bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary heart disease risk factors in hansen's disease sufferers
Authors: Diamantopoulos Emmanuel J. , Anthopoulos Lambros P. , Moulopoulos Spyridon D. 
Published: February 2009

AbstractIn the frame of an epidemiologic study of Hansen's disease (HD) sufferers, several risk factors have been investigated which might explain the high prevalence of coronary heart disease (CHD) among HD patients. The data analyzed in the present study are derived from 293 HD patients (157 men and 136 women). The patients, after having completed a WHO adopted questionnaire, were given a complete physical examination, a resting and an exercise electrocardiogram, and biochemical as well as hematological examinations. Coronary HD patients, when compared to noncoronary HD patients, showed statistically significant differences in the following parameters: (1) mean age, (2) mean concentration of the electrophoretic fraction of α‐lipoproteins, (3) deviation from mean weight, (4) prevalence of hypertension, and (5) prevalence of the borderline lepromatous form of HD. However, the differences found when comparing other parameters, such as blood pressure, smoking, diabetes mellitus, total cholesterol, triglycerides, pre‐β and β‐lipoproteins, uric acid, erythrocyte sedimentation rate, ABO blood groups, etc., did not reach the level of significance.These findings suggest that HD sufferers are a special population subgroup with reference to CHD risk factors, differing in many ways from the general population.
Anatomy, histology, and pathology of coronary arteries: A review relevant to new interventional and imaging techniques—Part I
Authors: Waller Bruce F. , Orr Charles M. , Slack John D. , Pinkerton Cass A. , Van Tassel James , Peters Thomas 
Published: February 2009

AbstractIn the last 15 years, intense interest has focused on various interventional pharmacologic and mechanical forms of therapy for the treatment of atherosclerosis coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques.1,2 Part I of this review will focus on anatomic aspects of the epicardial coronary artery system, coronary arterial distribution, myocardial supply, and histologic features of the normal coronary artery.
Isolated left main coronary stenosis and mediastinal irradiation
Authors: Chinnasami Bernard R. , Schwartz Robert C. , Pink Stuart B. , Skotnicki Robert A. 
Published: February 2009

AbstractThis report draws an association between mediastinal irradiation and isolated left main coronary artery stenosis. The report highlights two patients who developed selective left main coronary artery stenosis post mediastinal treatment. In the animal model, it has been shown that high serum cholesterol levels at the time of, or soon after, irradiation are necessary to initiate arteriosclerotic plaque formation.
Anomalous origin of left coronary artery from the pulmonary artery: Evolution of left ventricular function and perfusion after surgery in a 44‐year‐old man
Authors: Nony Patrice , Beaune Jacques , Champsaur GÉRard , Bozio AndrÉ , Age Colette , Fontana JÉRǑMe , Tissot Alain 
Published: February 2009

AbstractAnomalous origin of left coronary vessel from the pulmonary artery is an almost universally fatal form of congenital heart disease unless appropriate corrective surgery is performed at an early age. A case was diagnosed in a symptomatic 44‐year‐old man who presented an impairment of systolic left ventricular function. The abnormality was successfully treated with ligation of the left coronary artery combined with left internal mammary artery anastomosis. Left ventricular function improved dramatically six months after surgery, both at rest and during exercise. Such an evolution suggests that surgery may be indicated not only in infants but also in adults with this congenital heart abnormality.
Ventricular tachycardia of right bundle‐branch block—left axis deviation morphology and organic heart disease
Authors: Rechavia Eldad , Strasberg Boris , Kusniec Jairo , Sclarovsky Samuel 
Published: February 2009

AbstractMost series of patients with ventricular tachycardia (VT) of right bundle‐branch block (RBBB)‐left axis deviation (LAD) morphology include young individuals with no overt evidence of structural heart disease. In the present report, the clinical and electrophysiologic findings in two patients with verapamil‐responsive VT and organic heart disease are described.
Transcatheter management of cyanotic congenital heart defects: A review
Authors: Rao P. Syamasundar 
Published: February 2009

