bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echocardiographic left ventricular wall thickness: A poor predictor of the severity of aortic valve stenosis
Authors: Griffith Michael J. , Carey Catherine M. , Christopher Byrne J. , John Coltart D. , Stephen Jenkins B. , Webb‐Peploe Michael M. 
Published: February 2009

AbstractEchocardiographic left ventricular hypertrophy is thought to be helpful in grading the severity of aortic stenosis. This study compared M‐mode echocardiographic left ventricular wall dimensions with Gorlin aortic valve area. Good quality echocardiograms were obtained in 294 patients with aortic stenosis who also underwent cardiac catheterization. Patients with grade 3 or 4 aortic regurgitation were excluded. The correlation was calculated between the aortic valve area and the left ventricular wall dimensions. Correlation coefficients were poor; r=0.13 for the septum, r=0.15 for the posterior wall, and r=0.17 for the mean wall dimension. Correlation was not improved significantly if patients with poor left ventricular function or systemic hypertension were excluded. Correlation with other hemodynamic parameters was better, peak left ventricular systolic pressure having r values of 0.36 and 0.30 for posterior wall and septum. Mean and peak aortic valve gradient had r values approaching 0.30 for both dimensions. If the peak gradient was included in multivariate analysis, the wall dimensions then had no predictive power for severity of aortic stenosis. This study demonstrates that the degree of left ventricular wall hypertrophy is not related to the severity of aortic outflow obstruction and therefore cannot be used to grade the severity of aortic stenosis.
Percutaneous balloon mitral valvuloplasty in rheumatic mitral stenosis: An experience of 50 patients in india
Authors: Shrivastava S. , Dev V. , Das G. , Rajani M. , Mukhopadhyaya S. 
Published: February 2009

AbstractWe attempted percutaneous balloon mitral valvuloplasty in 50 patients (27 female and 23 male, age 10–38 years) with rheumatic mitral stenosis. The procedure could be completed in 40 patients. The failures were caused by problems related to transseptal puncture in eight cases and inability to cross the mitral valve in two cases. Immediately after valvuloplasty there was a remarkable reduction in the mean pulmonary artery pressure, left atrial mean pressure, mean diastolic gradient across the mitral valve, and the calculated pulmonary vascular resistance. The calculated mitral valve area increased and the cardiac index increased marginally. Inadequate results with a post valvuloplasty mitral valve area of 0.9 cm2 were seen in only one patient. Repeat hemodynamic evaluation in 25 patients within two weeks of valvuloplasty showed persistent benefit in all except one patient, who showed partial restenosis. Follow‐up cardiac catheterization at 3–6 months in 13 patients showed evidence of restenosis (mitral valve area <1.0 cm2 and mean diastolic gradient of > 10 mmHg) in one patient, while all others maintained hemodynamic benefit. Repeat hemodynamic evaluation at 9–18 months after valvuloplasty in eight patients showed evidence of restenosis in an additional two cases. The patients in our series are young (28 patients <20 years), small body surface area (1.35–0.2 m2), and have high left atrial and pulmonary arterial pressures.
Pacing‐induced myocardial ischemia does not affect the endothelial release of coagulant and fibrinolytic factors into the coronary circulation
Authors: Gössinger H. D. , Siostrzonek P. , Jung M. , Mösslacher H. , Speiser W. , Kyrle P. A. , Heistinger M. , Lechner K. 
Published: February 2009

AbstractThe present study addresses the potential effects of pacing‐induced myocardial ischemia on the secretion of coagulant and fibrinolytic factors within the coronary circulation. In 6 patients undergoing programmed ventricular stimulation with repeated induction of clinical ventricular tachycardia, the coronary release of tissue‐type plasminogen activator (t‐PA) antigen, plasminogen activator inhibitor (PAI) capacity, von Willebrand factor antigen (WF: Ag), and prostacyclin (6‐keto‐PGF la) was measured. Blood samples were collected simultaneously from the ascending aorta and the coronary sinus at baseline and immediately after the induction of ventricular tachycardia. The occurrence of pacing‐induced myocardial ischemia was established by myocardial net lactate production. Myocardial ischemia was induced in every patient by repeated pacing trials. Pacing‐induced ischemia did not affect the coronary release of any of the above factors. Consequently, there was no alteration of transcardiac gradients of thrombin‐antithrombin complexes and D‐dimer. The present results indicate that pacing‐induced myocardial ischemia does not affect the release of coagulant and fibrinolytic endothelial factors or prostacyclin into the coronary circulation.
Lipomatous hamartoma of the tricuspid valve: Echocardiographic–pathologic correlations
Authors: Crotty Thomas B. , Edwards William D. , Oh, Jae K. , Rodeheffer Richard J. 
Published: February 2009

