bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nifedipine infusion in acute myocardial infarction: Experience in twelve patients
Authors: Heagerty A. M. , Bing R. F. , Pohl J. E. F. , Walley T. J. , Woods K. L. , Barnett D. B. 
Published: February 2009

AbstractStudies of nifedipine have not shown that it reduces myocardial infarct size in humans. These studies did not consider the pharmacokinetics and dynamics of nifedipine. Oral doses of nifedipine cause high plasma concentrations and possibly harmful hemodynamic changes. Intravenous nifedipine infusion can rapidly achieve and maintain a steady concentration without repeated hemodynamic upsets. We studied 24‐h intravenous nifedipine infusion in 12 patients with acute myocardial infarct, starting within 6 (mean 4.0±0.7) h of onset of pain, to determine its safety, pharmacokinetics, and dynamics. An intravenous nifedipine bolus of 15 μg/kg was followed by an infusion of 0.9 mg/h for 24 h. After the bolus, pulse rate rose 12.5±8.0 p<0.01) and blood pressure fell (systolic by 20±34, p<0.05, and diastolic by 7.5±15.6, p<0.05). There were similar but lesser changes during the infusion. Myocardial oxygen requirements, as measured by the rate‐pressure product, did not increase. The mean nifedipine concentration at steady state was 17.2±4.2 ng/ml and mean elimination T1/2 3.57±2.70 h. Nifedipine was discontinued in 3 patients because of hypotension (SBP<90), rapid atrial fibrillation, and complete heart block in one patient each. Seven patients developed thrombophlebitis. Large studies of this preparation examining infarct size limitation and mortality are feasible, although in view of the problems of thrombophlebitis in peripheral veins, shorter infusion times or infusion via central lines would be more acceptable.
Effect of ibopamine on the failing heart at rest and during isometric exercise: A noninvasive study
Authors: Partanen J. , NIEMINEN M. S. , Lehto H. 
Published: February 2009

AbstractEleven patients suffering from heart failure were treated with oral ibopamine, a di‐isobutyric ester of N‐methyldopamine, 100 mg three times a day for 1 week and 200 mg three times a day for 3 weeks. Therapy was discontinued by one patient because of tachycardia. Left ventricular performance was evaluated with echocardiography and systolic time intervals at rest and after 3 minutes of isometric exercise using a handgrip. Six of 10 patients completing the study were in New York Heart Association (NYHA) functional class III, 2 in class IV, and 2 in class II. All patients, except one who remained stable in class II, improved their subjective condition by one functional class during 4 weeks of therapy (p<0.01). There were no changes in heart rate, blood pressure, rate‐pressure product, cardiac index, or total peripheral vascular resistance. The left ventricular end‐systolic diameter decreased after four weeks from 71.2±12.7 (SD) to 65.9±13.0 mm (p<0.001); the left ventricular end‐diastolic diameter did not change. The ejection fraction increased from 26±8 to 32±9% (p<0.01). Afterload, that is, left ventricular circumferential systolic wall stress, declined as a result of decreased systolic diameter. Systolic time intervals did not vary. There were no changes due to ibopamine during isometric exercise probably owing to increased beta‐adrenergic stimulation induced by the handgrip. Neither urine volume nor body weight changed. Side effects were mild except for tachycardia of one patient. It is suggested that ibopamine improves the performance of the compromised left ventricle and that it may be of value in therapy for patients with heart failure.
Exercise stress test in young hypertensive patients. response to vasodilators (prazosin) vs. beta‐blocker (atenolol) agents
Authors: Gascón J. V. Gimeno , De Ros J. Olague , REIG J. Ferrer , Martinez M. Hernandez , Siscar P. Bordes , Flores J. Serra , Catala G. Estruch , Vidal F. J. Algarra 
Published: February 2009

