bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term double‐blind evaluation of amlodipine and nadolol in patients with stable exertional angina pectoris
Authors: Singh Steven 
Published: February 2009

AbstractThe efficacy and tolerability of amlodipine 2.5–10 mg once daily was compared with nadolol 40–160 mg once daily in a long‐term double‐blind parallel‐group study in patients with stable exertional angina pectoris. A total of 80 patients were randomized to receive amlodipine or nadolol for 26 weeks after a 2‐week single‐blind placebo run‐in period. The effects of amlodipine and nadolol on total exercise time were minimal and not significantly different. However, amlodipine produced a slightly but not significantly greater increase in time to onset of angina than nadolol (+21% amlodipine; +8% nadolol). No significant differences were noted between amlodipine and nadolol on ST‐segment depression, angina attack rate, or nitroglycerin consumption. A slightly greater improvement was attained after amlodipine on patient and investigator assessments of treatments. A statistically significant difference (p < 0.0001) was found between treatments on the effects on myocardial oxygen requirements (as assessed by the rate pressure product). Nadolol produced a reduction of 29% compared with a slight reduction of 4% with amlodipine. Fewer side effects were reported with amlodipine (43%) than with nadolol (83%) (p<0.0001), resulting in discontinuation of therapy in three amlodipine and four nadolol patients. Long‐term treatment with amlodipine and nadolol produced comparable effects in patients with angina pectoris, with fewer side effects being reported after treatment with amlodipine.
Effects of physical exercise training in syndrome x
Authors: Leaf David A. , Goldhaber Joshua 
Published: February 2009

AbstractSyndrome X categorizes myocardial disease characterized by impaired myocardial flow without macrovessel injury.1,2 The pathogenesis of this condition remains obscure.3,4 Similarly, therapy is not well defined.5 We report the effects of physical exercise training in a patient with Syndrome X.
Cardioprotection with angiotensin‐converting enzyme inhibitors: Redefined for the 1990s
Authors: Kloner Robert A. , Przyklenk Karin 
Published: February 2009

AbstractThe concept of “cardioprotection” with ACE inhibitors has evolved over the last decade. In the 1980s, protective benefits of ACE inhibitors in hypertension were established, regression of left ventricular hypertrophy was demonstrated, and improved ventricular function and survival in mild‐to‐moderate and severe congestive heart failure was documented. A further “protective” role of ACE inhibitors in coronary artery disease is emerging as more attention is focused on the concept of local tissue reninangiotensin systems. Recent contributions to the literature describe significant benefits of ACE‐inhibitor therapy in acute myocardial infarction, including suppression of ventricular arrhythmias and reduction of both early and late ventricular dilation, preservation of left ventricular function, and improved survival. All of the above effects can be considered “cardioprotective.” However, as new benefits are reported in the 1990s, a broadened view of “cardiovascular protection” emerges from investigative studies in the literature. ACE inhibitors may reduce tolerance to nitrates, reduce angina in some but not all studies, and limit smooth muscle cell proliferation (and perhaps restenosis) induced by experimental balloon angioplasty. Local vascular effects may attenuate atherosclerotic changes in the arterial wall in experimental animals and may decrease the incidence of aneurysm formation in hypertensive animals. The effectiveness of ACE inhibitors in acute myocarditis, suggested by reports that captopril may reduce lesions of murine myocarditis when administered early after infection with coxsackievirus B3, requires clinical confirmation. Despite these apparently diverse “cardiovascular protective” consequences of ACE inhibitor therapy, the mechanism(s) of action of these agents remain to be elucidated. These agents affect not only the systemic renin‐angiotensin systems, but local tissue systems as well. Debate continues as to the significance of the sulfhydryl group in certain ACE inhibitors: at the present time it is not clear whether the thiol group provides a treatment benefit. Finally, stimulation of other vasodilator systems by ACE inhibitors (bradykinin, prostacyclin) may play an important role in the “cardiovascular protective” effects of these agents.
Differences of intravenous nitroglycerin responses in left ventricular systolic and end‐diastolic pressures and coronary artery diameters during long‐term treatment with cutaneous nitroglycerin patches
Authors: Naito Hidetoshi , Matsuda Yasuo , Yorozu Tadao , Maeda Toshiaki , Tada Toshmko , Shomi Kohtaro 
Published: February 2009

