bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative effects of pravastatin and lovastatin on nighttime sleep and daytime performance
Authors: Richardson Gary R. , Sullivan Jason P. , Lee Richard M. , Roth Thomas , Merlotti Lori , Roehrs Timothy 
Published: February 2009

AbstractPravastatin and lovastatin, two HMG‐CoA reductase inhibitors with similar cholesterol‐lowering effects, differ in their lipid solubility. The hydrophilic characteristics of pravastatin may explain why the drug has not been detected in cerebrospinal fluid. On the other hand, lovastatin, a lipophilic compound, has been detected in the cerebrospinal fluid. Previous reports have suggested that lovastatin administration may be associated with insomnia, which reflects an action in the central nervous system. The effects of the two drugs on nocturnal sleep and daytime performance in young, healthy men have been assessed in randomized, double‐blind, placebo‐controlled studies. Computer‐based performance tests were administered on two consecutive days before drug administration and at the end of a 3‐week active drug or placebo treatment period. Results from both sites were combined for analysis. Neither pravastatin nor lovastatin significantly affected nocturnal sleep or daytime sleepiness in this study population, but lovastatin significantly affected daytime performance. In subjects treated with lovastatin, the results showed that two measures of performance, divided attention (p<0.05) and vigilance (p<0.01), worsened significantly from baseline as did global performance (p<0.01). Performance was not affected in the pravastatin and placebo groups. These results provide preliminary evidence of an adverse effect of lovastatin on daytime performance.
Use of transesophageal echocardiography to visualize an anomalous right coronary artery arising from the left main coronary artery (single coronary artery)
Authors: Henson Kenneth D. , Geiser Edward A. , Billett Jeanette , Alexander James A. , Akins E. William , Bopitiya Chandana 
Published: February 2009

AbstractThis case report demonstrates a role for transesophageal echocardiography in defining the course of anomalous coronary arteries. Origin of the right coronary artery (RCA) from the left main (LM) (single coronary artery) is an exceedingly rare congenital anomaly. It is not always benign and may result in myocardial infarction. This may be due to compression between the aorta and the pulmonary artery. Transesophageal echocardiography offers a low‐risk, noninvasive means of imaging the proximal coronary arteries. In the majority of patients, the proximal segments of the three major coronaries can be clearly visualized. With the addition of color flow, it is possible to visualize flow in most patients. Proximal obstructive lesions can be seen in some patients although sensitivity thus far seems low.
Amlodipine combined with beta blockade for chronic angina: Results of a multicenter, placebo‐controlled, randomized double‐blind study
Authors: Dibianco Robert , Schoomaker Fred W. , Singh Jang B. , Awan Najam A. , Bennett Tyson , Canosa Frank L. , Kawanishi David T. , Bamrah Virinderjit S. , Glasser Stephen P. , Barry William 
Published: February 2009

AbstractAmlodipine, a potent long‐acting dihydropyridine calcium antagonist, was compared with placebo in a parallel, randomized, double‐blind study in 134 patients with chronic stable angina pectoris maintained on betaadrenergic blocking agents. After a single‐blind, two‐week placebo period, patients were randomized to receive either amlodipine (2.5, 5, and 10 mg) or placebo once daily for four weeks. The effects of amlodipine on maximal exercise time, work, time to angina onset, and subjective indices including angina frequency, nitroglycerin tablet consumption, and patient and investigator ratings were assessed. Each dose of amlodipine produced increases in exercise time and calculated total work accomplished compared to baseline. Improvements at 5 and 10 mg were significantly greater than placebo which produced no significant change (p<0.05). Qualitative improvements in the severity of angina were produced by amlodipine at 5 and 10 mg daily assessed by patient‐rating questionnaires (p<0.05). Reductions in angina frequency attacks per week and weekly nitroglycerin tablet consumption occurred but were not statistically significant when compared with placebo. Adverse effects observed during amlodipine treatment prompted discontinuation of treatment in only 2 out of 100 patients. Three patients discontinued treatment for reported lack of efficacy. No laboratory abnormalities prompted treatment discontinuation and minor side effects of dizziness, nausea, headache, and fatigue were observed infrequently. The results of this controlled, large‐scale multicenter trial suggest that amlodipine significantly increased exercise capacity and was well tolerated when added to the antianginal regimen of patients remaining symptomatic while receiving beta‐blocking agents.
Anatomy, histology, and pathology of coronary arteries: A review relevant to new interventional and imaging techniques—Part II
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. Part II of this four‐part review will focus on aging changes seen in the epicardial coronary arteries and will review selected features of atherosclerotic plaque, including fissure and topography.
The effects of beta blockade with (epanolol) and without (atenolol) intrinsic sympathomimetic activity in stable angina pectoris
Authors: Boberg Jonas , Larsen Flemming F. , Pehrsson S. Kenneth 
Published: February 2009