AbstractDynamic response of arterial blood pressure during exercise has been studied in 40 normotensive young subjects and 20 mild hypertensive young patients (20–40 years of age). Hypertensive patients were treated with atenolol (beta blocker) and prazosin (vasodilator). Both groups underwent maximal exercise stress test. A double‐blind nonrandomized study was practiced in hypertensive patients with placebo, prazosin (3 mg/12 h), and atenolol (100 mg/24 h). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and exercise duration (ED) were analyzed. All parameters remained stable in both groups. The hypertensive patients showed an increase in maximum SBP more than 230 mmHg during the placebo phase. This same group showed a significant increase in HR at rest two hours after administration of prazosin. Atenolol produced a significant reduction in HR both during rest and exercise. Both drugs produced a significant decrease in SBP and DBP (at rest and exercise). We conclude that exercise test is a noninvasive procedure that could distinguish mild arterial hypertension. The dynamic changes of arterial blood pressure can be controlled with prazosin (3 mg/12 h) or 1 daily intake of 100 mg atenolol.
Is localization of acute myocardial infarction time related?
Authors: Stoupel E. , Shimshoni M. , Agmon J. 
Published: February 2009

AbstractA total of 1744 patients admitted to the ICCU with acute myocardial infarction (AMI) were studied in 1462 consecutive days (1982–1986). The aim of the study was to check whether the localization of the AMI was time related. Anterior (anterolateral) (AW) (n=834) versus inferior‐posterior (inferolateral) (IPW) (n=823) AMI were compared: a third group with isolated lateral wall (LW) AMI (n=87) was included in the study. Significant differences between monthly AMI localizations were registered, but no rhythmicity (monthly, seasonal) was found. A small absolute prevalence of AW localizations was found in all four seasons, but monthly differences made those differences not statistically significant. Some significant correlation (p<0.01) was found between AW AMI domination and daily geomagnetic activity (GMA level I‐IV). Only on days with low (quiet) levels of GMA were there more IPW AMIs. Adverse relationship was seen with LW AMI, relatively benign in AMI, was adversely correlated with GMA level (p<0.01). Differences in AW/IPW and left/right coronary artery autonomic receptors distribution and flow regulation and/or changes in cardiovascular homeostasis/coagulation, aggregation, viscosity, microcirculation, and so on connected with AMI expansion may be involved in these differences of AMI localization.
An infant with suspected right ventricular dysplasia presenting unique ventriculograms
Authors: Matsuoka Y. , Kawaguchi K. , Okishima T. , Hayakawa K. 
Published: February 2009

AbstractAngiocardiography was performed twice in a male infant at ten days after birth due to cyanosis during crying and at 4 years and 10 months of age for close examination of the heart prior to an operation for cerebral abscess. Outpouchings resembling multiple diverticula were observed in both ventricles, though more notably in the right ventricle, as well as slight enlargement and reduced ejection fraction of both ventricles. Evaluation of oxygen saturation indicated right‐to‐left shunt at the atrial level. Electrocardiography suggested a marked superior axis deviation, and chest roentgenography and two‐dimensional echocardiography revealed enlargement of the right atrium and right ventricle. Soon after the examinations, the patient died suddenly during sleep at home. Since autopsy was not performed, a definitive diagnosis could not be made, but right ventricular dysplasia appeared likely. The unique angiocardiographic findings and clinical course of this rare patient are described.
Comparative use of cold blood potassium cardioplegia in coronary bypass patients necessitating long (2.5–6 h) versus short (< 1.5 h) aortic cross‐clamp times
Authors: SOMMERHAUG R. G. , WOLFE S. F. , REID D. A. , LINDSEY D. E. , PRATO S. J. , FROUNFELKNER L. E. , DEROCHER R.A. 
Published: February 2009

AbstractIn symptomatic patients with severe diffuse multivessel coronary disease undergoing bypass surgery, complete revascularization with multiple bypass grafts using saphenous vein and internal mammary conduits, and multiple endarterectomies may be necessary. Such complex surgeries may require long aortic cross‐clamp times in excess of 2.5 h. To evaluate the myocardial preservation provided by cold potassium blood cardioplegia, two groups of consecutive patients using nearly similar surgical techniques were compared. Group A consisted of 100 patients who received an average of 3.8 grafts per patient and had a mean aortic cross‐clamp time of 66 (range 15‐90) min. Group B was comprised of 100 patients who received an average of 9.3 grafts per patient and had a mean cross‐clamp time of 187 (range 150‐351) min. Operative mortality and perioperative myocardial infarction were low (0‐2%) and were not significantly different between the groups. In addition, the postoperative creatine kinase‐MB isoenzyme levels, use of pharmacologic and/or mechanical (i.e., intra‐aortic balloon) support, and follow‐up exercise treadmill tests were not significantly different in the two groups. These findings suggest that cold potassium blood cardioplegia is equally protective of the myocardium during surgical revascularization in patients with short aortic cross‐clamp times (less than 1.5 h) as in those with severe diffuse multivessel coronary artery disease requiring long cross‐clamp times exceeding 2.5 h and up to 6 h.
Severe aortic stenosis in systemic lupus erythematosus and mucopolysaccharidosis type II (hunter's syndrome)
Authors: Zimmermann B. , Lally E. V. , Sharma S. C. , Schoen F. J. , Kaplan S. R. 
Published: February 2009

