authors: Morishita T. , Yamazaki J. , Ohsawa H. , Uchi T. , Kawamura Y. , Okuzumi K. , Nakano H. , Wakakura M. , Okamoto K. , Koyama N. , Komatsu H. 
Published: February 2009

AbstractPrimary cardiac tumor is an extremely rare disease entity. Only three cases of primary malignant cardiac schwannoma, the subject of this report, have been recorded in Japan. Recently, we encountered a case of malignant schwannoma in which retention of pericardial effusion was the first clinical finding. This case was a 30‐year‐old female, who had dyspnea at work, general fatigue, and fever. Striking cardiac expansion was seen, with a cardiothoracic ratio (CTR) of 69% on chest x‐ray. Two‐dimensional echocardiograms showed a large volume of pericardial effusion between the side wall of the left ventricle and the epicardium, and the presence of a parenchymatous tumor. An increase in tumor size was detected on chest computer tomography (CT) scan. Using a pump oxygenator, median sternotomy was performed to reach the epicardium. A pale yellow, soft tumor was seen in the left atrium near the left ventricle. Histologically, the patient was diagnosed as having a malignant schwannoma. We have reported a case of primary malignant schwannoma which was surmised to have arisen from the boundary between the atrium and the ventricle.
Endocardial late potentials recorded during sinus rhythm in man: Incidence in different cardiac disease states
Authors: Bethge K.‐P. , Gonska B.‐D. , Kreuzer H. , Kühn R. , Sauthoff G. , Beie C. , Saathoff H. 
Published: February 2009

AbstractIn a prospective study, 100 patients with various cardiac diseases not selected on the basis of previous ventricular arrhythmias underwent left ventricular endocardial mapping. With 10 different positions of the quadripolar catheter per patient, 90 of the 100 patients showed late potentials. These findings were documented in 50 of 52 patients with coronary heart disease compared to 26 of 34 patients with dilative cardiomyopathy (p<0.025). Late potentials in diastole were the most frequent type of abnormal electrogram, found in 82 patients. Fractionated electrograms were documented in 43 patients. They were seen in 27 (52%) coronary patients more often than in 8 (24%) patients with dilative cardiomyopathy (p<0.025). Onset of fractionated electrograms in coronary patients was somewhat later (301 ± 177 ms after the QRS) than in the cardiomyopathy group (263 ± 141 ms). The duration was longer (189 ±114 ms) in the former group than in the latter (148±87 ms). Thus, endocardial late potentials are not uncommon in patients with various cardiac diseases. The more frequent occurrence in coronary heart disease and the higher frequency of fractionated electrograms may indicate a more inhomogeneous, patchy type of fibrosis in the ischemically diseased myocardium.
Postinfarction left ventricular pseudoaneurysm: Echocardiographic diagnosis and prolonged survival in three patients
Authors: Otto C. M. , Stratton J. R. 
Published: February 2009

AbstractBoth echocardiography and radionuclide angiography have been proposed as noninvasive modalities for the diagnosis of left ventricular pseudoaneurysm. In the only three cases seen at our institution over the past five years, this diagnosis was missed with radionuclide blood pool imaging, while two‐dimensional echocardiography demonstrated the typical features of a pseudoaneurysm. Our patients were asymptomatic and diagnosis was made incidentally 4 to 6 years after myocardial infarction. Although the patients survived an extended period without surgery, the reported incidence of rupture is high, and prophylactic surgical repair probably is indicated. It is likely that the increased use of noninvasive cardiac imaging techniques will lead to the detection of other cases of unsuspected left ventricular pseudoaneurysm. Two‐dimensional echocardiography appears superior to planar radionuclide ventriculography in establishing the diagnosis.
Heart with circulatory failure secretes and processes atrial natriuretic peptide in a manner different from normal heart
Authors: Matsubara H. , Umeda Y. , Nishikawa M. , Yamane Y. , Kurimoto T. , Iwasaka T. , Inada M. 
Published: February 2009