AbstractBeta blockade constitutes efficient therapy for stable angina pectoris. The effects of lowering blood pressure and heart rate with such treatment are not always desired. Epanolol is a beta1‐selective partial agonist with minor effects on blood pressure and heart rate at rest. Atenolol is a pure beta1‐selective antagonist with more pronounced effects on blood pressure and heart rate at rest. The effects of epanolol, 200 mg o.d., and atenolol, 100 mg o.d., were compared in 173 middle‐aged patients with stable angina pectoris in a randomized, double‐blind, parallel group‐controlled study for one year. No significant differences were shown in angina attack rate, nitrate consumption, or exercise performance. Resting heart rate and blood pressure were significantly lower on atenolol. Epanolol tended to be better tolerated than atenolol, as shown by visual analogue scales of well‐being, activity, energy, and warm extremities, further supported by fewer reports on possible adverse reactions. In conclusion, epanolol appears to be as effective as atenolol and better tolerated in patients with stable angina pectoris.
A case of neurofibromatosis associated with a coronary artery aneurysm and myocardial infarction
Authors: Daly Mel P. , Rubinstein Michael N. 
Published: February 2009

AbstractAneurysms of the aorta, vertebral arteries, carotid artery, thyrocervical trunk, and mesenteric and celiac arteries have been described in patients with neurofibromatosis. These aneurysms may have part of the vessel wall replaced by neurofibromatosis tissue. One previous case reports a coronary artery aneurysm in a patient with neurofibromatosis who suffered a myocardial infarction due to thrombosis formation within the aneurysm. We document a second case of aneurysmal dilatation of a coronary artery in a patient with neurofibromatosis. This patient also had a myocardial infarction in a vascular distribution not involved by the aneurysm. The vascular changes associated with neurofibromatosis are reviewed. Aneurysmal dilatation of the coronary arteries may be a further vascular manifestation of this condition.
A case of accessory mitral valve leaflet associated with solitary mitral cleft
Authors: Kanemoto Nariaki , Shiina Yutaka , Goto Yuichiro , Inamura Schunichi , Suzuki Ichiro , Koide Shirosaku , Shohtsu Akira 
Published: February 2009

AbstractAccessory mitral valve leaflet is a rare congenital anomaly.1–19 More than half of the cases show other congenital cardiac defects and almost all of the cases show subaortic obstruction.1–9,11–13,18,19 We report a case of an accessory mitral valve tissue without outflow obstruction associated with mitral cleft of the posterior mitral leaflet. To our knowledge, this is the first reported case of the combination of these two congenital anomalies.
Single moving dipole obtained from magnetic field of the heart in patients with left ventricular hypertrophy
Authors: Nomura Masahiro , Nakaya Yutaka , Miyoshi Yukiko , Wakatsuki Tetsuzo , Saito Ken , Bando Shigenobu , Ito Susumu , Nakayasu Kimiko 
Published: February 2009

AbstractMagnetocardiograms (MCGs) were recorded by means of a second‐derivative SQUID (superconducting quantum interference device) magnetometer in 20 normal subjects and 28 patients with left ventricular overload to analyze the activation sequence of the heart and amplitude of estimated current source. In the normal subjects, the dipole was directed to the left and gradually superiorly 40 ms after the beginning of the QRS wave mainly due to the activation of the left ventricle. In the patients with hypertension, the direction and location of the dipoles were similar to those of the normal subjects, but their dipole moments were increased. In the patients with mitral regurgitation, the dipoles of late QRS were directed more inferiorly than in the normal subjects and their amplitude was increased. In the patients with aortic valve disease, the amplitude of the dipoles was increased markedly and their location was deviated more to the left than the dipoles of the normal subjects. We established the criterion for diagnosis of LVO from the dipole moment of 50 ms of 3.13×10–3A or more. The sensitivity of this criterion is significantly higher in the diagnosis of left ventricular overload than the electrocardiogram (ECG). The present study shows that the moving dipole method is useful to determine the increased electromotive force in patients with left ventricular overload and that sensitivity in diagnosis of left ventricular overload is increased.
Delayed presentation of a mitral annular perforation complicating staphylococcus aureus infective endocarditis
Authors: Quigley Robert L. , Peter Robert H. , Lowe James E. 
Published: February 2009