AbstractCardiac manifestations of the mucopolysaccharidoses often include valvular regurgitation, but stenotic lesions are quite rare. This report describes a 30‐year‐old man with mucopolysaccharidosis type II (Hunter's syndrome) and systemic lupus erythematosus who developed severe progressive aortic stenosis and died. Autopsy examination revealed evidence of various cardiac mucopolysaccharide disease including valvular leaflets thickened and distorted with fibrocalcific nodules. A brief review of previously reported valvular disease in Hunter's syndrome and other mucopolysaccharidoses is presented. This is also the first report of a patient with both systemic lupus and a mucopolysaccharidosis.
The effect of oral diltiazem on left ventricular performance in postinfarction patients
Authors: Boström P.‐Å. , Lilja B. , Johansson B. W. , Meier K. 
Published: February 2009

AbstractThe purpose of the present study was to evaluate the effect of diltiazem on the left ventricular function in postinfarction patients. Twelve patients without cardiac decompensation at rest began diltiazem therapy beginning 3 months after an acute myocardial Q‐wave infarction. Oral diltiazem was administered on the first day in a single dose (120 mg) and the following 2 weeks in a 60 mg three times a day (tid) regimen. The therapeutic effect was studied by isotope angiocardiography at rest using equilibrium measurements with technetium‐99m. Acute as well as continuous treatment improved left ventricular function in terms of increased synergy of the contraction (decreased phase deviation from a median of 20.0° to median of 12.4° and 13.0°, respectively, p<0.01) and increased ejection fraction from a median of 46% to a median of 50% and 51%, respectively, p<0.05. It is suggested that the improvement of left ventricular function may be due in part to decreased pressure rate product. This improved left ventricular function during diltiazem treatment may explain the improved prognosis induced by diltiazem in postinfarction patients.
Relation between serum digoxin concentration and the electrocardiogram
Authors: Saner H. E. , Lange H. W. , Pierach C. A. , Aeppli D. M. 
Published: February 2009

AbstractThe relation between serum digoxin concentration and the electrocardiogram was assessed by correlating computerized measurements of electrocardiographic parameters (PR, QRS, QT and QTc intervals, ST segment, and T‐wave amplitude) with the serum digoxin concentration in 97 patients on digoxin maintenance therapy and in 40 nondigitalized control subjects. None of the patients had unstable ischemic heart disease, electrolyte disorders, medication known to influence the ST segment, and/or the presence of a bundle‐branch block or ventricular hypertrophy. We found a trend toward lengthened PR interval and shortened QT and QTc intervals in digitalized versus nondigitalized patients. Increasing serum digoxin concentrations were associated with progressive depression of the ST segment and decreased T‐wave amplitude (p<0.001). A normal ST segment in four leads (I, aVF, V5, V6) excluded the presence of a serum digoxin concentration > 1.3 ng/ml in our patients, whereas severe ST‐segment depression with aJpoint of > 100 m̈V was a strong indicator for the presence of a serum digoxin concentration >2.0 ng/ml in our selected patient population (specificity 99%, sensitivity 30%, predictive accuracy 85%). We conclude that computerized electrocardiographic analysis of the ST segment may provide clinically useful information for the management of selected patients on digitalis therapy and may therefore increase the diagnostic yield of the electrocardiogram in predicting the presence of higher serum digoxin concentrations in a small but significant percentage of patients.
Evaluation of left ventricular contractile performance from baseline stress‐shortening data in humans: comparison with pharmacological afterload challenge
Authors: Hausdorf G. , Rettig T. , Keck E. W. 
Published: February 2009