AbstractIn this review, the role of transcatheter methods in the management of cyanotic congenital heart defects is discussed. In patients with interventricular right‐to‐left shunting secondary to pulmonary outflow tract obstruction (most commonly tetralogy of Fallot), balloon dilatation may be an effective palliative procedure in a substantial proportion of patients, obviating the need for a palliative shunt. We would recommend this if the patient's size or cardiac anatomy makes that patient an unsuitable candidate for safe total surgical correction. Infundibular myectomy with atherectomy catheter in tetralogy of Fallot patients may become a useful adjunct in the management of these infants. Cyanotic children with interatrial right‐to‐left shunt secondary to severe valvar pulmonary stenosis respond to balloon pulmonary valvuloplasty in a manner similar to mat seen with isolated pulmonary valve stenosis. In these patients, balloon valvuloplasty is the treatment of choice and may be corrective in most cases. In patients with a narrowed Blalock‐Taussig shunt, balloon angioplasty may improve pulmonary oligemia and systemic arterial hypoxemia and may obviate the need for a second systemic‐to‐pulmonary artery shunt. Balloon angioplasty is recommended if the patient's cardiac defect is not amenable to surgical correction at a low risk either because of the size of the patient or because of the complexity of the cyanotic heart defect. In patients with pulmonary valve atresia, initial opening of the atretic pulmonary valve by either laser or surgery with subsequent balloon dilatation is potentially beneficial in reducing the total number of surgical procedures that these children are likely to require. However, further clinical trials are needed prior to their general use.
Hemofiltration as treatment for patients with refractory heart failure
Authors: Inoue Teruo , Sakai Yoshihiko , Morooka Shigenori , Takayanagi Kan , Hayashi Terumi , Takabatake Yutaka 
Published: February 2009

AbstractHemofiltration was performed in 15 patients with refractory congestive heart failure. All of these patients had oliguria, although intensive treatment with diuretics, digitalis, vasodilators, and catecholamines was prescribed. Hemofiltration was performed under hemodynamic monitoring in 14 patients. The water removal by hemofiltration decreased pulmonary arterial pressure, pulmonary capillary wedge pressure and right atrial pressure. Despite these hemodynamic improvements, nine patients (60%) died within one month after the start of hemofiltration; the causes were fatal arrhythmia in three, renal failure in two, sepsis in one and irreversible cardiogenic shock in three. Oliguria for over 15 h or a serum creatinine concentration of more than 4.0 mg/dl at the start of hemofiltration related to poor prognosis. In view of these results, hemofiltration for refractory heart failure should be started earlier and performed carefully in order to avoid arrhythmia, cardiogenic shock, and other complications.
Histologic evidence of myocardial damage in apparently healthy subjects with ventricular arrhythmias and myocardial dysfunction
Authors: Contini C. , Berti S. , Levorato D. , Bongiorni M. G. , Baratto M. T. , Arlotta C. , Piacenti M , Pozzolini A. , Paperini L. , Kraft G. , Biagini A. 
Published: February 2009

AbstractThe association of ventricular arrhythmias and myocardial dysfunction could be considered an early step toward cardiomyopathy; therefore, we studied 28 patients in NYHA class I and II, characterized by complex ventricular arrhythmias (VA) on 24‐h Holter monitoring and volumetric and/or contractile abnormalities on a standard two‐dimensional echocardiogram (2‐D echo). All patients underwent radioisotopic angiography, 20 patients complete hemodynamic study, and 15 patients endomyocardial biopsy. Ambulatory ECG monitoring showed the presence of frequent premature ventricular contractions in 14 patients (50%) and episodes of ventricular tachycardia in 16 patients (57%). 2‐D echo showed mono‐ or biventricular enlargement and dyssynergies in 25 patients (89%) (left ventricle in 6, right ventricle in 11, both in 8). Two patients showed only left ventricle enlargement and one patient isolated left ventricular dyssynergies. Radioisotopic angiography showed mono‐ or biventricular ejection fraction reduction in 24 patients (85%) and regional dyssynergies in 24 patients (85%) in accordance with 2‐D echo. Hemodynamic study showed in all patients normal coronary arteries, and right and left angiography confirmed enlargement and/or regional dyssynergies. Endomyocardial biopsy was abnormal in 11 of 15 patients: various degrees of hypertrophy, parcellar fibrosis, and adipogenic infiltration were found. Our preliminary data suggest that the simultaneous occurrence of ventricular arrhythmias and ventricular dyssynergies and/or enlargement in patients without apparent clinical heart disease may represent an early stage of dilated cardiomyopathy.
Hemodynamic findings during exercise on a bicycle ergometer following balloon valvuloplasty of pulmonary stenosis in children and adolescents
Authors: Zellmer S. , Graevinghoff L. , Keck E. W. 
Published: February 2009