AbstractThis report describes a patient who presented with congestive heart failure secondary to a mitral annular‐left atrial fistula. There was a remote history of Staphylococcus aureus endocarditis involving the mitral valve which was treated medically 30 years previously. The sterile fistula was managed surgically with an annuloplasty.
Recurrent myocardial infarction in a postpartum patient receiving bromocriptine
Authors: Eickman Francis Michael 
Published: February 2009

AbstractMyocardial infarction in puerperium is infrequently reported. Spasm, coronary dissection, or atheromatous etiology has been described. Bromocriptine has been implicated in several previous case reports of myocardial infarction in the puerperium. Our case (including an inadvertent rechallenge) suggests such a relationship. Although generally regarded as “safe,” possible serious cardiac effects of bromocriptine should be acknowledged.
Ventricular arrhythmias and the autonomic tone in patients with mitral valve prolapse
Authors: Śniez̊ek‐Maciejewska M. , Dubiel J. P. , Piwowarska W. , Mroczek‐Czernecka D. , Mazurek S. , Jaśkiewicz J. , Kitliński M. 
Published: February 2009

AbstractThe aim of this study was to evaluate a possible relation between the autonomic tone determined by daily urine catecholamine excretion and the incidence of ventricular arrhythmias (VA) in patients with mitral valve prolapse (MVP). The study included 53 patients (31 women and 22 men) aged 19–52 years (mean age 32.7). The diagnosis of MVP was based on medical history, physical examination, and echocardiography. Cardiac arrhythmias were detected by Holter monitoring and classified according to Lown grades. Daily heart rate and duration of corrected QT interval using Basett's formula were also analyzed. Daily urine adrenaline and noradrenaline levels were determined fluorometrically by Von Euler and Lishajko's method. The patients with Lown's grade III‐V VA were evaluated with particular consideration. Student's t‐test was used for statistical analysis. On Holter monitoring 26 patients showed VA, including 6 with grade I, 11 with grade II, 2 with grade III, 4 with grade IV, and 3 with grade V according to Lown's classification. The remaining 27 patients were free of cardiac arrhythmias. Mean daily heart rate ranged from 54–93 beats/min (73±8.44, mean±SD) and corrected QT from 336–494 ms (411±37.17). Daily adrenaline and noradrenaline excretion for the whole group of patients were 0.01–16.2 μg (2.1±2.38) and 1.6–31.0 μg (13.1±7.27), respectively, which was within normal range. However, the patients with serious ventricular arrhythmias showed significantly higher daily adrenaline excretion. Individual analysis of two‐thirds of patients with ventricular arrhythmias grade III‐V showed daily urine noradrenaline levels exceeding mean values for the whole group. Our results suggest that in patients with MVP and serious VA, increased autonomic tone may be of great importance.
Influence of serum potassium on the electrocardiographic pattern of left ventricular hypertrophy in primary hyperaldosteronism
Authors: Maciejewska M. , Dabrowska B. 
Published: February 2009

