bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echocardiographic findings of left ventricular hypertrophy and normalization of parameters of left ventricular function in patients with previous evidence of dilated and poorly contracting left ventricle and coexisting systemic hypertension
Authors: Dall'Aglio V. , Nicolosi G. L. , Burelli C. , Zardo F. , Pavan D. , Lestuzzi C. , Zanuttini D. 
Published: February 2009

AbstractWe report 6 cases of dilated left ventricle with poor left ventricular function and coexisting systemic hypertension in whom left ventricular hypertrophy and normalization of left ventricular function and dimensions have been subsequently documented by M‐mode and two‐dimensional echocardiographic follow‐up studies. Four patients were in New York Heart Association functional Class IV, one in Class III, and one in Class II when first seen. Normalization of left ventricular function and dimensions and features of left ventricular hypertrophy (fractional shortening from 15.0±5.2 to 39.7±5.4, left ventricular end‐diastolic diameter from 6.6±0.6 to 4.6±0.6 cm, left ventricular end‐systolic diameter from 5.6±0.8 to 2.8±0.6 cm, left ventricular end‐diastolic radius/posterior wall thickness from 3.1±0.5 to 2.0±0.4, interventricular septum thickness from 1.2±0.3 to 1.5±0.3 cm, left atrium from 4.6±0.6 to 3.5±0.9 cm) were achieved after adequate medical treatment at the end of the follow‐up (11–39 months). It appears from this study that normalization of left ventricular dimensions and function with features of left ventricular hypertrophy can occur after adequate treatment in patients with echocardiographic findings of dilated and poorly contracting left ventricle and coexisting systemic hypertension. It is conceivable, in such cases, to classify the dilatation of the left ventricle as secondary and to suggest the hypothesis of a cause‐effect relationship between therapy and normalization of left ventricular parameters with findings of left ventricular hypertrophy. Further studies are needed to clarify this phenomenon.
Balloon valvuloplasty 1988: A review
Authors: Hill J. A. , Conti C. R. 
Published: February 2009

AbstractCatheter balloon valvuloplasty is a procedure which has been applied in stenotic lesions of all four cardiac valves in the last several years. This review discusses available data regarding the mechanism of effect, risks, and clinical utility of balloon valvuloplasty as it is applied to stenotic lesions of the pulmonic, mitral and aortic valves.
Echocardiography abnormalities in chronic asymptomatic alcoholics
Authors: Cregler L. L. , Worner T. M. , Mark H. 
Published: February 2009

AbstractAlcohol abuse is a frequent contributor to elevated blood pressure, but the literature is ambiguous about the role of hypertension in producing left ventricular dysfunction. Fifty asymptomatic male alcoholics admitted for detoxification were studied using echocardiograms and systolic time intervals. Alcoholics were separated into Group I (28 with hypertension) and Group II (22 without hypertension). Forty‐four patients had analyzable echocardiograms and were compared to 29 nonalcoholics. Group III consisted of 14 nonalcoholics with hypertension. Group IV consisted of 15 normotensive nonalcoholics (controls). The ejection fraction and shortening fraction were reduced in Group I (p < 0.05). Hypertensive alcoholics had increased left ventricular mass indices but less than hypertensive nonalcoholics. Left ventricular wall stress was compared to mass as an index of ventricular compensation. The wall stress to mass index for hypertensive alcoholics was 1.65 as compared to 1.43 for the controls. Alcoholics without hypertension had a wall stress to mass ratio of 1.54. Hypertensive patients had a reduced wall stress to mass ratio of 1.38 when compared to controls. These data suggest an inappropriate compensatory response to afterload. Alcohol and hypertension combined may be more harmful to left ventricular function than either disease alone.<
Serum reverse T3 and amiodarone efficacy
Authors: Haberman R. J. , Ladenson P. W. , Griffith L. S. Cameron , Veltri E. P. 
Published: February 2009