AbstractThe purpose of this study was to evaluate whether the baseline stress‐shortening data reflect the contractile state adequately and give results comparable to the evaluation of the end‐systolic stress‐shortening relationships using pharmacological manipulation of afterload. Five groups were studied (total 152 patients): a control group of 30 healthy volunteers, 32 patients after surgical correction of infantile tetralogy of Fallot, 50 patients treated for childhood malignancies with doxorubicin, 17 patients with left ventricular hypertrophy due to systemic hypertension, and 23 patients with congestive cardiomyopathy. In all patients except those with congestive cardiomyopathy, afterload was altered pharmacologically to evaluate the individual stress‐shortening relationship. In all patients the baseline stress‐shortening data were evaluated, as well as their relative positions to two predefined normal ranges for the relationship between end‐systolic stress and shortening. Additionally, a slope value was calculated from the baseline data of the five groups studied and compared with the data obtained by pharmacological afterload increment. Our data show that the comparison of individual baseline data of end‐systolic wall stress and fractional shortening with predefined normal ranges for the relationship between end‐systolic stress and shortening is inadequate. The appropriate normal range to compare with is the 95% confidence interval of baseline stress‐shortening data in normal subjects. Also the calculation of a slope value from the baseline stress‐shortening data of a group of patients seems to be inappropriate. Such a slope value does not necessarily reflect the contractile state, as the specific conditions leading to variations of end‐systolic wall stress are undefined and not standardized, and the correlation between baseline stress‐shortening data depends largely on the influence of the end‐systolic dimension on both parameters.
A system approach to intravenous thrombolysis in acute myocardial infarction in community hospitals: The influence of paramedics
Authors: Hartmann J. , Mckeever L. , Bufalino V. , Marek J. , Brown A. , Goodwin M. , Colandrea M. , Stamato N. , Cahill J. , Amirparviz F. 
Published: February 2009

AbstractDuring a 3‐year period, intravenous streptokinase (IV STK) was given to 110 consecutive patients ages 34–78 in the course of acute myocardial infarction (AMI) in three community hospitals served by the same paramedic system. 1.5 million units of IV STK was given over 30 minutes. Half of the patients were brought to the hospital by paramedics. The average time from onset of pain to administration of IV STK was 107 minutes in the paramedic group and 182 minutes for the others. Of 110 patients, 98 (89%) showed clinical evidence of reperfusion and 94 of 106 patients (89%) showed angiographic reperfusion. Angiography was performed from 1 to 10 days post‐AMI. Mean time to angiography was 6 days for the first 58 patients and 2 days for the last 52 patients. In‐hospital mortality was 2 of 110 patients and there was 1 late death at 8 months for an overall 3‐year mortality 2.7%. Of 86 patients, 83 (96%) working before their infarct are working now. Of 107 survivors, 96 (90%) are Functional Class I. Conclusions: (1) IV STK is safely administered in a high percentage of AMI patients. (2) IV STK is safely administered in community hospitals. (3) Paramedics act as an early warning system and allow for earlier treatment than patients presenting without paramedic involvement. (4) Successful coronary reperfusion with IV STK results in low mortality rates and minimizes functional disability. (5) A systemwide approach to reducing time to treatment in AMI may be the most influential factor in affecting morbidity and mortality.
Morphologic correlates of coronary angiographic patterns at the site of percutaneous transluminal coronary angioplasty
Authors: Waller B. F. 
Published: February 2009

AbstractOver the last 10 years considerable interest has been paid in the angiographic recognition of successful percutaneous transluminal coronary artery angioplasty (PTCA), complication of the technique, and angiographic predictors of restenosis. This report summarizes various angiographic patterns visualized at the site of angioplasty and correlates these patterns with morphologic findings. Of 66 patients undergoing PTCA for chronic or unstable angina pectoris, 76 PTCA sites were available for analysis. The two most common angiographic patterns at the angioplasty site (intimal flap=43%, intraluminal haziness=38%) correlated morphologically with intimal‐medial splits with localized dissections (79%). Shallow, superficial intimal lesions, laminated thrombus, and adventitial tears accounted for the remaining morphologic changes. Eight PTCA sites without morphologic injury corresponded to smooth wall changes and spasm at angiography.
Hemodynamic effects of intravenously administered magnesium on patients with ischemic heart disease
Authors: Rasmussen H. S. , Larsen O. G. , Meier K. , Larsen J. 
Published: February 2009

