bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congestive heart failure in a patient with systemic hypertension
Authors: Hackel Donald B. , Wagner Galen S. 
Published: February 2009

AbstractA 70‐year‐old man developed hypertension many years previously and had a bout with severe congestive heart failure 4 to 5 years before his death. Autopsy showed congestion and edema characteristic of heart failure, an enlarged heart, and slight focal interstitial left ventricular fibrosis, but only slight to moderate coronary atherosclerosis.
Abnormal signal‐averaged electrocardiogram in patients with duchenne muscular dystrophy: Comparison of time and frequency domain analyses from the signal‐averaged electrocardiogram
Authors: Kubo Masahiro , Matsuoka Suguru , Hayabuchi Yasunobu , Akita Hiroshi , Kuroda Yasuhiro , Matsuka Yutaka 
Published: February 2009

AbstractThe clinical significance of an abnormal signal‐averaged electrocardiogram (SA‐ECG) in time‐ and frequency‐domain analyses was assessed in patients with Duchenne muscular dystrophy (DMD). Twenty‐four DMD patients and 20 age‐matched healthy volunteers were studied. The SA‐ECG was recorded by time‐domain signal processing using the vector‐magnitude method and frequency‐domain signal processing using the fast‐Fourier transform. Abnormal SA‐ECGs were based on comparison with controls and eight abnormal SA‐ECGs were detected among 24 DMD patients, seven by frequency‐domain analysis and four by time‐domain analysis. The end‐diastolic left ventricular volume was larger in the patients with abnormal SA‐ECG than in those with normal SA‐ECG (136±32 ml vs. 77±43 ml, p<0.01). Compared with patients with normal SA‐ECGs, the DMD patients with abnormal SA‐ECGs had a lower left ventricular (LV) ejection fraction (54±6 vs. 61 ± 8%, p < 0.05), as an index of LV contractility, and less LV posterior wall velocity (46±9 mm/min vs. 62 ± 16 mm/min, p <0.01), as an index of LV relaxation. The sensitivity and specificity of frequency‐domain analysis for predicting malignant ventricular arrhythmias was 60 and 85%, respectively, compared with 30 and 92%, respectively, for time‐domain analysis. The combination of time‐ and frequency‐domain analyses can facilitate identification of DMD patients with ventricular tachyarrhythmias associated with depression of cardiac performance.
A clinical trial evaluating the 24‐hour effects of bisoprolol/hydrochlorothiazide 5 mg/6.25 mg combination in patients with mild to moderate hypertension
Authors: Lewin A. J. , Lueg M. C. , Targum Shari , Cardenas Pamela 
Published: February 2009

AbstractThis study used 24‐h ambulatory blood pressure (BP) monitoring to investigate the effectiveness of a novel low‐dose combination of bisoprolol/hydrochlorothiazide in adult patients with mild to moderate essential hypertension. Thirty‐six patients with stable mild to moderate hypertension (sitting diastolic BP 95–114 mmHg) after a placebo run‐in phase received oral bisoprolol/hydrochlorothiazide 5 mg/6.25 mg once daily for 4 weeks in a single‐blind regimen. At office visits, BP and pulse were measured with statistically significant reductions (p<0.01) recorded after 2 and 4 weeks of treatment Twenty‐four‐h ambulatory BP monitoring at the completion of therapy revealed significant reductions (p<0.01) in both systolic and diastolic 24‐h, daytime, and nighttime BP, compared with the end of the placebo treatment phase. Systolic and diastolic load were also reduced (p<0.01). The combination was well tolerated, and overall quality‐of‐life questionnaire scores indicated an improvement after bisoprolol/hydrochlorothiazide therapy (p = 0.02). No clinically significant changes from baseline in laboratory parameters were observed; in particular, serum potassium was unchanged. This is the first study to demonstrate the 24‐h effectiveness of the bisoprolol/hydrochlorothiazide 5 mg/6.25 mg combination, using 24‐h ambulatory BP monitoring. In addition, antihypertensive therapy with low doses of bisoprolol/hydrochlorothiazide in combination may improve tolerability.
Traumatic rupture of an aortic ulcerative atherosclerotic plaque producing aortic dissection: A complication of interscapular back blows used to dislodge objects from the esophagus
Authors: Patterson David L. , Brennan Shawn , Cartwright Thomas , Jolly Walter , Adlam James H. , Waller Bruce F. 
Published: February 2009