AbstractWe report the eighth example of a cardiac valvular hamartoma (five mitral, three tricuspid). An intracavitary right atrial mass was present in a 76‐year‐old man and was characterized echocardiographically by a mobile cystic structure involving the septal tricuspid leaflet. Microscopically, the affected leaflet was comprised predominantly of mature adipose tissue. Formation of a valvular windsock in this case was attributed to the chronic effect of right ventricular pressure on tissue that was weaker than a normal leaflet. Valvular hamartomas should be included in the differential diagnosis of lesions that produce prolapsing, cystic, or windsock malformations of atrioventricular valves.
Normalization of reverse redistribution of thallium‐201 with procainamide pretreatment in wolff‐parkinson‐white syndrome
Authors: Nii T. , Nakashima Y. , Nomoto J. , Hiroki T. , Arakawa K. , Ohshima F. 
Published: February 2009

AbstractStress thallium‐201 myocardial perfusion imaging was performed in a patient with Wolff‐Parkinson‐White syndrome. Reverse redistribution phenomenon was observed in the absence of coronary artery disease. This seems to be the first report of normalization of this phenomenon in association with reversion of accessory pathway to normal atrioventricular conduction after pretreatment with procainamide.
Echocardiographic diagnosis of an aortic root abscess after mycobacterium fortuitum prosthetic valve endocarditis
Authors: Chow W. H. , Leung W. H. , Tai Y. T. , Cheung K. L. , Lee W. T. 
Published: February 2009

AbstractA patient with an aortic root abscess complicating Mycobacterium fortuitum prosthetic endocarditis is described. The correct diagnosis had been made preoperatively by echocardiography and was confirmed subsequently at surgery.
Noise stimulus in normal subjects: Time‐dependent blood pressure pattern assessment
Authors: Germanó Giuseppe , Milito Umberto , Germanó Ugo , Giarrizzo Cesare , Santucci Anna , Damiani Silvio 
Published: February 2009

AbstractEnvironmental noise may have various effects on blood pressure. The aim of our study was to verify noise impact on blood pressure in normal young subjects, using the “white noise” stimulus. Thirty subjects (16 males and 14 females, median age 22 years) were studied. The presence of hypertension, hypertensive hereditibility and loss of acoustic acuity were criteria for exclusion. Noninvasive measurements of systolic and diastolic blood pressure at three‐minute intervals were performed with an oscillometric system (Omega 1000, In Vivo Research), for each of four phases of the trial. After an initial rest phase (9 min) to avoid the patient's “alarm reaction,” “white noise” with an intensity equal to 40, 100, and 40 adjusted decibels (dBa) was administered consecutively for 18 min (2nd phase), 9 min (3rd phase), and 18 min (4th phase), respectively. Preliminary analysis with standard statistical tools was not able to analyze the blood pressure patterns during the test. On the contrary, polygonal analysis, taking into account the “time‐dependent” changes, showed that noise exposure (100 dBa) significantly increased systolic blood pressure in 22/30 subjects. However, systolic blood pressure rose only at the beginning of the 100 dBa exposure, indicating that stimulus changes rather than noise are key provoking factors in blood pressure increases.
Noninvasive detection of the morphologic and hemodynamic changes during normal pregnancy
Authors: Vered Zvi , Mark Poler S. , Gibson Patrick , Wlody David , Pérez Julio E. 
Published: February 2009