AbstractThe use of serum reverse T3 (rT3) levels in the assessment of amiodarone efficacy is controverstal. We prospectivly studied 10 patients with frequent ventricular ectopy and symptomatic ventricular tachycardia (VT) treated with amiodarone. Serial 24‐h Holter monitor, thyroid function studies incliding serum rT3, and 12‐lead electrocardiogram were performed on each patient at baseline, and at 1, 4, 12, and 24 weeks of oal amiodarone therapy. Serial Holter moniotors on therapy were analysed for 100% suppression of VT, 90% suppression of couplets, and 85% suppression of ventricular ectopic beats (VEBs) compared with baseline Holter, defining patient groups VT−, Co−, and VEB−, respectively. Lack of arrhythmia suppression to this degree defined groups as VT+, Co+, and VEB+. These were no statistically significnat differneces in rT3 levels between VT+ and VT− groups, Co+ and Co− groups, or the VEB+ and VEB− groups. VT suppression could not be predicted at any rT3 level. We conclude than serum rT3 is an insensive means of assessing amiodarone efficacy.
Myocardial rupture in expanded infarcts: Repair using pericardial patch
Authors: Carey J. S. , Cukingnan R. A. , Eugene J. 
Published: February 2009

AbstractMyocardial rupture is found in approximately 20% of fatal infarctions, but the diagnosis is rarely made before death. Rupture occurs in “expanding” transmural infarctions. The diagnosis should be considered in any patient who develops recurrent chest pain and cardiovascular instability within the first week after infarction. Echocardiographic evidence of a dilated infarct with pericardial effusion is confirmatory. Three cases are described, and previous reports are reviewed. Because most patients have multivessel disease, we recommend pericardiocentesis and rapid cardiac catheterization. Infarctectomy may be appropriate when the edges of the lesion are obvious, but the more typical diffuse, serpiginous defects should be closed with dacron‐bolstered sutures covered with a wide autologous pericardial patch. Myocardial rupture is a treatable condition, and a high index of suspicion is necessary in order to recognize it more frequently.
A rare case of recurrent vasodepressive attacks of 2‐hours duration: Analysis of the mechanism by muscle sympathetic nerve activity recording
Authors: Yatomi A. , Iguchi A. , Uemura K. , Sakamoto N. , Iwase S. , Mano T. 
Published: February 2009

AbstractMuscle sympathetic nerve activity was recorded in a 57‐year‐old male patient suffering from severe hypotensive attacks with bradycardia for 10 years. Continuous blood pressure recording demonstrated frequent drastic falls in pressure. Disappearance and reappearance of muscle sympathetic nerve activity coincided with the onset and termination of attacks. Awakening from sleep or emotional and/or cardiovascular stress seems to trigger hypotension. Cardiac pacemaker was not useful in limiting the attack, because right ventricular pacing caused abrupt falls in both blood pressure and heart rate.
Percutaneous transluminal coronary angioplasty in patients with reduced left ventricular ejection fraction: Effects on myocardial perfusion and left ventricular response to exercise
Authors: Singh A. , Chandler S. , Pears D. , Perry R. , Murray R. G. , Shiu M. F. 
Published: February 2009

AbstractMany patients with coronary artery disease treated by percutaneous transluminal coronary angioplasty (PTCA) have a history of previous myocardial injury resulting in a reduced left ventricular ejection fraction (EF). The effects of successful PTCA on myocardial perfusion and left ventricular function in these patients were compared to treatment in patients with normal left ventricular EF. There were 21 patients with a normal EF (mean EF 59 2%) (Group I) and 15 patients with reduced EF (mean EF 43 1%) (Group II). Before PTCA a similar degree of reversible myocardial ischemia was present on thallium scintigraphy. At peak exercise left ventricular EF in the Group I patients decreased by 4 1 % compared to 8 1 % in Group II. At one month following succesful PTCA there was resolution of reversible myocardial ischemia in both groups. No changes in EF at rest were observed. At the same level of exercise as before PTCA the mean EF was 5 1% higher than the pretreatment value in Group I and 10 1% higher in Group II. Thus in this study reversible myocardial ischemia was associated with severe compromise in the left ventricular response to exercise which was substantially improved by PTCA.
Signal‐averaged electrocardiography and the significance of late potentials in patients with ‘idiopathic’ ventricular tachycardia: A review
Authors: Mehta D. , Camm A. J. 
Published: February 2009