AbstractThe role of catecholamine in atrial natriuretic peptide (ANP) secretion and its secretory mechanism in normal humans is not well defined; therefore, we studied the relationship among ANP, catecholamine, and atrial pressures in 25 patients without cardiovascular disease and in 35 patients with chronic congestive heart failure (CHF, 20 in mitral valve disease and 15 in dilated cardiomyopathy). In patients without cardiovascular disease, right atrial pressure at rest showed a positive correlation (r = 0.80, p>0.001) with ANP concentration, whereas left atrial pressure did not. The relation narrowed (r = 0.82) when the bicycle ergometer exercise in the supine position was conducted. Neither adrenalin nor noradrenalin significantly correlated with ANP concentration. In patients with mitral valve disease and dilated cardiomyopathy, the significant relations (r = 0.56 p>0.001, r = 0.85 p>0.001, respectively) between left atrial pressures and ANP concentrations at rest were observed, and following exercise, induced more significant relations. Right atrial pressures did not correlate positively with ANP concentrations. The increments of ANP concentrations induced by exercise load were markedly reduced compared with those of patients without cardiovascular disease. Although concentrations of both noradrenalin and adrenalin in patients with mitral valve disease and dilated cardiomyopathy at rest were much higher than those without cardiovascular disease, only noradrenalin had a highly positive correlation with ANP concentrations (r = 0.88 p> 0.001, r = 0.78 p>0.001, respectively). Furthermore, the circulating ANP molecular weight forms in all patients studied were analyzed by gel chromatography coupled with radioimmunoassay. In contrast to the predominant form of α‐ANP in patients without cardiovascular disease, larger molecular forms occurred in most patients with CHF. We conclude that ANP secretion from the heart of patients with CHF is regulated not only by atrial pressure but noradrenalin, and that its processing mechanism is different from that of the normal heart.
Prognostic value of supine scintigraphic heart function and simultaneous conventional exercise response in patients after myocardial infarction
Authors: Fridrich L. , Gassner A. , Sommer G. , Klicpera M. 
Published: February 2009

AbstractA total of 240 survivors of one or more myocardial infarctions were consecutively admitted to perform supine exercise radionuclide ventriculography. Within 3 years after the test, 22 died; this group was compared to an age‐matched control group of 22 survivors for left and right ventricular function during rest, exercise, and simultaneously assessed exercise performance as well as ECG variables. Evaluation of 3‐year survival by linear discriminant analysis revealed an accuracy of 82% for discriminant models using ECG and exercise performance variables. Implementation of resting left ventricular ejection fraction and change of right ventricular ejection fraction during exercise, as well as scintigraphic presence or absence of dyskinesia, improved the accuracy of the model to 91% of correctly classified patients.
Preventive effects of batroxobin on experimental canine coronary thrombosis
Authors: Tomaru T. , Uchida Y. , Sonoki H. , Sugimoto T. 
Published: February 2009

AbstractThe thrombolytic effects of urokinase (UK) and preventive effects of batroxobin, heparin, and aspirin on the recurrence of thrombosis in the coronary artery were studied in 118 anesthetized dogs with severe endothelial denudation and luminal stenosis of the coronary artery. Occlusive thrombi developed in 68 (58%) preparations (dogs), accompanied by a decrease of coronary blood flow and pressure, an electrocardiographic ST elevation, and epicardial cyanosis. An intravenous infusion of 20,000 IU/kg of UK reopened the occluded coronary artery in all 32 preparations with 1‐h‐old thrombi, in 6 (86%) of 7 preparations with 2‐h‐old thrombi, and in 5 (83%) of 6 preparations with 3‐h‐old thrombi. However, recanalization was not observed in preparations with thrombi more than 4‐h‐old. Occlusion recurred within 6 h after recanalization in 2 (18%) of 18 preparations pretreated with batroxobin (1‐2 BU/kg) (p> .005 vs. control UK group), in 1 (14%) of 7 preparations administered a continuous infusion of 30 U/kg per h of heparin (p > .05 vs. control UK group), in 4 (57%) of 7 preparations pretreated with 2 mg/kg of aspirin, and in 7 (64%) of 11 preparations not pretreated (control UK group). Complete prevention was observed only in the group administered 2 BU/kg of batroxobin. Histologically, these thrombi closely simulated clinical arterial thrombi. Myocardial hemorrhage and contraction band necrosis were observed in the reperfused hearts. In conclusion, experimental canine coronary thrombi more than 4‐h‐old were resistant to thrombolytic therapy, and batroxobin and heparin were effective in the prevention of coronary reocclusion.
Thallium‐201 scintigraphy perfusion defect with dipyridamole in a patient with a myocardial bridge
Authors: Bennett J. M. , Blomerus P. 
Published: February 2009