AbstractThe differences of intravenous nitroglycerin responses in left ventricular (LV) systolic and end‐diastolic pressures and in coronary artery diameters (cross‐tolerance) were investigated in patients receiving nitroglycerin patches. During diagnostic cardiac catheterization, graded doses of 50,100, and 150 meg of intravenous nitroglycerin were given. Left ventricular systolic and end‐diastolic pressures and left coronary arteriograms were obtained during each dose. Twenty patients with coronary artery disease were studied. Before cardiac catheterization, 10 received nitroglycerin patch (patch group), and 10 did not (control group). In the control group, graded intravenous nitroglycerin doses of 50,100, and 150 meg caused decrease in LV systolic pressure of 18 ± 7%, 20 ± 5%, and 23 ± 6%, respectively. In the patch group, the same intravenous nitroglycerin doses decreased LV systolic pressure by 12 ± 6% (p < 0.05), 19 ± 7% (NS), and 18 ± 6% (p<0.05), respectively, (p value: vs. control group). At the same intravenous nitroglycerin doses, LV end‐diastolic pressures were decreased by 48 ± 14%, 52 ± 17%, and 56 ± 9%, respectively, in the control group. However, there were no significant differences in LV end‐diastolic pressure between the two groups for any of the three intravenous nitroglycerin doses. The same intravenous nitroglycerin doses caused increase in diameter of the left anterior descending coronary artery and circumflex coronary artery in the control group, which was attenuated significantly in the patch group. Tolerance may develop in LV systolic pressure and coronary artery diameters, whereas it may not develop in LV end‐diastolic pressure. These results suggest that tolerance to nitroglycerin in relieving ischemic manifestations may be different for each system, depending on the dose of nitroglycerin.
Limited value of anaerobic threshold for assessing functional capacity in patients with heart failure
Authors: Miyagi Kyoko , Asanoi Hidetsugu , Ishizaka Shinji , Kameyama Tomoki , Sasayama Shigetake 
Published: February 2009

AbstractExercise tolerance was assessed in 146 patients with cardiac dysfunction in terms of anaerobic threshold (ATge). Patients were divided into four classes according to the peak oxygen uptake: Class A (72 patients) exceeding 1000 ml/min; Class B (27 patients) 800‐999 ml/min; Class C (37 patients) 500‐799 ml/min; and Class D (10 patients) below 500 ml/min. An incidence of the ATge breakpoint was lower in patients of Class C (38%) than in those of either Class B (70%, p < 0.05) or Class A (87%, p < 0.05). The ATge could not be determined in any patients in Class D. The V‐slope method improved the ability to determine ATge by 20%. In Classes C and D, ATge detection was precluded considerably by the fact that the initial workloads of exercise test involved oxygen uptake levels already close to or above the ATge. An oscillatory hyperventilation pattern was also significantly related to failure in defining ATge in Class C patients. Of the 51 patients whose ATge was undetermined, 9 had an atrial septal defect In two of these, exercise‐induced right‐to‐left shunting led to progressive arterial hypoxemia, and the consequent hyperventilation masked the appearance of ATge. Thus, ATge is virtually undetectable in patients with severe heart failure largely because of the early onset of anaerobic metabolism or abnormal ventilatory responses to exercise. Accordingly, the clinical application of ATge in the assessment of functional capacity would be limited to patients with mild to moderate heart failure.
Acute myocardial infarction with ventricular septal rupture
Authors: Hackel Donald B. , Wagner Galen S. 
Published: February 2009

AbstractThe interventricular septum is one of the three main sites at which the myocardium can rupture. The features of the interventricular septal rupture that occurred in a 72‐year‐old woman are characteristic of interventricular septal ruptures in general: (1) they occur most commonly in elderly women; (2) the most common site is the midportion of an acute, transmural anteroseptal apical infarct; (3) they are also most common during the patient's first heart attack; (4) the clinical diagnosis of acute myocardial infarct is confirmed by both ECG and by serum enzyme levels; (5) the usual time of the rupture is 3–10 days after the onset of the infarction (it occurred after 3 days in our patient); (6) a new cardiac murmur usually is heard and the patient frequendy goes into shock; (7) the diagnosis can be confirmed by a step‐up in pO2 levels from right atrium to right ventricle; (8) the usual cause is severe old coronary atherosclerosis with a recent thrombotic occlusion as the final precipitating event.
Transesophageal echocardiography in the diagnosis of acquired aneurysms of the left atrial appendage
Authors: Culver Deborah L. , Bezante Gian Paolo , Schwarz Karl Q. , Meltzer Richard S. 
Published: February 2009