AbstractHigh‐frequency, low‐amplitude electrical activity during and in continuation with the ventricular electrogram in sinus rhythm is now accepted as an indirect marker for reentrant pathways in ventricular muscle. Because the amplitude of these signals is low, much effort has recently been directed toward finding methods of recording these noninvasively. This essentially involves averaging the electrocardiogram, amplifying it, and filtering out the low frequency and nonrepetitive signals. This review discusses the methods presently available for signal‐averaged electrocardiography and their background. The clinical application of signal‐averaged electrocardiograms in patients with or suspected to have ventricular tachycardia is summarized. Data regarding the incidence of abnormal signal‐averaged electrocardiography in patients with ‘idiopathic’ ventricular tachycardia compared with normal subjects and patients with ventricular tachycardia related to ischemic heart disease are presented.
Tocainide and metoprolol: An efficacious therapeutic combination in the treatment of premature ventricular beats
Authors: Capucci A. , Frabetti L. , Gubelli S. , Boriani G. , Magnani B. , Marchesini B. , Boschi S. , Ambrosioni E. 
Published: February 2009

AbstractA double‐blind crossover study was performed in 20 patients to verify the efficacy of tocainide plus metoprolol in patients with premature ventricular contractions (PVCs) class Lown ≥2 (mean frequency ≥30/h) judged as being ‘stable’ by at least three basal 24‐h Holter ECGs with PVC variation of less than ≥ 25 %. All 20 patients were submitted to a placebo period; and all were subsequently randomized to therapy with tocainide 1800 mg/day or metoprolol 200 mg/day for 15 days and then to tocainide 1800 mg + metoprolol 200 mg/day or tocainide 1200 mg + metoprolol 200 mg/day for 15 days, followed by a crossover of the two combination treatments. At steady state in every stage we controlled for plasma levels of the drugs, a 24‐h Holter recording, and a 12‐lead ECG. A modified Lown score was evaluated together with the Lown class. Tocainide (mean plasma level 3.3±0.7 μg/ml) was efficacious in 3 of 8 patients, the modified Lown score decreased from 63±32 (placebo period) to 42±27 (p<0.01) and Lown 4B arrhythmias were abolished in 3 of 4 patients. Metoprolol (mean plasma level 97.4±89.6 ng/ml) was efficacious in 2 of 10 patients; the modified Lown score and Lown classes did not change significantly. Administration of tocainide 1200 mg + metoprolol 200 mg obtained a positive response in 9 of 12 patients, the modified Lown score decreased significantly compared with placebo (from 53±31 to 32±30, p+0.01) and Lown 4B arrhythmias were abolished in 2 of 5 cases. Tocainide 1800 mg plus metoprolol 200 mg was scarcely tolerated owing to neurologic and gastroenteric side effects, and only three patients completed this stage with no better antiarrhythmic results compared to the lower dose. in conclusion, the combination of tocainide at 1200 mg and metoprolol 200 mg is well tolerated, efficacious in a high percentage of patients, and superior to single drug therapy in patients with stable PVCs.
Cardiac manifestations of noncardiac tumors. Part II: Direct effects
Authors: Weinberg B. A. , Conces D. J. , Waller B. F. 
Published: February 2009

AbstractCardiac manifestations of secondary tumors of the heart exert their effects directly by endocardial, myocardial, epicardial or cavitary deposits (metastatic lesions); indirectly via tumor products such as carcinoma; or mediated by therapy (chemotherapy, radiation) to treat the primary neoplasm. Part II of this review summarizes certain direct effects of noncardiac tumors on the heart including superior and inferior vena cava syndromes, pulmonary artery and vein obstruction or compression, myocardial implants, and intracavitary metastases. Many of these direct effects may be noninvasively diagnosed by computed tomography, magnetic resonance imaging and/or two‐dimensional echocardiography.
The effects of adenosine on sinus node reentrant tachycardia
Authors: Griffith M. J. , Garratt C. J. , Ward D. E. , Camm A. J. 
Published: February 2009

AbstractThe effects of adenosine given during sinus node reentrant tachycardia were investigated in two patients. Both patients received intravenous bolus doses of 0.1 mg/kg and 0.15 mg/kg. Adenosine slowed the atrial rate in both patients and terminated the tachycardia in one. These effects of adenosine on sinus node reentrant tachycardia suggest that sinus nodal tissue (as opposed to perinodal atrial tissue) is involved in the tachycardia circuit and that these effects should be considered when adenosine is used as a diagnostic agent in narrow‐complex tachycardia.
Reduction in coronary heart disease: Clinical and anatomical considerations
Authors: Satler L. F. , Pearle D. L. , Rackley C. E. 
Published: February 2009

