bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of early diastolic time intervals for the differentiation of idiopathic dilative cardiomyopathy from ischemic cardiomyopathy
Authors: Sekiya M. , Hamada M. , Kokubu T. 
Published: February 2009

AbstractIn order to differentiate idiopathic dilative cardiomyopathy from ischemic çardiomyopathy noninvasively, systolic time intervals (STIs) and early diastolic time intervals were investigated in patients with idiopathic dilative cardiomyopathy (n = 11), patients with ischemic cardiomyopathy (n = 8), and normal controls (n = 17). Minimal left ventricular pressure and pulmonary capillary wedge pressure (PCWP) were also measured to clarify the relationship between early diastolic time intervals and early diastolic hemodynamics. Cardiac function estimated by STIs was markedly depressed both in idiopathic dilative cardiomyopathy and ischemic cardiomyopathy, and there was no difference between the two diseases. In early diastolic time intervals, IIA‐O time (the interval from the aortic component of the second heart sound to the O point of apexcardiogram) was significantly prolonged both in idiopathic dilative cardiomyopathy (144±31 (SD); p<0.01) and ischemic cardiomyopathy (153±15; p<0.01) compared to normal controls (126±11). IIA‐MVO time (the interval from IIA to the mitral valve opening) in idiopathic dilative cardiomyopathy (49±23) was significantly shorter than that in normal controls (70±8; p<0.05). On the contrary, IIA‐MVO time in ischemic cardiomyopathy (126±11) was markedly prolonged compared with normal controls (p<0.01) and idiopathic dilative cardiomyopathy (p<0.01). MVO‐O time was significantly prolonged in idiopathic dilative cardiomyopathy (94±18; p<0.01). However, it was conversely shortened in ischemic cardiomyopathy (25±15) compared with normal controls (54±7; p<0.01). Minimal left ventricular pressure in ischemic cardiomyopathy was significantly higher than that in idiopathic dilative cardiomyopathy and normal controls (each p<0.05). PCWP in idiopathic dilative cardiomyopathy was relatively higher than that in ischemic cardiomyopathy. The smaller value of pressure difference between PCWP and minimal left ventricular pressure in ischemic cardiomyopathy might contribute to the shortening of MVO‐O time. The different characteristics of early diastolic time intervals in idiopathic dilative cardiomyopathy and ischemic cardiomyopathy are of important diagnostic value in differentiating idiopathic dilative cardiomyopathy from ischemic cardiomyopathy noninvasively.
Short‐ and long‐term dobutamine treatment in chronic ischemic heart failure
Authors: Lewin R. F. , Davidson E. , Zafrir N. , Strasberg B. , Sclarovsky S. , Hellman C. , Agmon J. 
Published: February 2009

AbstractThis study was undertaken in order to characterize the short‐term (1 hour) and long‐term (72 hours) effect of dobutamine on hemodynamic and regional ejection fraction parameters measured by radionuclear angiography in patients with chronic congestive heart failure due to coronary artery disease. Baseline hemodynamic and radionuclear parameters were measured and then intravenous dobutamine (8.5 ±/kg/min) was administered. The above parameters were determined again after 1 hour and 72 hours of continuous dobutamine administration. Sixty minutes (short‐term) after dobutamine administration heart rate and cardiac index increased significantly (p<0.001 for both) and peripheral resistance decreased concomitantly (p<0.005). Global left ventricular ejection fraction (LVEF) as measured by multigated equilibrium nuclear angiography (MUGA) increased from 21.8±10.6% to 25±13.5 (p<0.02). Count‐based mean regional ejection fraction in the septal, inferoapical, posterolateral (45d̀ left anterior oblique view) and inferior, apical and anterolateral (30d̀ right anterior oblique gated first pass) regions increased also. At 72 hours (long‐term) after continuous dobutamine infusion, heart rate and cardiac index were still significantly higher and peripheral resistance lower than in the control study. However, global and count‐based regional ejection fraction decreased to control values in the right anterior oblique view (first‐pass analysis) and the left anterior oblique view (MUGA). Global LVEF measured in the right anterior oblique view by first‐pass technique was significantly higher than control in the longterm study (23±9.7 vs. 27.8±2.4; p<0.01). The improved global and regional ventricular performances observed in the short‐term, followed by a return to baseline values after long‐term treatment, concomitantly with improved hemodynamic parameters, suggest a relatively short positive inotropic effect of dobutamine and that the effectivity for long term seems to stem, most probably, from the combination of dobutamine's chronotropic effect and its influence upon reducing peripheral resistance (long‐term ventricular loading improved).
Endocardial fibroelastosis in mucopolysaccharidosis type VI
Authors: Fong L. V. , Menahem S. , Wraith J. E. , Chow C. W. 
Published: February 2009