AbstractEleven patients (4 female, 7 male), age range 3.3 to 24.8 years (mean 11.10 years) treated for isolated pulmonary stenosis underwent cardiac catheterization and percutaneous transluminal balloon valvuloplasty (PTVP). The right ventricular systolic pressure (RVSP) before valvuloplasty ranged from 31 to 127 mmHg (mean 79 mmHg) decreasing to 28 to 62 mmHg (mean 42 mmHg) immediately after the dilatation. The peak systolic gradient of the pulmonary valve (Ap RV‐PA) before valvuloplasty ranged from 22 to 107 mmHg (mean 61 mmHg) and decreased to a range of 14 and 45 mmHg (mean 23 mmHg) immediately after the dilatation. Balloon valvuloplasty was performed using balloons of 13 to 31 mm in diameter. On 11 patients cardiac catheterization and Doppler echocardiography were repeated between 11 months and 5.3 years (mean 3.11 years) after the balloon valvuloplasty showed a further significant fall in the gradient of pressure. The right ventricular systolic pressure ranged from 20 to 51 mmHg (mean 31.7 mmHg) while the transpulmonary gradient varied from 3 to 24 mmHg (mean 11.6 mmHg). At the time of follow‐up examination the patients were aged between 7.2 and 25.7 years (mean 15.9 years). On average the second catheterization was performed 3.11 years following the first hemodynamic study. The follow‐up examination encompassed clinical examination, electrocardiogram, Doppler echocardiography, and right heart cardiac catheterization. During right heart cardiac catheterization the children exercised on a bicycle ergometer for three min at 50 or 100 W depending on their body surface area. During this exertion, pressures of the right ventricle and the pulmonary artery as well as heart rate and oxygen saturation were recorded. Right ventricular systolic pressure increased from 34 to 85 mmHg (mean 57.4 mmHg). The gradient between the right ventricle and the pulmonary artery increased from 10 to 35 mmHg (mean 25 mmHg). All patients tolerated the procedure well and no complications were observed. It was concluded that percutaneous balloon valvuloplasty is a safe and effective method of relieving right ventricular obstruction due to moderate or severe valvular pulmonary stenosis.
Anatomy, histology, and pathology of coronary arteries: A review relevant to new interventional and imaging techniques—Part III
Authors: Waller Bruce F. , Orr Charles M. , Slack John D. , Pinkerton Cass A. , Van Tassel James , Peters Thomas 
Published: February 2009

AbstractIn the last 15 years, intense interest has focused on various interventional, pharmacologic, and mechanical forms of therapy for the treatment of atherosclerotic coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques.1,2 Part III of this four‐part review focuses on eccentric and concentric plaques, formation of coronary thrombus, and status of the “infarct artery” after mechanical and pharmacologic forms of acute reperfusion therapy.
Comparison of exercise electrocardiography and dobutamine echocardiography
Authors: Martin Timothy W. , Seaworth John F. , Johns Joseph P. 
Published: February 2009