AbstractCoronary artery bypass surgery, percutaneous transluminal coronary angioplasty and thrombolytic therapy in acute myocardial infarction have relieved symptoms, preserved myocardium, and prolonged life but have not modified the progression of atherosclerosis in the coronary arteries. In the last 10 years, however, progress has been made in establishing the cholesterol‐atherogenesis hypothesis. Epidemiologic studies have demonstrated that the higher the total plasma cholesterol and low density lipoprotein cholesterol (LDL‐C), the greater the risk that coronary artery diesase will develop. Recently, clinical trials including the Coronary Drug Project, the Lipid Research Clinics Coronary Primary Prevention Trial (LRC‐CPPT), and the Helsinki Heart Study provided evidence that lowering cholesterol reduces the frequency of fatal and nonfatal coronary events. In addition, the National Heart, Lung, and Blood Institute (NHLBI) Type II Coronary Intervention Study and the Cholesterol Lowering Atherosclerosis Study demonstrated that lowering of cholesterol was associated with a decreased incidence of progression of coronary disease, as well as with the potential for reduction in the atherosclerotic plaque. Beneficial effects of diet and lifestyle changes also have an important effect on atherosclerosis. The impact of lowering cholesterol has been limited primarily by pharmacologic programs which lower cholesterol only 10–20% and are associated with a high incidence of intolerable side effects. With the recent introduction of the HmG co‐A reductase inhibitors and their more profound effect on serum lipids, it may be possible to further promote plaque regression. The future of all these interventions, however, must still be assessed by overall mortality; studies to date have demonstrated beneficial effects on cardiovascular mortality but age‐adjusted total mortality has remained unchanged. Future management of patients with acute and chronic coronary artery disease will involve a collaboration of cardiologists, endocrinologists, and epidemiologists to coordinate screening, recognition, and treatment of this disease.
Long‐term efficacy of percutaneous transluminal angioplasty on incidence of myocardial infarction, relief of symptoms and survival
Authors: Sahni R. , Maniet A. R. , Banka V. S. 
Published: February 2009

AbstractThis study was conducted to determine the long‐term effects of percutaneous transluminal coronary angioplasty (PTCA) on the incidence of myocardial infarction, survival, and relief of symptoms. A total of 124 patients were included in the study and were followed for 16 to 25 months. The success rate of PTCA was 91.2% and 160 stenoses were dilated. Fifty‐nine patients had multivessel disease (MVD) and 54 had single‐vessel disease (SVD). There was no difference in survival when patients with SVD were compared with those with MVD. The cardiac survival rate for both groups was greater than 98%. Nine patients had myocardial infarction in the area of the dilated artery: 3 patients (5.5%) with SVD and 6 patients (10.1%) with MVD. Ninety‐six patients (84.9%) remained free of symptoms: 46 patients (85.2%) with SVD and 50 patients (84.7%) with MVD. These data demonstrate the long‐term efficacy of PTCA in patients with SVD and MVD with regard to control of symptom of angina, improved survival, and prevention of myocardial infarction.
Separation of afterload reduction and a direct beneficial cardiac effect of nifedipine in congestive cardiomyopathy
Authors: Percy R. F. , Bass T. A. , Conetta D. A. , Miller A. B. 
Published: February 2009

AbstractTo assess whether the calcium antagonist nifedipine has a specific, direct effect on left ventricular diastolic function separate from its vasodilatory action, we studied 10 patients with idiopathic congestive cardiomyopathy (ages 28‐69, New York Heart Association Class III or IV) at 30 min, 2 h, and 6 h after administration of 10 mg of sublingual nifedipine. Hemodynamic parameters were assessed with Swan‐Ganz catheter and two‐dimensional echo images were processed with computer‐assisted analysis (Quantic 1200) to obtain left ventricular chamber areas and an index of rapid diastolic filling. Indices of left ventricular systolic performance (cardiac index and left ventricular area change fraction) improved during the early (30 min and 2 h) observation periods as afterload (estimated by systolic blood pressure and systemic vascular resistance) was reduced (p<.05 vs. baseline). Pulmonary capillary wedge pressure fell from 17 mmHg to 11 mmHg and rapid diastolic filling index increased from .28 (% area change/ms) to .37 (% area change/ms)(p<.05 vs. baseline) during the early observation periods. Indices of left ventricular systolic performance and afterload had returned to baseline at the late (6 h) observation period. However, pulmonary capillary wedge pressure remained reduced significantly at 10 mmHg after 6 h (p<.05 vs. baseline). Preload (estimated by left ventricular end‐diastolic chamber area) did not vary throughout the study period. Reduction of pulmonary capillary wedge pressure at 6 h, despite return of afterload reduction to baseline and no change in preload, suggests improved left ventricular chamber compliance after sublingual nifedipine, not related to alteration of left ventricular loading conditions.
Probable triggers of onset of acute myocardial infarction
Authors: Muller J. E. , Tofler G. H. , Edelman E. 
Published: February 2009