AbstractCentral hemodynamic parameters were registered by right‐side heart catheterization before and after intravenous administration of 12 mmol magnesium chloride (MgCl) in 15 patients with chronic ischemic heart disease and heart failure, New York Heart Association classes II and III. Serum magnesium concentrations increased from 0.76±0.03 (mean ± SD) to 1.54±0.05 mmol/1, which resulted in a reduction in mean arterial as well as pulmonary artery pressure by 10% (p<0.0001) and 7% (p<0.05), respectively. This reduction was caused by a marked decrease in systemic as well as pulmonary vascular resistance (from 1323 ±205 to 1132 ± 158 dyn•s/cm5, p<0.001 and from 156±73 to 133±72 dyn•s/cm5 (p<0.05). Heart rate, cardiac index, stroke volume index, and stroke work index increased slightly, although these differences did not reach statistical significance. Right and left ventricular filling pressures were not influenced, which indicates that the dilatory effect of magnesium, at the dosages used in the present study, is pronounced only at the arterial side of the vascular bed. The observed hemodynamic effects of the magnesium infusions may be beneficial in the setting of an acute myocardial infarction by reducing left ventricular afterload, which, together with the antiarrhythmic effect of magnesium may contribute to the positive effect of magnesium infusions on mortality in patients with acute myocardial infarction.
Heart rate, pr, and qt intervals in normal children: A 24‐hour holter monitoring study
Authors: Romano M. , Clarizia M. , Onofrio E. , Caiazzo M. R. , Adinolfi L. , Cutillo S. , Chiariello M. , Condorelli M. 
Published: February 2009

AbstractA dynamic electrocardiographic Holter monitoring study was performed in 32 healthy children (20 males and 12 females, age range 6–11 years old), without heart disease, according to clinical and noninvasive instrumental examination. We evaluated atrioventricular conduction time (PR), heart rate (HR), and QT interval patterns defining the range of normality of these electrocardiographic parameters. The PR interval ranged from 154± 10 ms (mean±SD) for HR≤60 to 102±12 ms for HR ≥ 120 (range 85–180). The absolute mean HR was 87 ± 10 beats/min (range 72–104), the minimum observed HR being 61 ± 10 (range 51–79), the maximum 160±20 beats/min (range 129–186). Daytime mean HR gave a mean value of 93 ± 10 (range 71–148), while during night hours it was 74 ± 11 (range 54–98). The minimum QT interval averaged 261 ± 10 ms for HR> 120 and the maximum 389 ± 9 ms for HR ≤ 60; the corresponding mean value of QTc (i.e., QT corrected for HR) ranged from 388 ±8 for HR≤60 beats/min to 403 ±14 ms for HR> 120 beats/min. The results of the present study provide data of normal children which can be readily compared against those of subjects in whom cardiac abnormalities are suspect or patent. Some of the data reported here differ from those currently available, as for PR and HR, obtained from standard resting electrocardiogram, and cast doubt on the usefulness of correcting for HR in the QT interval in these subjects.
Septal rupture: Effect of oxygen administration
Authors: Hollander G. , Horowitz J. , Greengart A. , Shani J. , Lichstein E. 
Published: February 2009

AbstractA patient with interventricular septal rupture as a complication of myocardial infarction was studied to determine whether varying the concentration of inspired oxygen would alter the magnitude of intracardiac shunt. A significant correlation was found showing that high concentration of inspired oxygen results in increased left to right shunting probably due to systemic vasoconstriction and pulmonary vasodilatation.
Unusual electrocardiogram in hypertrophic cardiomyopathy
Authors: Teplitsky I. , Wurzel M. , Aygen M. 
Published: February 2009

AbstractElectrocardiographic criteria of right ventricular hypertrophy were found in a 17‐year‐old male with nonobstructive hypertrophic cardiomyopathy involving the left ventricle. Right ventricular hypertrophy pattern is a rare electrocardiographic abnormality in patients with hypertrophic cardiomyopathy and the presence of Q waves in leads V5‐V6 could be helpful in differentiating this syndrome from true right ventricular hypertrophy.