AbstractPenetrating atherosclerotic ulcer of the aorta is a rare entity which usually occurs in the descending thoracic aorta. Herein, we report an unusual case of penetrating aortic ulcer which ruptured into the mediastinum. Interscapular back blows were performed on our patient in an attempt to dislodge an aspirin which she thought was lodged in her esophagus. Unlike previously reported cases of this entity, the penetrating aortic ulcer in our patient was located in the distal thoracic asending aorta. Diagnosis of penetrating aortic ulcer can be made by utilizing aortography, contiguous dynamic contrast‐enhanced computed tomography or magnetic resonance imaging. Treatment consists of adjunctive medical therapy until surgery can be performed.
Successful delivery following myocardial ischemia during the second trimester of pregnancy
Authors: Shalev Yoseph , Epstein Menashe , Ayzenberg Oded , Caspi Abraham , Ben‐Hur Herzl , Hagay Zion , Blickstein Isaac , Gelven Alan 
Published: February 2009

AbstractAcute myocardial infarction during pregnancy is considered to be associated with approximately 50% mortality of both mother and fetus. However, there are not enough data regarding the role of acute myocardial ischemia. We present a 36‐year‐old, pregnant, white female who was admitted twice at 18 and 20 weeks of gestation with acute myocardial ischemia. Cardiac catheterization revealed 70–80% stenosis of the mid left anterior descending artery (LAD) with normal antegrade flow and very good retrograde filling of the LAD from distal collaterals of the right coronary artery. Therefore, due to angiographic suggestion of protected LAD territory, we recommended medical therapy and scheduled a vaginal delivery that was successfully completed without cardiovascular complications. A stress thallium test performed 6 months later was normal, supporting our clinical judgment. In conclusion, every case of a pregnant woman with coronary insufficiency should be treated according to individual coronary anatomy and blood supply to the territory of the diseased artery, and should not be based on the old data in the literature. The decision for revascularization prior to delivery versus medical therapy, or Caesarean section versus natural delivery, should be made by a team of a cardiologist and an obstetrician.
Magnesium and the heart: Antiarrhythmic therapy with magnesium
Authors: Fazekas Tamás , Scherlag Benjamin J. , Vos Marc , Wellens Hein J. J. , Lazzara Ralph 
Published: February 2009

AbstractMagnesium is an essential transmembrane and intracellular modulator of the electrical activity of cardiac cells. This review provides an up‐to‐date consideration of the cellular and clinical electrophysiological role of magnesium. This ubiquitous element seems to be important from both the theoretical and clinical point of view, because magnesium salts (MgSO4, MgCl2) administered intravenously are particularly effective in those arrhythmias in which the mechanism involves early or delayed afterdepolarization‐induced triggered activity. The authors share the view that I. V. magnesium is the drug of choice in “torsade de pointes” ventricular tachycardia accompanying acquired long QT/QTU syndrome. It is a complementary therapeutic agent in digitalis‐induced tachycardias. Further studies are needed to elucidate magnesium's mode of action and efficacy in other types of clinical tachyarrhythmias.
Different pressure gradients can be produced in a fixed stenosis— an in vitro study
Authors: Chiang Hung‐Ting , Lin Shoa‐Lin , Hwang Daw‐Yang , Wang Shih‐Pu , Chang Mau‐Song 
Published: February 2009

AbstractAn in vitro study was conducted, using a stenotic model to demonstrate that different pressure gradients can be produced by the same degree of valvular stenosis. This model is comprised of two cylindric chambers with a diaphragm in the center which had a small central hole. An injector was connected to one end of the prestenotic chamber to produce a steady pulsed flow. A rubber tube was connected to the other end of the poststenotic chamber and led upward to a large reservoir which provided a constant afterload pressure. Two pressure transducers were attached to the two connecting tubes, both linked with two pigtail catheters which were accommodated in the chambers just before and after the stenotic diaphragm. Two sets of injection volumes (20 and 30 ml) and multiple injections with different flow rates (5, 10, 15,…49 ml/s) were administered and resulting pressures measured by the two transducers were recorded. Results showed that different pressure gradients could be produced using the same injection volume, the same afterload, and the same degree of stenosis. The greater the flow rate, the higher the pressure gradient. Good correlation existed between the pressure gradient and the injection flow rate (r = 0.95 and 0.97 for the study groups receiving 20 and 30 ml injection volumes, respectively; p< 0.001 in all comparisons). Thus, a higher pressure gradient may not necessarily indicate a severe degree of valvular stenosis. Evaluation of a stenotic lesion should not be made from the degree of pressure gradient alone—other hemodynamic conditions should also be taken into account.
Quantification of left‐side intracardiac pressures and gradients using mitral and aortic regurgitant velocities by simultaneous left and right catheterization and continuous‐wave doppler echocardiography
Authors: Ge Zhi‐Ming , Zhang Yun , Fan Dong‐Sheng , Zhang Mei , Fan Jue‐Xin , Zhao Yu‐Xia 
Published: February 2009