AbstractWe report a patient with what appeared to be a pericardial cyst by transthoracic echocardiography but was, in effect, an aneurysm of the left atrial appendage as documented by transesophageal echocardiography.
Cardiogenic shock: Elements of etiology, diagnosis, and therapy
Authors: S. Alpert Joseph , C. Becker Richard 
Published: February 2009

AbstractCardiogenic shock usually is the result of marked depression in myocardial function. Rapid recognition and stabilization are essential if the patient is to survive. A variety of cardiovascular conditions can lead to cardiogenic shock; the most common of these is acute myocardial infarction. Once stabilization of the cardiogenic shock patient has been effected, hemodynamic monitoring and definitive therapy should be attempted if appropriate. Intra‐aortic balloon counterpulsation is effective in stabilizing these patients temporarily. Definitive therapy may include surgical or catheterization interventions. Mortality, even under the best of circumstances, remains high.
Functional health status in male patients without restenosis following successful ptca
Authors: Franzen Damian , Nicolay Claudia , Maria Schannwell Mira , Albrecht Dirk , Wilhelm Höpp Hans , Herman Hilger Hans 
Published: February 2009

AbstractIn a prospective pilot study, subjective and objective parameters of the health status were assessed in 148 male patients (mean age 56 ± 8.4 years) before and 4 months after successful coronary angioplasty (PTCA). Restenosis was defined as residual diameter stenosis >50%. Although 96 patients (65%) had not developed restenosis at 4 months' invasive follow‐up, subjective asessment of general well‐being was unchanged in 26% or worse in 71%; overall anginal status and exercise performance had however improved. Of 71 men younger than 60 years who had no restenosis at follow‐up, 4 men retired and 13 remained on medical leave. The striking disparity between subjective and objective parameters was not related to significant differences of age, exercise capacity, and left ventricular ejection fraction, as well as to baseline characteristics (previous myocardial infarction, extent of coronary heart disease, comorbidity) compared with 52 patients with restenosis. Thus, despite documented sustained success after PTCA, the majority of patients failed to resume the status of subjective well‐being.
Isolated left posterior fascicular block: A reliable marker for inferior myocardial infarction and associated severe coronary artery disease
Authors: J. Godat François , Gertsch Marc 
Published: February 2009

AbstractThe electrocardiographic (ECG) pattern of isolated left posterior fascicular block (LPFB) is a rare condition. It seems that true LPFB is often not recognized, whereas in cases of simple QRS axis of +60d̀ to+100d̀ in the frontal plane, the diagnosis of LPFB is made erroneously. Both facts rely on controversial and partially misleading opinions in the literature. Therefore, a retrospective and prospective study was performed in order to determine the prevalence of LPFB and to correlate its presence to the underlying disease. Retrospective study: Of a cohort of 830 patients referred in 1988 to a cardiologic laboratory for invasive investigation of certain or suspected coronary artery disease (CAD), 163 patients had an old inferior myocardial infarction (IMI). Nine patients (5.5%) showed the typical pattern of LPFB; eight of these had three‐vessel disease. The diagnosis of IMI had been made only in one case before entry of the patient into the hospital, since LPFB generally masks IMI. Prospective study: 2502 ECGs were investigated, 1710 from a department of cardiology and 792 from two departments of internal medicine. Six LPFBs were detected (0.24%), all associated with IMI and four of them with three‐vessel CAD. It is concluded that LPFB is a rare but clinically important intraventricular conduction disturbance. Its appearance is reliably connected with IMI and generally reflects severe three‐vessel CAD, requiring invasive investigation.
Myocardial infarction in qatar: The first 2515 patients
Authors: Chaikhouni A. , Chouhan L. , Pomposiello C. , Banna A. , Mahrous F. , Thomas G. , Abu Al‐Hassan N. , Khalifa S. , Jaddan A. , Bsata M. W. , Hajar H. A. 
Published: February 2009