AbstractOnly a few studies deal with electrocardiographic (ECG) signs of left ventricular hypertrophy (LVH) in patients with primary hyperaldosteronism, although it may be presumed that many factors such as arterial hypertension, hypokalemia, increased blood volume, and decreased activity of the renin‐angiotensin system can modify LVH pattern in this entity. For that reason, we evaluated ECG signs of LVH in 55 patients with primary hyperaldosteronism hospitalized in our department from 1971 to 1990. These data were compared with age, serum potassium level, plasma renin activity (PRA) and—in 14 patients—with left ventricular mass, measured echocardiographically.We found inverse correlation between serum potassium concentration and the Sokolow‐Lyon index: SV1 + RV5/6 (r = –0.47, p<0.001). Among 24 patients with only abnormal QRS voltage, without ST‐T changes suggestive of LVH, 19 (79.2%) had hypokalemia. In multivariate analysis, potassium concentration was the single independent predictor of an abnormal QRS voltage: –0.743, p = 0.01 vs. 0.153 (age), –0.337 (PRA) and 0.454 (LV mass).Our observations suggest that hypokalemia is an important factor influencing an amplitude of QRS complexes and may be responsible for false‐positive LVH diagnosis.
A fast fourier transform analysis of coronary reperfusion‐induced ventricular fibrillation and the modification by dibutyryl cyclic amp in a cat model
Authors: Tashiro Noritami , Kumagai Kouichirou , Yamanouchi Yoshio , Matsuo Kunihiro , Hiroki Tadayuki , Arakawa Kikuo 
Published: February 2009

AbstractTo investigate the effect of dibutyryl cyclic AMP (dbcAMP) on ventricular fibrillation after coronary reperfusion, the proximal portion of the anterior descending branch of left coronary artery was reperfused 20 min after ligation in 24 cats. McFee X Y Z electrocardiograms were recorded and ventricular fibrillation was analyzed using a fast Fourier transform analysis (FFT). Ventricular fibrillation occurred in 20 of 24 cases. Sixty seconds after the occurrence of ventricular fibrillation, an intracardiac infusion of dbcAMP was administered. Nine of the 20 were defibrillated and converted to sinus rhythm or junctional rhythm after the administration of dbcAMP. The amplitude and frequency of the main power spectrum of the ventricular fibrillation waves were analyzed by FFT before and after the infusion of saline or dbcAMP. In the saline group there was no significant change in FFT. However, in the dbcAMP group, the amplitude increased significantly from 0.036±0.015 (MV∧2) to 0.054±0.013 (MV∧2) (p<0.01) and the frequency decreased significantly from 4.22± 1.37 (Hz) to 1.33±0.91 (Hz) (p<0.01). Those results indicate that dbcAMP increased the amplitude and decreased the frequency of the main power spectrum of ventricular fibrillation analyzed by FFT. These distinctive changes in FFT analysis were associated with defibrillation in 9 of 20 cases.
Embolus in transit
Authors: Thompson Richard , Slack John D. , Taliercio Charles P. , Waller Bruce 
Published: February 2009

AbstractSince the advent of echocardiography, embolus in transit, historically found during surgical exploration or on postmortem examination, has been found with increasing frequency on antemortem examination. There is an inherent high mortality rate with this condition and awareness of the association between deep venous thrombosis and embolus in transit is paramount. On echocardiography the embolus is typically seen as a pleomorphic mass moving in a tumbling fashion. The most frequent symptoms are dyspnea and near syncopal episodes. The most common signs are diastolic “tumor plop” and a systolic ejection murmur heard on auscultation. Despite the success of some medical interventions, surgery should be strongly considered in patients with embolus in transit.
Inotropic therapy of the failing myocardium
Authors: Om Anil , Hess Michael L. 
Published: February 2009

AbstractThe clinical syndrome of congestive heart failure remains a therapeutic dilemma and challenge for the physician in 1992. This is a disease process that appears to be increasing in frequency and continues to carry an unacceptably high mortality rate. For years it has been well recognized that the combination of digoxin, Lasix and vasodilator therapy improved symptoms in these patients and decreased hospitalization, but did not increase survival. It was not until 1986 that the combination of digoxin, Lasix, Isordil, and hydralazine was shown to increase survival. Further significant improvement in quality of life and survival has recently been established in three large clinical trials, and it is now safe to say that the standard of care for symptomatic congestive heart failure in 1992 is digoxin, furosemide, and an ACE inhibitor, with the survival trials favoring the ACE inhibitor enalapril. The IV inotropic drug dobutamine remains the mainstay of pharmacological therapy for the treatment of severely refractory heart failure. Unfortunately, the phosphodiesterase inhibitors—amrinone, milrinone, and enoximone—have demonstrated unacceptable clinical side effects and have been withdrawn from further clinical study. In spite of these promising developments, the mortality and morbidity of congestive heart failure remains unacceptably high, and continued investigation in the new fields of pharmacology and the pathophysiology of congestive heart failure still must be aggressively pursued.
Usefulness of ckmb and troponin t determinations in patients with acute myocardial infarction complicated by ventricular fibrillation
Authors: Zabel Markus , Köster Wolfgang , Hohnloser Stefan H. 
Published: February 2009