AbstractA patient with myocardial bridging and a thallium‐201 scintigraphy perfusion defect after the administration of intravenous dipyridamole is presented. The same patient had a normal perfusion study on exercise stress testing. The effects of coronary vasodilators and dipyridamole on coronary artery flow patterns in patients with myocardial bridging are discussed. We suggest that coronary vasodilators may induce perfusion defects in patients with myocardial bridging and should be avoided in such patients.
Clinical assessment of beta blockade
Authors: Weston M. W. , Glasser S. P. , Stoner D. J. , Lyman G. H. 
Published: February 2009

AbstractThis study was undertaken to assess a clinical measurement (leg squats) in order to determine the adequacy of beta‐adrenergic blockade (AdBB) utilizing the symptom‐limited exercise test heart rate of less than 120 beats/min as the standard. Seventy subjects were tested, 35 receiving beta‐adrenergic‐blocking drugs in clinically determined maximal doses, and 35 subjects not receiving these agents. Sensitivity (Se), specificity (Sp), and positive (Pv +) and negative (Pv ‐) predictive values were calculated for post‐leg squat heart rates of ≤ 100, ≤ 110 and < 120 beats/min. Other variables analyzed for AdBB were resting heart rates and post‐leg squat heart rate increase > 50% over baseline. A cost‐benefit analysis was also performed. It was concluded that: (1) Neither the resting heart rate or percent increase in heart rate compared to baseline reliably predicted AdBB. (2) In patients receiving beta‐blocking drugs, a post‐squat heart rate of ≤ 100 beats/min had a Se = .82, Sp = .67, Pv + .70, and Pv ‐ .80, values not high enough to be reliably used in many clinical situations. (3) If the post‐squat heart rate was > 110 beats/min, however, AdBB is probably absent, since no subjects on beta blockers with maximum exercise test heart rate ≤ 120 beats/min had a post‐leg squat heart rate > 110 beats/min. (4) For a reasonable range of cost and test performance estimates, utilization of the leg squat test as described here is favored on the basis of cost‐benefit analysis.
Myocarditis with multinucleated giant cells detected in biopsy specimens
Authors: Fukuhara T. , Morino M. , Sakoda S. , Bito K. , Kinoshita M. , Kawakita S. 
Published: February 2009

AbstractA 42‐year‐old woman was transferred to our hospital for evaluation of bradycardia with a complete atrioventricular block. Her pulse was 41 regular beats/min with blood pressure 166/92 mmHg. There were no skin lesions, edema, or lymphadenopathy. The white blood cell count was 6300/mm3. The serum glutamic oxaloacetic transaminase was 21 IU and creatine phosphokinase was 34 IU. C‐reactive protein was negative. The level of serum angiotensin converting enzyme was slightly increased at 25.8 IU/1/37.0°C (normal range: 7–24.0). Chest radiography showed congestive heart failure with a cardiothoracic ratio of 54%. There was no bilateral lymphadenopathy or fibrous changes during her clinical course. The coronary arteries were completely normal angiographically. Left ventriculograms revealed slight hypokinesis and dilatation (end‐diastolic volume index of 112 ml/m2, ejection fraction of 53%). Left ventricular end‐diastolic pressure was slightly abnormal at 16 mmHg. Two right and two left ventricular endomyocardial biopsies were performed. Right ventricular biopsy demonstrated edematous tissue and a slight mononuclear cell infiltration with little fibrosis. Left ventricular specimens showed an extensive area of fibrosis, with large, multinucleated giant cells with an asteroid body and chronic inflammation without epitheloid cells. The less affected areas of another specimen showed mild interstitial fibrosis and degenerative myocytes with vacuolation, and some multinucleated myocytes without an asteroid body were present. This case was diagnosed as cardiac sarcoidosis rather than idiopathic giant cell myocarditis. The patient has been implanted with a permanent pacemaker. This case is of clinical interest from three aspects: (1) the specific lesion in the myocardium was confirmed by examination of several biopsy specimens; (2) the multinucleated giant cells are of two sizes: the larger cells, having an asteroid body in the cytoplasm, appear to be derived from histiocytes, and the smaller cells are considered to be derived from myocyte; (3) the patient is doing well with a permanent pacemaker and requires no immunosuppressive therapy at one and half years later.
“A‐wave” liver
Authors: George D. S. , Marsh C. , Leier C. V. 
Published: February 2009