AbstractThree cases of acute myocardial infarction are presented in which a probable triggering mechanism can be identified. The presence of triggering physical and mental stresses is consistent with recent documentation of a morning increase in frequency of acute myocardial infarction. This documentation suggests that the onset of acute myocardial infarction is not a random event. Recent advances in knowledge of the pathophysiology of acute myocardial infarction provide a background to the understanding of the probable triggering mechanism in these three cases. Further prospective study of patients with acute myocardial infarction in whom detailed information is collected sufficient to identify triggering activities may provide important insight into the pathophysiology of myocardial infarction and improved strategies for prevention.
Ventricular ectopy in cardiac rehabilitation patients on exercise training and nonexercising days
Authors: Lillis D. L. , Hanson P. 
Published: February 2009

AbstractWe evaluated the effect of routine exercise training sessions on the frequency of ventricular ectopic activity (VEA) in 18 coronary artery disease patients (mean age=60 years) who were active participants in a cardiac rehabilitation program. Nine patients were classified as high risk and nine patients were low risk according to clinical status and cardiac catheterization criteria. Five patients in each group were on beta blockade, but none were on antiarrhythmic agents. Serial 24‐h ECG monitoring was obtained on a routine supervised exercise day and nonexercise control day. VEA were compared during three time periods: (1) exercise training and recovery (4 h) and the corresponding 4 h during control, (2) activities of daily living (12 h), and (3) sleep (8 h). Both groups showed a moderate increase in total VEA during the three activity periods from control day to exercise day. However, this increase was only significant (p<0.05) in the high‐risk group during the 12‐h activity of daily living period postexercise. VEA was significantly greater (p<0.05) in the high‐risk group during all activity intervals except the sleep period on the exercise day. We conclude that VEA occurs with similar frequency during exercise training or corresponding control periods. High‐risk patients have significantly greater VEA on exercise and control days and show additional increased in VEA during activities of daily living (eating and driving) on exercise days.
Diabetic heart disease: The clinical and pathological spectrum—Part I
Authors: Van Hoeven K. H. , Factor S. M. 
Published: February 2009

AbstractDiabetes mellitus is a significant condition affecting major segments of all population groups studied. With the introduction of insulin and oral hypoglycemic therapy, and with better understanding of diet and weight control over the past half century, the primary causes of diabetic morbidity and mortality have shifted in varying proportions from metabolic derangements, infection, and renal insufficiency to different types of cardiovascular disease. Despite extensive clinical and laboratory research on the etiology, pathogenesis, and even the existence of cardiovascular disease associated with diabetes mellitus, however, considerable debate is still apparent in this field. Our purpose is to present an overview of the subject of diabetic heart disease, with a critical analysis of epidemiologic, clinical, and pathological data. Some of this material will be addressed from the perspective of research in this area over the past decade by one of us (SMF), particularly in experimental hypertensive and diabetic cardiomyopathy. However, overall, an attempt will be made to provide an objective and balanced analysis, in order to answer the question: does diabetic heart disease exist?
Recurrence of two myocardial aneurysms infected with tuberculosis after a previous aneurysmectomy
Authors: Bennett J. M. , Naude D. F. , De Villiers J. S. 
Published: February 2009

AbstractThis case report concerns a patient who initially presented with an apparent congenital left ventricular aneurysm with successful aneurysmectomy. The patient had a recurrence of the aneurysm and, at reoperation, the diagnosis of cardiac tuberculosis was made.