AbstractNoninvasive determination of left‐side intracardiac pressures is of clinical importance in many cardiac diseases. To test the reliability and accuracy of left‐side intracardiac pressure measurements by continuous‐wave Doppler echocardiography, using left‐side valvular regurgitations, 47 patients with mitral regurgitation, with or without associated aortic regurgitation, underwent simultaneous Doppler and left and right catheterization. Doppler‐derived left atrial and ventricular end‐diastolic pressures were respectively estimated by subtracting mitral regurgitant gradient from systolic blood pressure and by diastolic blood pressure minus aortic regurgitant gradient. There were high correlations of mitral (r = 0.961) and aortic regurgitant gradients (r = 0.896) and of left atrial (r = 0.945) and ventricular end‐diastolic pressures (r=0.854) between noninvasive and invasive measurements. Also, agreement analyses showed that there was close agreement between the two technical measurements for each parameter. The present study concluded that continuous‐wave Doppler echocardiography provides a reliable and accurate method for the noninvasive evaluation of left‐side intracardiac pressures and gradients in patients with mitral and aortic regurgitations.
Myocarditis as a complication in scleroderma patients with myositis
Authors: Kerr Leslie Dubin , Spiera Harry 
Published: February 2009

AbstractThis report describes six diffuse scleroderma (PSS) patients with skeletal muscle myositis accompanied by severe myocarditis, diagnosed by CPK‐MB elevation in conjunction with severe left ventricular (LV) hypokinesis. Although the myositis improved with steroid therapy in all patients, those treated with steroids alone died due to progressive LV failure. This experience suggests that the LV dysfunction in PSS patients with myositis may have an inflammatory component. Since the myocarditis may not be clinically apparent initially, it is suggested that CPK‐MB fractionation and studies of LV function are undertaken in all PSS patients with myositis. The optimal treatment of this disorder, however, has yet to be determined.
Anomalous origin of the circumflex coronary artery from the right sinus of valsalva as a cause of ischemia at old age
Authors: Rozenman Yoseph , Schechter David , Gilon Dan , Gotsman Mervyn S. 
Published: February 2009

AbstractThe case of a patient with an anomalous origin of the circumflex coronary artery causing myocardial ischemia and infarction is presented. Even though the anomalous artery was not located between aorta and pulmonary artery, this anomaly, which is usually considered benign, was responsible for the ischemic symptoms. Transesophageal echocardiographic study demonstrated an acute angulation at the proximal portion of this abnormal vessel, very close to its origin from the right coronary sinus, which we believe caused the abnormality in coronary flow in this patient.
I‐123 metaiodobenzylguanidine—thallium‐201 mismatch following myocardial infarction
Authors: Lekakis John , Antoniou Anna , Vassilopoulos Nicos , Tsinikas Dimitrios , Palaistides Christos , Kostamis Panos , Moulopoulos Spyridon 
Published: February 2009

AbstractExperimental data show that myocardial infarction (MI) results in regional depletion of myocardial cathecholamines more extensively than necrosis. To investigate the extent of adrenergic denervation post MI in humans, we examined 16 patients, 59 ± 12 years old, with recent (7‐12 days) MI. Resting thallium‐201 (201Tl) single photon emission computerized tomography (SPECT) imaging was performed to assess necrosis; metaiodobenzylguanidine I123 (MIBG) SPECT was used to evaluate adrenergic denervation. 201Tl and I123 MIBG defects were evaluated quantitatively using polar maps, and differences in defects were expressed as percent of total polar map. in all patients, I123 MIBG defect was larger than 201Tl defect, and difference ranged from 19 to 61 % (39.5 ± 13.2%). Thrombolysis and age > 60 did not influence the difference. Anterior MI showed larger differences (44± 13 vs. 32± 11 %, p < 0.05); patients with ischemic electrocardiographic (ECG) changes in leads without abnormal Q waves had larger differences (45 ± 9 vs. 33 ± 14%, p< 0.05). It was concluded that (a) patients with recent MI present denervation larger than 201Tl perfusion defect, and (b) patients with anterior MI and ischemic ECG changes present a larger area of denervation.
Termination of pacemaker‐mediated tachycardia by adenosine
Authors: Conti Jamie B. , Curtis Anne B. , Hill James A. , Raymenants Erwin R. 
Published: February 2009