AbstractThe finding and timing of hepatic pulsations can provide important information regarding the status of right heart structures and function. We report a 54‐year‐old woman with idiopathic dilated cardiomyopathy, who had prominent hepatic presystolic pulsations (“A‐wave” liver). The clinical findings and the venous and hepatic pulse recordings are presented and discussed in terms of clinical pathophysiology and significance.
One‐year death rate in 270 patients with suspected acute myocardial infarction, initially treated with intravenous magnesium or placebo
Authors: Rasmussen H. S. , Grønbaek M. , Cintin C. , Balsløv S. , Nørregård P. , Mcnair P. 
Published: February 2009

AbstractIn a double‐blind, placebo‐controlled study, 273 patients with suspected acute myocardial infarction (AMI) were randomized to receive either 48‐h magnesium (Mg) or placebo therapy intravenously, initiated immediately on admission to hospital. We describe the results from a 1‐year survey in 270 of the patients, who were available for follow‐up. Patients were equally divided: 135 received Mg and 135 received placebo. Mg treatment was associated with a marked reduction in 1‐year death rate from 32% in the placebo group to 20% in the Mg group (p = 0.018). If only death from ischemic heart disease is considered, the figures were 28% in the placebo group as opposed to 15% in the Mg group (p = 0.006). This reduction was mainly due to a reduction in mortality during the initial 30 days after inclusion in the study (17% vs. 7%), after which the difference in mortality between the two groups did not reach statistical significance (18% vs. 15%, p = 0.56). The beneficial effect of Mg on mortality was partly linked to a reduced incidence of arrhythmias (27% vs. 16%), and partly to a reduced incidence of infarction (63% vs. 48%) during the initial hospitalization. However, factors unknown to us were also involved, as revealed by a remaining statistically significant partial regression coefficient, when sex, age, cardiovascular history, development of AMI, and development of arrhythmias were considered. It is concluded that intravenous Mg treatment is beneficial to patients with acute ischemic heart disease and should be adopted as part of the routine treatment of these patients.
Reliability of qt intervals as indicators of clinical hypercalcemia
Authors: Ahmed R. , Hashiba K. 
Published: February 2009

AbstractReliability of corrected QT intervals (QoTc, QaTc, and QeTc) as indicators of clinical hypercalcemia was assessed in 14 hypercalcemic patients. Hypercalcemia was severe to extreme (serum calcium 14.9 to 22.8 mg/dl) in 11, moderate (13.4 mg/dl) in 1, and mild (12.2 and 11.8 mg/dl) in 2 patients. QT intervals during hypercalcemia were compared with those during normocalcemia either before or after development of hypercalcemia. QeTc interval showed neither significant correlation with serum calcium nor any consistent pattern of change with development of hypercalcemia or normalization of serum calcium. In contrast, QoTc and QaTc intervals shortened with development of hypercalcemia and returned toward normal with normalization of serum calcium in all the patients, and showed significant correlation with serum calcium (QoTc: r = ‐0.77, p < 0.001, n = 35; QaTc: r = 0.82, p < 0.001, n = 35). QaTc was short (> 0.30 s) in all the ECGs in severe and moderate hypercalcemia and in 2 of the 5 ECGs in mild hypercalcemia. Combination of short QoTc ( < 0.18 s) and short QaTc was found to be highly specific for, and was present in 65% of ECGs, in moderate and severe hypercalcemia. Combination of normal QoTc (> 0.18 s) and normal QaTc (> 0.30 s) was not observed in moderate or severe hypercalcemia. We conclude that QoTc and QaTc intervals are reliable indicators of clinical hypercalcemia.
Coronary artery spasm and its relationship to exercise in patients without severe coronary obstructive disease
Authors: Hill J. A. , Conti C. R. , Feldman R. L. , Pepine C. J. 
Published: February 2009