AbstractThis case report describes two siblings less than 1 year of age who presented severely ill with a dilated cardiomyopathy. Full blood examination in both cases revealed marked granularity of neutrophils suggestive of mucopolysaccharidosis type VI. There were no physical features of a mucopolysaccharidosis but biochemical evaluation confirmed mucopolysaccharidosis type VI in both children. Autopsy in one patient confirmed endocardial fibroelastosis and electron microscopy of fibreblasts in the myocardium showed distention with membrane‐bound vacuoles, consistent with a mucopolysaccharidosis. These siblings developed endocardial fibroelastosis before other clinical manifestations of the mucopolysaccharidosis. Assessment for metabolic causes of a cardiomyopathy is important, as cardiac disease may be the initial manifestation of a metabolic disease.
Effect of amiodarone on sinus node function in patients with sick sinus syndrome
Authors: Hoffmann A. , Jost M. , Burckhardt D. , Kappenberger L. 
Published: February 2009

AbstractThe effect of amiodarone on sinus node function has been studied in 9 patients with symptomatic sick sinus node as documented by Holter‐ECG. All patients had programmable dual‐chamber pacemakers. Sinus node activity was assessed by intermittently inhibiting the pacemakers before and after four weeks of oral amiodarone treatment. Sinus node function was not altered by amiodarone in 5 patients but was severely depressed in 4 patients. Thus, it is concluded that amiodarone cannot be used safely in all patients with the tachybrady syndrome for the treatment of symptomatic tachyarrhythmias without concomitant pacing.
The value of right atrial emptying rate in predicting reduction in pulmonary artery pressure in patients with chronic obstructive pulmonary disease
Authors: Marmor A. T. , Michaeli S. , Plich M. , Frankel A. , Schneeweiss A. 
Published: February 2009

AbstractWe used an improved noninvasive radio‐nuclide method, recently developed by us, to evaluate changes in pulmonary artery pressure induced by sublingual nifedipine in patients with chronic obstructive pulmonary disease and pulmonary hypertension. The new method enhances the predictive power of right ventricular ejection fraction by using the right atrial emptying rate as an index of reduced right ventricular compliance. The results were compared to those of invasively measured pulmonary arterial pressure. In the 21 patients studied 20 mg of nifedipine sublingually reduced pulmonary arterial pressure by 13.35% from 36.95±13.95/12.71±6.24 (mean 20.79±8.19) mmHg to 32.67±12.17/10.9±6.2 (mean 18.16±7.3) mmHg (p<0.05 for all pressures). Cardiac index increased and the pulmonary and systemic resistances decreased. The percent changes in right atrial emptying rate showed an excellent correlation with the percent change in pulmonary pressure. An increase of 12% or more in right atrial emptying rate predicted in all patients a reduction in pulmonary arterial pressure of at least 8%, the specificity and positive predictive accuracy being 100%. The sensitivity and the predictive accuracy of a negative test were 93% and 80%, respectively. The new method is useful for long‐term evaluation of drug therapy in patients with pulmonary hypertension.
Echocardiographic documentation of atrial mechanical systole after dual‐chamber pacemaker implantation in a patient without electrically evident atrial activity
Authors: Butman S. M. , Mechling E. , Copeland III J. G. 
Published: February 2009

AbstractDocumentation of synchronized atrial transport mechanical systole, after dual‐chamber pacemaker implantation is generally not sought clinically. In this patient, no electrical atrial activity was seen after elective revision to dual‐chamber from single‐chamber pacing. M‐mode echocardiography provided definitive proof of proper pacemaker function with intact mechanical atrial systole. Echocardiography should be considered in the postoperative evaluation of patients in whom proper atrial or ventricular mechanical function is in doubt.
Attenuation of nitroglycerin‐induced coronary hyperemic blood flow in patients with left anterior descending coronary collaterals
Authors: Kern M. J. , Miller J. T. , Henry R. L. 
Published: February 2009