AbstractA 30‐year‐old woman was referred for follow‐up right‐ and left‐heart catheterization 4 years after cardiac transplantation. She had an implanted epicardial pacemaker for bradycardia; this was programmed to the DDD mode. At the time of her catheterization, as a pigtail catheter was pulled back across the aortic valve, runs of premature ventricular complexes occurred and tachycardia with ventricular pacing spikes and ventricular capture was initiated at a rate of 126 beats/min. Adenosine 6 mg was given intravenously through a femoral venous sheath and within 20 s the tachycardia broke. The tachycardia was consistent with pacemaker‐mediated tachycardia (PMT), a circus movement tachycardia occurring when ventricular pacing causes retrograde atrial depolarization followed by triggering of ventricular pacing. With reprogramming of the pacemaker to an AV delay of 160 ms and a postventricular atrial refractory period of 300 ms, no further episodes of PMT have occurred. This case illustrates that intravenous adenosine can effectively terminate PMT by causing ventriculoatrial block, thus interrupting the reentrant circuit by eliminating retrograde atrial activation.
High frequency qrs electrocardiography in the detection of reperfusion following thrombolytic therapy
Authors: Aversano Thomas , Rudikoff Bari , Washington Antonio , Traill Saskia , Coombs Vicki , Raqueno Judith 
Published: February 2009

AbstractThe hypothesis that an increase in the amplitude (root‐mean‐square voltage) of the high frequency (150‐250 Hz) components of the QRS complex occurs with successful reperfusion following thrombolytic therapy in acute myocardial infarction (AMI) and fails to occur when thrombolysis fails was tested. Clinical markers for successful or failed reperfusion following thrombolytic therapy for AMI are notoriously insensitive. The amplitude of the high‐frequency components of the QRS complex decreases during ischemia and returns to normal with resolution of ischemia, but neither the variability in measurement of these potentials nor their patterns of change during the course of AMI have been described. In 32 control subjects, the average coefficient of variation for the amplitude of the highfrequency QRS complex was 10% or 0.3 uV. Based on these data, for the acute infarction population a significant change in this measurement was therefore defined as a change in amplitude > 20% or 0.6 uV on two consecutive recordings. In 30 patients with AMI treated with a thrombolytic agent, either cardiac catheterization, serial serum myoglobin, or complete resolution of ST‐segment elevation were used to define successful or failed reperfusion. High‐frequency QRS electrocardiograms were obtained at the start of treatment with a thrombolytic agent and for 3 h thereafter using a signal‐averaging technique and digital filtering. Standard 12‐lead electrocardiograms were obtained at the same time. In patients who reperfused successfully, the high‐frequency QRS amplitude increased significantly (1.2 ± 0.9 uV above its nadir at 83 ± 36 min after initiation of thrombolytic therapy) in 23 of 25 patients. In contrast, the highfrequency QRS amplitude did not change or declined in all five patients who failed to reperfuse (‐0.4 ± 0.4 uV, p < 0.05 compared with successful reperfusion). Traditional clinical markers such as resolution of chest pain and ST‐segment elevation failed to distinguish successful and failed reperfusion. High‐frequency QRS electrocardiography is a rapid, reliable bedside technique for discriminating between successful and failed reperfusion in patients treated with thrombolytic agents for AMI.
A case of trichosporon beigelii endocarditis 8 years after aortic valve replacement
Authors: Sidarous Michael G. , O'Reilly Michael V. , Cherubim Charles E. 
Published: February 2009

AbstractWe report a case of Trichosporon beigelii endocarditis in a 77‐year‐old diabetic man who presented with an embolic stroke 8 years ago after a porcine aortic valve replacement. He was treated successfully with amphotericin, rifampin, and replacement of the original porcine valve; however, he died suddenly 8 months later from unknown causes. Blood cultures 2 months prior to death were negative. The first manifestation of the endocarditis was a left hemiparesis followed some days later by a splenic infarction. Transthoracic echocardiography failed to demonstrate the aortic vegetation, which was clearly visualized subsequently by transesophageal echocardiography. The literature on Trichosporon beigelii endocarditis is reviewed.
Idiopathic dilated cardiomyopathy
Authors: Hackel Andrea J. , Wagner Galen , Hackel Donald B. 
Published: February 2009