AbstractThe usefulness of creatine kinase (CK) time activity curves for diagnosis of acute myocardial infarction in patients who have been defibrillated for ventricular fibrillation is limited due to the release of the enzyme as a result of the countershock. The present study of four patients with acute infarction complicated by primary ventricular fibrillation indicates that analysis of CKMB and even more so of troponin T, a specific cardiac antigen, permits reliable diagnosis of acute myocardial infarction in this particular setting. Furthermore, the data indicate that noninvasive assessment of coronary artery patency may be also possible in these patients by means of these two serum markers.
Inadvertent thrombolytic therapy for cardiovascular diseases masquerading as acute coronary thrombosis
Authors: Kahn Joel K. 
Published: February 2009

AbstractWe report three cases of inadvertent thrombolytic administration to patients with cardiovascular diagnoses masquerading as acute coronary thrombosis presenting to a tertiary care private hospital. Despite a final diagnosis of myocarditis, aortic dissection, and pericarditis, the initial presentation and electrocardiogram were believed to indicate an acute myocardial infarction due to coronary thrombosis. Intravenous thrombolytic agents were administered early in their presentation. Cardiac catheterization in two of the patients revealed normal coronary arteriography and in the third patient confirmed an aortic dissection. The patient with an aortic dissection died while the other two recovered without adverse consequences of the thrombolytic agents. Prior reports of five patients, treated with intravenous thrombolytic agents for suspected coronary thrombosis, who proved to have a final diagnosis of pericarditis or aortic dissection are reviewed. Death or tamponade occurred in four of five. The consequences of inadvertently administering intravenous thrombolytic agents to patients with nonthrombotic cardiac disorders can be serious. If the diagnosis of acute myocardial infarction due to coronary thrombosis is uncertain, serial electrocardiograms, bedside echocardiography, or urgent cardiac catheterization may be appropriate before administering these agents.
Effect of oral captopril on premature ventricular complexes in patients with preserved left ventricular systolic function: A randomized clinical trial
Authors: Steinman Russell T. , Ghxey Deborah , Gunther Stephen , Fromm Barbara S. , Lehmann Michael H. 
Published: February 2009

AbstractSome studies have suggested that angiotensin‐converting enzyme (ACE) inhibition in patients with heart failure is associated with a decrease in frequency of spontaneous premature ventricular complexes (PVCs). It is not clear whether such a finding represents a primary effect of ACE inhibition or, instead, a secondary result of treatment of heart failure. For a primary drug effect to be present, PVC suppression during ACE inhibition should also occur in patients with preserved left ventricular systolic function. We therefore undertook a randomized double‐blind placebo‐controlled crossover clinical trial to assess the effect of oral captopril (50 mg. b. i. d.) on ventricular arrhythmia frequency in 11 patients with > 30 PVCs/h (during a 48‐h ambulatory recording) and a left ventricular ejection fraction of ≥ 45% (measured by radionuclide multigated acquisition scan). Pharmacologic activity of the administered drug was evidenced by an increase in median plasma renin activity to 2. 4 ng/AI/ml/h from a value of 1.1 ng/AI/ml/h during placebo (p = 0.001) and an 8.5 ± 10.3 drop in mean diastolic blood pressure during captopril versus placebo (p < 0.03).During captopril treatment, a mean of 491 ± 378 PVCs/h were observed compared with 389 ± 169 PVCs/h during placebo, a nonsignificant difference. There was also no significant change in left ventricular ejection fraction, plasma catecholamines, or serum potassium during captopril treatment. Thus, ACE inhibition in patients with preserved left ventricular systolic function fails to suppress ventricular ectopic activity. Extrapolated to patients with heart failure, our observations argue against a primary PVC suppressive action of ACE inhibitors but do not rule out possible secondary antiarrhythmic effects of these agents.