AbstractAlthough intracoronary nitroglycerin (NTG) is frequently administered to patients having occluded coronary arteries undergoing invasive procedures such as percutaneous transluminal coronary angioplasty or thrombolysis, the extent of NTG‐induced augmentation of myocardial blood flow in patients with collaterally filled occluded arteries is incompletely understood. To examine NTG‐induced increases in coronary blood flow in patients with occluded left anterior descending coronary arteries (LAD), coronary and systemic hemodynamics were measured during bolus administration of NTG into the left coronary artery in 10 patients with normal LAD (Group 1), 11 patients with >70% and <100% narrowing of the LAD (Group 2), and 10 patients who had total occlusion of the LAD with angiographic collateral filling and anterior ventricular wall motion abnormalities (Group 3). NTG increased anterior regional great vein flow (thermodilution) from 72±19 to 140±60 ml/min (p< 0.05), 67 ± 27 to 108±66 ml/min (p< 0.05), and 59±27 to 74±36 ml/min (p = NS vs. control, p< 0.05 vs. peak flow for Group 1) with relative increases from control of 91±41%, 56±34%, and 25±22% for the three groups, respectively. The percent change for Group 3 was significantly lower than both Groups 1 (p< 0.01) and 2 (p< 0.05). These data indicate that myocardial hyperemic blood flow responses to intracoronary NTG are markedly attenuated in patients with occluded but collaterally supplied vessels. During invasive procedures in these patients, although significantly attenuated, intracoronary NTG may potentially provide a beneficial effect by augmenting blood flow through collaterals or in adjacent regions.
Pathophysiology in malignant hypertension: With special reference to the renin‐angiotensin system
Authors: Kawazoe N. , Onoyama K. , Abe I. , Takishita S. , Ueno M. , Fujishima M. , Kobayashi K. , Muratani H. , Kimura Y. , Tomita Y. , Tsuchihashi T. , Uezono K. , Kawasaki T. , Eto T. , Fukiyama K. , Omae T. 
Published: February 2009

AbstractPathophysiology of malignant hypertension, of which underlying disease was essential hypertension (EHT) in 33 cases and chronic glomerulonephritis (CGN) in 26 cases, was studied with reference to the renin‐angiotensin system. Plasma renin activity (PRA) was significantly higher in the EHT than in the CGN group, and angiotensinII antagonist [Sar1, Ile8] angiotensin II (AIIA) induced a significant lowering of blood pressure only in the former group. PRA was linearly correlated with both pretreatment mean blood pressure (MBP, r=0.474, n=29, p< 0.01)and serum creatinine (r=0.540, n=29, p< 0.01) in the EHT group but not in CGN patients, although there was an inverse correlation between PRA and serum sodium in both groups. Multiple regression analysis revealed that PRA was independently related to MBP, serum creatinine, and serum sodium in the EHT group, but not in the CGN group. These results suggest that the renin‐angiotensin system plays a significant role in elevating blood pressure and deteriorating renal function in malignant hypertension derived from EHT, but it is less important in CGN related hypertension.
Baroreceptor reflex in a patient with coarctation of the aorta
Authors: Matsuyama K. , Sonoda E. , Nakao K. , Horio Y. , Yasue H. 
Published: February 2009

AbstractWe report the case of a 23‐year‐old man with coarctation of the aorta whose baroreceptor sensitivity was extremely reduced. Antihypertensive therapy was effectively performed after coarctectomy. Only one month after coarctectomy, baroreflex sensitivity had recovered. The present case is believed to be the first in which reduced baroreceptor sensitivity in coarctation of the aorta was reversible in the early phase after coarctectomy.
Aneurysm of patent ductus arteriosus in an adult case: Findings of cardiac catheterization, angiography, and pathology
Authors: Ohtsuka S. , Kakihana M. , Ishikawa T. , Noguchi Y. , Kuga K. , Ishimitsu T. , Sugishita Y. , Ito I. , Ijima H. , Hori M. , Kimura Y. 
Published: February 2009

AbstractA 42‐year‐old male was admitted to our hospital for evaluation of a left precordial continuous murmur. Results of catheterization revealed a step‐up of oxygen content in the pulmonary arteries and the calculated left‐to‐right shunt flow was 40% of the pulmonary arterial flow. Furthermore, aortography unexpectedly revealed an aneurysm of the patent ductus arteriosus. During surgery, the aneurysm was discovered to arise from the frontal wall of the ductus arteriosus, and histological observation showed focal necrosis and mucoid degeneration of the media of the aneurysmal wall in contrast to a thickened intimal fibroelastosis of the adjacent ductal wall. This is presumed to be the first adult case of patent ductal aneurysm ever reported in which antemortem diagnosis and surgical treatment were successfully conducted. Our case may suggest that the fragility of the ductal wall following the structural change in an incomplete closing process is considered as a potential pathogenesis of ductal aneurysm formation.
Endomyocardial fibrosis with massive endocardial calcific deposits
Authors: Chan. W. L. , Chiang B. N. , Kong C. W. , Lee J. B. , Wang S. P. , Hsu T. L. 
Published: February 2009