AbstractIt is uncertain whether dobutamine echocardiography is a better test than exercise electrocardiography for the detection of coronary disease in patients who can exercise. We compared the hemodynamics, sensitivity, and specificity of these tests in 24 patients, 16 with coronary disease and 8 controls. The tests were performed within six weeks of one another and were interpreted without knowledge of other clinical data. The exercise electrocardiogram was considered abnormal if the patient developed one mm of ST‐segment depression, while the dobutamine test (up to 40 μg/kg/min) was considered abnormal if the patient developed ST‐segment depression or a left ventricular wall motion abnormality. Exercise testing resulted in a higher heart rate (145±29 vs. 110±24, p<0.001) and blood pressure (176±31 vs. 148±24, p<0.001). Dobutamine testing was 25% more sensitive than exercise testing (94 vs. 69%, 95% confidence interval for difference is 0 to 50%, p=0.09), while exercise testing was 38% more specific (88 vs. 50%, 95% confidence interval for difference is –3 to 79%, p=0.14). We conclude that exercise results in a higher heart rate and blood pressure than dobutamine infusion. Differences in sensitivity and specificity are inconclusive, but indicate that the sensitivity of exercise testing is, at best, equivalent to dobutamine testing, while any increase in specificity with dobutamine testing, compared with exercise testing, would not be clinically significant.
Noninvasive evaluation of left ventricular performance by the shortest distance between mitral leaflets coaptation and interventricular septum at end‐systole
Authors: Ohte Nobuyuki , Narita Hitomi , Hashimoto Takeshi , Takase Rie , Kobayashi Kenji , Akita Sachie , Fujinami Takao 
Published: February 2009

AbstractWe attempted to evaluate left ventricular performance from the shortest distance between the mitral leaflets coaptation and the interventricular septum at endsystole (MVC‐IVS distance). The subjects were 37 patients with coronary artery disease (CAD) with prior myocardial infarction (MI), 8 with CAD without prior MI, 22 with atypical chest pain, and 4 with aortic regurgitation. The MVC‐IVS distance was measured on a two‐dimensional echocardiogram obtained from the parasternal or apical long‐axis view and frozen at end‐systole. Left ventricular end‐systolic volume and end‐diastolic volume were obtained by left ventriculography, and the left ventricular ejection fraction was calculated. A significant positive correlation was observed between the MVC‐IVS distance and the end‐systolic volume (r=0.83, p<0.001); a close correlation was found between the left ventricular end‐systolic volume and ejection fraction by monoexponential fitting (r= –0.91, p<0.001). Thus, a significant negative correlation was observed between the MVC‐IVS distance and the left ventricular ejection fraction (LVEF) (r= –0.83, p<0.001). An MVC‐IVS distance of 30 mm suggests diagnosis of left ventricular dysfunction (LVEF < 50%) with high sensitivity (94.4%) and specificity (90.6%), while a value <30 mm suggests that the left ventricular performance is likely to be normal. Thus one can easily evaluate the left ventricular performance noninvasively using this new index.
Anatomy, histology, and pathology of coronary arteries: A review relevant to new interventional and imaging techniques‐part iv
Authors: Waller Bruce F. , Orr Charles M. , Slack John D. , Pinkerton Cass A. , Tassel James Van , Peters Thomas , Waller Bruce 
Published: February 2009

AbstractIn the last 15 years, intense interest has focused on various interventional pharmacologic and mechanical forms of therapy for the treatment of atherosclerosis coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques. Part IV of this review will focus on congenital coronary artery anomalies Myocardial bridges, coronary aneurysm, emboli, and dissection and clinical implications regarding echocardiographic imaging techniques.
Triggered activity as arrhythmogenic mechanism after myocardial infarction: Clinical and electrophysiologic study of one case
Authors: Wiesfeld Ans C. P. , Cruns Harry J. G. M. , Van Veldhuisen Dirk J. , Lie Kong I. , Van Gilst Wiek H. 
Published: February 2009

AbstractIn a woman with an old infarction and sustained ventricular tachycardia, tachycardias were only inducible after short‐long RR sequences. After isoprenaline, tachycardias became incessant and all were preceded by short‐long RR sequences. This strongly suggests that triggered activity plays a role in initiation of ventricular tachycardias in postinfarction patients.
QT‐interval abnormalities in hypertrophic cardiomyopathy
Authors: Dritsas Athanase , Sbarouni Eftichia , Gilligan David , Nihoyannopoulos Petros , Oakley Cella M. 
Published: February 2009