AbstractThe data registry of all patients admitted between 1982 and 1990 to the Coronary Care Unit at Hamad General Hospital with the diagnosis of documented acute myocardial infarction is reviewed. We report a total of 2,515 patients (86.6% men and 13.4% women) with a mean age of 51 years (range 18‐99). Of these, 62% were smokers, 29% had diabetes, and 20% had hypertension. The hospital mortality rate was 10%. The most significant factors associated with higher mortality were older age, female gender, and anteroseptal infarction. The age of 23% of the patients was 40 years or younger. Comparison between these younger patients (Group I) and those over 40 years (Group II) demonstrated that Group I had lower mortality (3.6%) than Group II (12%) (p<0.001). Group I patients were predominantly men (96.8%), of Asian nationalities (71 %), and usually smokers (78%). The observation that myocardial infarction occurs frequently in young Asian men needs further evaluation to identify specific risk factors.
Hemodynamic response to intravenous enalaprilat in patients with severe congestive heart failure and mitral regurgitation
Authors: Varriale Philip , David William , E. Chryssos Basil 
Published: February 2009

AbstractThe hemodynamic response 1 hour after 1.25 mg of intravenous (IV) enalaprilat was examined in 20 patients (mean age 75 years) with severe congestive heart failure (CHF) and mitral regurgitation (MR), secondary to ischemic heart disease (NYHA Class IV). Patients were classified into two groups based upon the magnitude of MR as derived from Doppler color flow imaging: Group I (n = 13) had severe MR and Group II (n = 7) had moderate MR. Acute therapy significantly reduced systemic vascular resistance index in both groups and provided effective afterload reduction. Although cardiac and stroke volume indices increased in both groups, an improved forward flow was significant only for Group I (cardiac index 2.2 ± 0.5 to 2.7 ± 0.51/min/m2, p < 0.02). The magnitude of MR, acutely reduced in all patients, was similarly significant only for Group I (56 ± 10% to 31 ± 12%, p < 0.01). The reduction of both pulmonary capillary wedge pressure and mean arterial pressure was significant for both groups. This study supports the use of IV enalaprilat, a parenteral angiotensin‐converting enzyme (ACE) inhibitor, as an effective and rapidly acting vasodilator in the management of selected patients with chronic heart failure and MR who require immediate hemodynamic improvement.
Polymorphism of the cardiac manifestations in dermatomyositis
Authors: Tami Luis F , Bhasin Surj 
Published: February 2009

AbstractCardiac involvement in polymyositis and dermatomyositis usually is asymptomatic and rarely the principal clinical feature at the time of initial presentation. We describe a patient with dermatomyositis who presented with overt acute pericarditis which has not, to our knowledge, been previously reported. Acute pulmonary edema resulting from documented acute myocarditis developed during a second exacerbation. Long‐term follow‐up failed to demonstrate new cardiac complications during subsequent exacerbations, adding to the known polymorphism of the heart involvement in these systemic disorders.
Exercise‐induced ventricular tachycardia: A rare manifestation of digitalis toxicity
Authors: Gosselink A. T. Marcel , J. G. M.Crijns Harry , Wiesfeld Ans C. P. , Lie Kong I. 
Published: February 2009

AbstractDigitalis intoxication is one of the most common adverse drug reactions. Although some arrhythmias are seen more frequently than others, virtually any rhythm disturbance, including ventricular tachycardia, may occur. However, to our knowledge, exercise‐induced ventricular tachycardia as a complication of digitalis therapy has never been described before. This case presents a patient with a digitalis‐induced ventricular tachycardia occurring exclusively during exercise.
Characteristics of reactive electropermeable points on the auricles of coronary heart disease patients–K. Saku et al.: Reactive electropermeable points in CHD
Authors: Saku Keijko , Mukaino Yoshtto , Ying Hong , Arakawa Kikuo 
Published: February 2009

AbstractIn oriental medicine there is a hypothesis related to acupuncture that the auricle is a projection of the functional anatomy of the whole human body. In this study reactive electropermeable points (REPP), that is, points on the skin with low electrical resistance, on the auricle were measured on patients with coronary heart disease using a neurometer LC‐M. Our findings correlated positively with the particular points—heart I (shin) and heart II (shinzo)Here, as throughout this paper, these readings represent the Japanese readings of the Chinese characters used to represent the various parts of the auricle.
—named by the Chinese group as being related to the functional anatomy of the heart. The incidence of positive REPP test results at the shin and shinzo points for subjects with acute myocardial infarction (AMI) were extremely high, and positive test results for patients with old myocardial infarction (OMI) and angina pectoris (AP) were also significant. There was no significant difference in the incidence rates of REPP at the shin and shinzo points between the OMI and AP groups. High incidence of positive REPP test results at the lung and heart III (shinyu) points occurred only in the AMI group, and this was significantly high when compared with the control group.
The effect of magnesium versus verapamil on supraventricular arrhythmias
Authors: Gullestad Lars , Birkeland Kare , Vanberg PÅL , Mølstad Per , Høyer Marit Moen , Kjekshus John 
Published: February 2009