AbstractMassive endocardial calcific deposits in the left ventricular chamber is such an uncommon lesion that only three cases have been reported previously. This report describes an apparently asymptomatic patient with endomyocardial fibrosis and massive endocardial calcific deposits. The results of electrocardiography, echocardiography, angiography, and endomyocardial biopsy findings are presented, and the pathogenesis of massive endocardial calcification is speculated upon. The interesting point is that the clinical history and manifestation of this patient suggests that endomyocardial fibrosis may occur in a benign form and long‐term survival may be expected.
The effects of beta‐adrenergic blocking agents on blood lipid levels
Authors: Wolinsky H. 
Published: February 2009

AbstractThis review examines the effects of beta‐adrenergic blocking agents on blood lipids. These agents have been effective in the treatment of angina and hypertension and in the reduction of recurrence of ischemic cardiac disease, such as myocardial infarction. Many beta blockers, however, have an adverse effect on blood lipids, especially by reducing high‐density lipoprotein (HDL) cholesterol and increasing triglycerides. One result is an unfavorable influence on the cholesterol ratio (expressed either as low‐density lipoprotein [LDL]/HDL or total cholesterol/HDL). These cholesterol parameters have been shown to have a strong influence on coronary heart disease (CHD) risk. Studies have shown that antihypertensive therapy has reduced the incidence of cerebrovascular disease but, in many instances, has not reduced the incidence of CHD. A hypothesis for this lesser effect on coronary disease is that antihypertensive agents may be adversely affecting blood lipids. Thus, while one major risk factor for CHD is reduced, another may be somewhat enhanced. Pharmacologic properties of some beta blockers such as peripheral alpha blockade (e.g., with labetalol) or intrinsic sympathomimetic activity (ISA) (e.g., with pindolol) may counteract some of these negative lipid effects. An investigational beta blocker, bevantolol, which will be marketed shortly in the United States, has been effective in antihypertensive therapy. Bevantolol has been shown to lower LDL cholesterol and not adversely affect HDL cholesterol; in this way, bevantolol favorably influences the serum lipoprotein profile. Whether this effect will have clinical significance remains to be seen.
Comparison of nitroglycerin‐tts and long‐acting nitroglycerin tablets in the treatment of angina pectoris: A double‐blind controlled study
Authors: Karlson B. W. , Henning R. 
Published: February 2009

AbstractA cohort of 99 patients with severe, stable angina pectoris participated in a 26‐week double‐blind, between‐patient trial of a transdermal therapeutic system (TTS) Nitroglycerin‐TTS 5 mg/24 h and long‐acting nitroglycerin tablets, 10.4 mg daily. The variables registered included daily sublingual nitroglycerin requirement, daily anginal attack rate, exercise test performance with ECG recordings, and a subjective patient evaluation on a visual analogue scale. There were no significant differences in the efficacy of the treatment between the two groups. Nor could we find any difference in the efficacy between the initial single‐blind placebo treatment and the active nitroglycerin treatments.
Echocardiographic findings in pannus ingrowth on an omniscience mitral prosthesis
Authors: Evangelista Masip A. , Bruguera Cortada J. , Serrat Serradell R. , Robles Castro A. 
Published: February 2009

AbstractSerial echocardiographic findings in a patient with an Omniscience mitral prosthesis presenting progressive perivalvular pannus ingrowth are described. The first echocardiographic study was carried out one year after prosthesis implantation and showed decreased prosthetic opening velocity. As prosthetic thrombosis was suspected, hemodynamic study was performed, which proved normal. The patient remained in functional grade II for a year and a half prior to the onset of progressive dyspnea and dizzy spells. Echocardiogram was thus repeated and revealed the presence of multiple dense echoes behind the prosthetic disc. Three months after this last study, the patient presented acute pulmonary edema and reduction of disc excursion and opening and closing velocities. Hemodynamic study suggested prosthetic obstruction. Surgery revealed the presence of perivalvular pannus trapping the prosthetic disc. The prosthesis was subsequently replaced by a Björk‐Sorin. This case emphasizes the usefulness of echocardiography in the early detection of perivalvular pannus ingrowth revealing prosthetic mobility anomalies, even before hemodynamic changes occur.
Analysis of ambulatory electrocardiograms in 14 patients who experienced sudden cardiac death during monitoring
Authors: Savage H. R. , Kissane J. Q. , Becher E. L. , Maddocks W. Q. , Murtaugh J. T. , Dizadji H. 
Published: February 2009