AbstractTo examine whether QTc and QTc dispersion across the leads of a surface electrocardiogram (ECG) are different in patients with hypertrophic cardiomyopathy (HCM) compared with normal subjects, we measured QT and calculated QTc in all 12 leads of a surface ECG in 24 patients with HCM and in 20 age‐ and sex‐matched normal control subjects. Maximal QTc was prolonged in HCM patients (465±24 ms) compared with controls (410±20 ms) (p<0.001). QTc dispersion defined as the difference of maximum‐minimum QTc was also greater in HCM patients (71±21 ms) compared with normals (35±11 ms) (p<0.001). A correlation was found between the degree of left ventricular hypertrophy expressed by the maximal wall thickness and maximal QTc (r=0.48, p<0.02). However, QTc dispersion did not correlate with maximal wall thickness. Thus, patients with HCM show a prolonged QTc (>440 ms) and increased QTc dispersion compared with normal subjects. In addition, the degree of left ventricular hypertrophy correlates with maximal QTc. The presence of a prolonged QT with increased regional dispersion may be associated with the occurrence of serious ventricular arrhythmia and sudden death in HCM.
Cardiac pathology in 2007 consecutive forensic autopsies
Authors: Waller Bruce F. , Waller Bruce , Catellier Michele J. , Clark Michael A. , Hawley Dean A. , Pless John E. 
Published: February 2009

AbstractThe incidence of various types of cardiovascular disease was evaluated in 2007 consecutive forensic patients. Cardiovascular deaths accounted for 22.8% of the study patients and atherosclerotic coronary heart disease was the most common type of cardiac disease (18%). Among subjects dying of atherosclerotic coronary disease, sudden death was three times more frequent than acute myocardial infarction. Expected cardiac findings included the incidence of severe coronary atherosclerosis (21%), floppy mitral valves (5%), and congenital bicuspid aortic valves (1%). Major cardiac findings occurred in 32% and minor cardiac findings were found in 40%. Only 17% of hearts were anatomically normal. An unexpected cardiac necropsy finding included the high frequency of myocardial bridges (23%). Unexpected cardiac findings included the low incidence of acute myocarditis (0.6%) and common finding of tunneled epicardial coronary arteries (“myocardial bridges”) (23%).
ACE inhibitors and regression of left ventricular hypertrophy
Authors: Gilbert Brian W. 
Published: February 2009

AbstractLeft ventricular hypertrophy (LVH) is a common condition and a powerful independent risk factor for coronary heart disease, congestive heart failure, and other cardiac morbidity. It is associated with the male sex and advancing age. Its most common cause is hypertension, and many antihypertensive agents induce regression of LVH. Angiotensin‐converting enzyme (ACE) inhibitors have been shown to reverse LVH by a mechanism as yet unknown. Reduction in afterload and other hemodynamic abnormalities by reduction of blood pressure is clearly a factor, but ACE inhibitors also block adrenergic action and other sympathetic nervous system influences, and the reduction in angiotensin II produces many effects. By inhibiting this potent vasoconstrictor and suppressing its degradation of the powerful vasodilator bradykinin, and by promoting sodium and water excretion, ACE inhibitors contribute to the restoration of normal ventricular function. Angiotensin II promotes protein synthesis in myocardial myocytes, and blocking this action may arrest the hypertrophic process. To determine the effect of angiotensin II on LVH and normalization of LV function, a study is now underway evaluating the effects of lisinopril, a new lysine analog of enalapril, and a diuretic agent in the treatment of hypertension LVH.
Cholesterol and lipoproteins: Beyond atherogenesis
Authors: Kuhn Frederick E. , Mohler III Emile R. , Rackley Charles E. 
Published: February 2009

AbstractAlthough much emphasis has been placed on the role of cholesterol and lipoproteins in atherosclerotic plaque formation, recent studies suggest that lipids have other vascular actions which may contribute to the pathogenesis of myocardial ischemia. These include deleterious effects of lipids on platelet and endothelial cell function, coagulation, fibrinolysis, and prostacyclin metabolism. The purpose of this report is to review recent data regarding the nonatherogenic effects of lipids and provide insight as to how lipid lowering might contribute to clinically important improvements in vascular biology.