AbstractMagnesium has previously been used in the treatment of various arrhythmias, but few randomized and prospective studies are available. In a single‐blind study, the efficacy and safety of intravenous magnesium sulfate (bolus doses of 5 + 5 mmol followed by infusion of 0.04 mmol/min) versus verapamil (5 + 5 mg followed by 0.1 mg/min) was evaluated in 57 patients with supraventricular arrhythmias (supraventricular tachycardia, atrial fibrillation, and atrial flutter) of recent onset (less than 1 week). Fifteen (58%) of the patients receiving magnesium (n = 26) converted to sinus rhythm within 4 h, and 16 (62%) within 24 h. Verapamil caused a lower ventricular rate, but only six (19%) of the patients (n = 31) converted to sinus rhythm within 4 h (p < 0.01) and 16 (52%) within 24 h (NS). No side effects were observed during magnesium infusion, whereas six patients receiving verapamil had to be withdrawn from further study medication due to symptomatic side effects (hypotension in three, cardiac failure in three). Magnesium appears to be an effective and safe drug for the treatment of supraventricular arrhythmias. The overall efficacy for conversion to sinus rhythm is at least as effective as with verapamil, and its action is more rapid.
Anatomy, histology, and pathology of the cardiac conduction system—part III
Authors: Waller Bruce F. , Gering Lawrence E. , Branyas Nancy A. , Slack John D. 
Published: February 2009

AbstractThe cardiac conduction system may be affected by various pathologic changes. Some of these changes are general and affect the nonconduction system tissues of the heart (atrophy, fibrosis, necrosis, segment deposition, mineral) and others are more localized to the conduction system (Lev and Lenegre disease). Pathologic conditions associated with atrial, junctional, and ventricular arrhythmias are reviewed.
Systolic apical filling in a patient with progressive apical hypertrophic cardiomyopathy and giant negative T waves
Authors: Joseph Waldo , Spellberg Richard D. 
Published: February 2009

AbstractA relatively asymptomatic 58‐year‐old nonhyper‐tensive male developed changes of remarkable apical hypertrophic cardiomyopathy associated with deep negative T‐wave change and marked ventricular dyssynergy without apparent precipitating cause over a nine‐year period.
Determinants of immediate and follow‐up results of pulmonary balloon valvuloplasty
Authors: Shrivastava S. , Krishna Kumar R. , Dev V. , Saxena A. , Das Gladwin 
Published: February 2009

AbstractThe data of 93 patients (age 11.4 ± 9.4 years, range 8 months ‐ 56 years) who underwent pulmonary balloon valvuloplasty (PBV) for valvular pulmonic stenosis (PS) in our institution are reviewed. The patients were classified into three groups: Group I (34 patients) had a right ventricular (RV) to aortic systolic pressure ratio of < 1, Group II (39 patients) had suprasystemic RV systolic pressures, and Group III (20 patients) included patients with elevated mean right atrial (RA) pressures irrespective of the RV systolic pressures. The percentage drop in immediate postdilatation peak systolic gradients (PSG) and the follow‐up PSG were similar in the three groups and were not influenced by any predilatation patient characteristics. A balloon‐annulus ratio < 1 predicted a poorer follow‐up outcome. Nine patients, eight of Group III and one of Group II, experienced difficult procedures requiring sequential use of progressively larger balloon catheters. Eleven patients, six of Group II and five of Group III, experienced procedure‐related events (hypotension, bradycardia/asystole, hypoxia, apnea, tachyarrhythmias, and seizures) and one patient (Group II) died. Although changes in immediate and follow‐up gradients after PBV are not influenced by the severity of PS, difficult procedures and procedure‐related events are particularly common in patients with severe PS and elevated RA pressures. A cautious and planned approach is therefore indicated in these patients.