AbstractA 43‐year‐old man had a 9‐year history of congestive heart failure manifested by an enlarged heart and symptoms of shortness of breath and chest discomfort. Heart failure had been preceded by a “viral illness” and he had been a heavy alcohol user until that time. Autopsy showed congestion and edema characteristic of heart failure and cardiomegaly with biventricular dilatation. Either viral or alcoholic disease, or both, could have been the cause of the cardiac problems.
The osborn wave of hypothermeia in normothermic patients
Authors: Patel Archana , Getsos John P. , Moussa Ghias , Damato Anthony N, 
Published: February 2009

AbstractThe Osborn wave (also referred to as “the J wave,” “the J deflection,” or “the camel's hump”) is a distinctive deflection occurring at the QRS‐ST junction of approximately 80% of hypothermic patients (core body temperature ≤95°F). Generally, the amplitude and duration of Osborn waves are inversely related to core temperature. We report on eight normothermic patients whose 12‐lead electrocardiograms demonstrated QRS‐ST junction notches similar to those seen in hypothermia. These data support the concept that the Osborn wave is not pathognomonic of hypothermia.
Response to upright exercise after cardiac transplantation
Authors: Martin Timothy W. , Gaucher Jay , Pupa Lawrence E. , Seaworth John F. 
Published: February 2009

AbstractThere is little information on the hemodynamic response to upright exercise in patients who have undergone cardiac transplantation. We compared the hemodynamic and metabolic response to upright bicycle exercise in 11 patients with heart transplants and 12 controls. Patients performed two tests—a steady‐state test with a right heart catheter and a maximal incremental test. During steady‐state exercise at 20% of their predicted maximum workload, patients with heart transplants had a higher (mean ± SD, p < 0.05) heart rate (108 ± 11 vs. % ± 15 beats/min), mean systemic blood pressure (116 ± 17 vs. 101 ± 11 mmHg), mean pulmonary artery pressure (29 ± 9 vs. 22 ± 3 mmHg), mean pulmonary wedge pressure (14 ± 6 vs. 9 ± 2), pulmonary (302 ± 101 vs. 220 ± 50 d‐sec‐cm−5 ‐ m2) and systemic (2049 ± 531 vs. 1459 ± 520) resistance indices, and lactate concentration (3.4 ± 1.7 vs. 1.7 ± 0.4 mmol/1), and a lower stroke index (39 ± 8 vs. 50 ± 8 ml/m2) compared with controls. Cardiac index, right atrial pressure, and mixed venous oxygen saturation were similar. During the maximal exercise test, patients with heart transplants achieved a significantly lower percentage of predicted maximum heart rate (77 ± 13 vs. 91 ± 8%), workload (70 ±25 vs. 102 ± 23%), oxygen consumption (63 ± 11 vs. 108 ± 19%), and ventilation (67 ± 18 vs. 89 ± 15%) compared with controls. Heart transplant patients also had a lower blood pressure and anaerobic threshold. We conclude that heart transplant patients have an altered hemodynamic and metabolic response to upright bicycle exercise.
The differential diagnosis on the electrocardiogram between ventricular tachycardia and preexcited tachycardia
Authors: Steurer Günter , Gürsoy Sinan , Frey Berhaerd , Simonis Frank , Andries Eric , Brugada Pedro , Kuck Karl 
Published: February 2009

AbstractThe 12‐lead surface electrocardiogram is a simple and useful tool for the differential diagnosis of regular wide QRS complex tachycardia. However, criteria do not as yet exist to discriminate between ventricular tachycardia and supraventricular tachycardia with anterograde conduction over an accessory pathway (preexcited tachycardia). Therefore, we designed a new stepwise approach with three criteria for the electrocardiographic differential diagnosis between ventricular tachycardia and preexcited tachycardia and prospectively studied 267 regular tachycardias with electrophysiologically proven mechanism and a wide QRS complex (≥ 0.12 s): 149 consecutive ventricular tachycardias and 118 consecutive preexcited regular tachycardias. Underlying heart disease was old myocardial infarction in 133 of 149 (89%) ventricular tachycardias. The patients presenting with preexcited tachycardia had no additional structural heart disease. Atrial fibrillation with preexcited QRS complex was not included. The criteria favoring ventricular tachycardia were: (1) presence of predominantly negative QRS complexes in the precordial leads V4 to V6, (2) presence of a QR complex in one or more of the precordial leads V2 to V6, and (3) AV relation different from 1:1 (more QRS complexes than P waves). The final sensitivity and specificity of these three consecutive steps to diagnose ventricular tachycardia were 0.75 and 1.00, respectively. This new stepwise approach is sensitive and highly specific for the differential diagnosis between ventricular tachycardia in coronary artery disease and preexcited regular tachycardia.