AbstractThe Holter monitors of 14 patients (out of 58,000 Holter recordings performed between 1978 and 1984) who experienced cardiac arrest and expired during the recording period were analyzed. Tachyarrhythmic arrest patients frequently had coronary heart disease, congestive heart failure, and prolonged QTc intervals. The highest incidence of intermediately frequent premature ventricular complexes (PVCs) occurred between 15 and 6 hours prior to death. The frequency of ventricular couplets increased toward the time of arrest. The hours with greatest frequency of ventricular tachycardia (VT) were found to be the last 5 hours of life. An increasing incidence of ST‐segment changes greater than 2 mm was noted throughout all of the risk periods until the third hour prior to arrest when the incidence diminished. Conversely, the incidence of lower amplitude ST‐segment changes (usually elevation) increased over the final 6 hours. The mean time of death was 0228 hours ± 5:20. In conclusion, we observed two patterns of Holter‐monitored changes which usually occurred prior to death and may represent predictors of sudden death: (1) an increasing incidence of intermediately frequent isolated PVCs followed by increased ventricular couplets and runs of VT; (2) return of high amplitude ST‐segment changes toward baseline. To our knowledge, the temporal relationship of the degree of ST‐segment deviation to sudden death and the time of sudden death have not been reported in large studies of Holter‐monitored sudden death patients.
Role of infarct expansion in rupture of the ventricular septum after acute myocardial infarction: A two‐dimensional echocardiographic study
Authors: Jugdutt B. I. , Michorowski B. L. 
Published: February 2009

AbstractTo verify the role of infarct expansion (IE) in ventricular septal rupture (VSR) after transmural acute myocardial infarction (TAMI), topographic parameters were measured using tomographic imaging with two‐dimensional echocardiography (2‐D echo) and computer‐aided analysis in four groups of patients: 8 patients with VSR (Group 1); 24 patients with TAMI but no mechanical complications (Group 2); 11 normal athletes (Group 3); 5 adults with congenital ventricular septal defect (Group 4). Measurements made on end‐diastolic outlines of mid‐left ventricular (LV) short‐axis images included: LV asynergy (akinesis and/or dyskinesis), expansion index (asynergy/nonasynergy‐containing endocardial segment length), thinning ratio (asynergic/nonasynergic wall thickness), and new indexes of regional shape distortion (RSD) by quantifying the deviation of the actual asynergic segment from the ideal asynergic arc constructed using the nearly circular nonasynergic contour. In Group 1, clinical IE (hypotension, congestive heart failure, no signs of new infarction) preceded detection of the VSR and portable 2‐D echo showed the VSR associated with LV asynergy, marked IE, and RSD. Although Groups 1 and 2 had similar LV asynergy (28.7 vs. 26.9% LV) and ejection fraction (38.9 vs. 41.8%), Group 1 had higher expansion index (1.50 vs. 1.17, p<0.05), lower thinning ratio (0.54 vs. 0.67, p<0.005), and higher RSD parameters (e.g., peak distortion, Pk or maximum radial distance from the ideal arc, 19.3 vs. 3.9 mm, p<0.01; area of distortion, Ad, 7.4 vs. 1.1 cm2, p<0.05) than Group 2. Groups 3 and 4 had normal regional and global function and no evidence of expansion, thinning, or RSD. Thus, IE with marked diastolic RSD on an early 2‐D echo after TAMI might identify patients at risk for VSR.
Comparison of arm and treadmill exercise at 85% predicted maximum heart rate
Authors: Coplan N. L. , Gleim G. W. , Scandura M. , Nicholas J. A. 
Published: February 2009

AbstractBoth treadmill exercise and arm exercise are used for evaluating coronary artery disease, but arm exercise has lower diagnostic sensitivity. We compared the two exercise modalities with respect to the rate‐pressure product at 85% predicted maximal heart rate, a parameter frequently used to denote performance of sufficient exercise to derive clinical conclusions. At this heart rate, treadmill exercise resulted in a significantly greater systemic oxygen consumption (2.7±.8 vs. 2.1±.6 l/min) and rate‐pressure product (30.6±4.4x103 vs. 28±3.3x103) than arm ergometry. An inability to generate sufficient imbalance of myocardial oxygen supply and demand may account for the relatively higher incidence of false negative exercise tests seen with arm ergometry, especially if the exercise test is stopped when the patient attains 85% predicted maximal heart rate.