AbstractCoronary artery spasm is reported to occur with exercise. In patients without severe coronary atherosclerosis, the evidence for exercise‐induced coronary artery spasm is limited. Three patients with positive exercise tests but no severe coronary atherosclerosis are presented. Coronary artery spasm was provoked and verified by angiography in all three, but coronary angiography during exercise failed to demonstrate spasm. The literature is reviewed and the value of a routine protocol for evaluation is discussed.
Severe constrictive pericarditis as an unsuspected cause of death in a patient with idiopathic hypereosinophilic syndrome and restrictive cardiomyopathy
Authors: Lui C. Y. , Makoui C. 
Published: February 2009

AbstractA 43‐year‐old man with idiopathic hypereosinophilic syndrome survived a relatively long term (6 1/2 years) before he succumbed to intractable heart failure. Six months before death, his chronic heart failure from restrictive cardiomyopathy was well compensated. Autopsy demonstrated severe constrictive pericarditis which was not suspected antemortem. Constrictive pericarditis as a late complication of idiopathic hypereosinophilic syndrome is discussed.
Nifedipine overdose
Authors: Whitebloom D. , Fitzharris J. 
Published: February 2009

AbstractOverdose with 300 mg of nifedipine in a 54‐year‐old woman led to profound hypotension and reflex tachycardia. The patient was treated with intravenous fluids, calcium gluconate, and dopamine. Cardiac rhythm disturbances, hypoglycemia, and myocardial depression were not found. Recovery was rapid and uneventful. The clinical aspects of nifedipine overdose are discussed and possible treatment modalities are given.
Effects of acute smoking on the hemostatic system in humans
Authors: Vicari A. M. , Margonato A. , Macagni A. , Luoni R. , Vicedomini G. , Pozza G. , Seveso M. P. 
Published: February 2009

AbstractHabitual smoking is one of the best established risk factors for cardiovascular disease. The pathogenesis of smoke‐induced damage is not so well clarified, but it probably includes—among some other aspects—an activation of the hemostatic system. Recently it has been shown that smoking a single cigarette can significantly decrease the coronary blood flow in coronary patients as well as in normal subjects. We tested the hypothesis that the acute effects of smoke are mediated by the hemostatic system. Seven healthy male volunteers, aged 20–40 years (mean 32±6 years), entered the study. All were habitual smokers, but had abstained from smoking in the 12 hours preceding the test. After lying in absolute rest for about 30 minutes, each subject smoked a cigarette containing 1.2 mg of nicotine. Immediately before and after smoking, blood was drawn by clear venipuncture for the evaluation of the following hemostatic variables: collagen‐induced platelet aggregation by the method of Born; thromboxane B2 (TxB2) production by platelets stimulated with collagen, radioimmunoassay (RIA); plasma beta thromboglobulin (TG) (RIA); plasma fibrinopeptide A (FPA) (RIA); plasma fibrinolytic activity in the euglobulin fraction (NEF) (fibrin plate method). The following results, respectively before and after smoking, were observed: collagen‐induced platelet aggregation 55±3 vs. 57±6%; TxB2 100.5±5.9 vs. 90.3±9.0 ng/108 platelets; plasma beta‐TG 20.8±2.2 vs. 19.2±2.3 ng/ml; plasma FPA 2.3±0.3 vs. 2.2±0.1 ng/ml; NEF, lysis diameter 16.8±1.6 vs. 16.7±1.7 mm; NEF + C1 inhibitor lysis diameter 8.8±0.7 vs. 9.1±0.7 mm. None of these variables was significantly changed after smoking. We conclude that acute smoking does not induce a prothrombotic state.