AbstractTo characterize the morphologic and hemodynamic changes during normal pregnancy, serial echocardiographic measurements (n = 210) of left ventricular (LV) dimensions and mass (M‐mode), volumes and ejection fraction (two‐dimensional), stroke volume, and cardiac output (Doppler: aortic, apical, and suprasternal) were performed in 15 patients (mean age 30 years) beginning as early as 12 weeks of gestation, at 2‐week intervals through delivery, and up to 12 weeks postpartum. Left atrial size increased from 3.4±0.4 (SD) to 3.8±0.4 cm near term, decreasing to 3.4±0.5 cm postpartum (p=0.006 overall). LV mass changes correlated with increases in body weight. No consistent significant changes in LV volumes and ejection fraction were observed. LV outflow tract cross‐sectional area increased significantly from 3.0 ± 0.2 cm2 at baseline to 3.5 ± 0.3 cm2 near term, decreasing to 3.2 ± 0.3 cm2 postpartum (p>0.002 for both). Heart rate increased from 70 ± 7 to 77 ± 10 beats/min near term decreasing to baseline postpartum (p>0.02 for both). Accordingly, cardiac output increased significantly, as detected from both the apical and suprasternal positions averaging from 4.7 ± 0.6 to 6.5 ± 1.5 1/min near term, returning to 4.3 ± 0.61/min postpartum (p>0.0005 for both). Thus, in normal pregnancy, left atrial size increases significantly without significant changes in LV dimensions, volumes, and ejection fraction. Increased LV mass is related to increased body weight. Cardiac output changes result from increased heart rate and an increase in LV outflow area, which contributes to increased stroke volume. Doppler echocardiography permits accurate detection and timing of the morphologic and hemodynamic changes during normal pregnancy.
Rupture of the left ventricular free wall following mitral valve replacement for mitral stenosis: A cause of complete (fatal) or contained (false aneurysm) cardiac rupture
Authors: Waller Bruce F. , Taliercio Charles P. , Clark Michael , Pless John E. 
Published: February 2009

AbstractComplete or incomplete left ventricular free wall rupture is a known complication of mitral valve replacement. Complete free wall rupture may result in fatal bleeding, whereas imcomplete rupture may result in the formation of a pseudoaneurysm with survival possible. Two necropsy patients are described illustrating both of these complications. Proposed mechanisms for injury to the left ventricular free wall are reviewed.
Initial clinical results with the wiktor stent: A new balloon‐expandable coronary stent
Authors: Buchwald A. , Unterberg C. , Werner G. , Kreuzer H. , Wiegand V. , Voth E. 
Published: February 2009

AbstractThe Wiktor stent, a new coronary balloon‐expandable tantalum stent, was implanted in 17 patients for otherwise nonmanageable occlusion after balloon angioplasty (n=11) and for recurrent restenosis (n=6). Stents of 3.0 to 4.0 mm were implanted (right coronary artery: n=10, left anterior descending artery: n=4, left circumflex artery: n=2, venous graft: n=1). All patients were fully anticoagulated initially with heparin followed by Coumadin for 3 months and were treated with acetylsalicylic acid indefinitely. Due to its good radiopacity, the device could be placed easily without complications. Early occlusion occurred in one patient after 8 h probably due to friable atheromatous material prolapsing between the meshes of the stent. Late occlusion occurred in another patient who was admitted in cardiogenic shock after prehospital reanimation and was stented after occlusive dissection following balloon angioplasty of an occluded right coronary artery. In this patient with severe hypoxic brain damage, reocclusion and reinfarction to which the patient finally succumbed occurred following cessation of anticoagulation. Histology demonstrated occlusive thrombosis without evidence of a neointimal covering of the stent. Another thrombotic occlusion due to inadvertent omission of anticoagulation occurred in another patient two weeks after stenting. Control angiography after 6 months in 12 patients revealed restenosis in two patients (50% and 80%). The patient with 80% restenosis of the right coronary artery and pathologic results during stress testing underwent surgical revascularization. The other patient with a 50% restenosis of the right coronary artery was managed medically as he was asymptomatic and without evidence of ischemia during stress testing. We conclude that, due to its good radiopacity, this new stent is technically easy to implant. Restenosis rate probably lies in the range of other devices. Anticoagulation before development of a neointimal covering is necessary to prevent reocclusion.
Hemodynamic and neuroendocrine response to acute administration of the phosphodiesterase inhibitor BM 14.478 in patients with congestive heart failure
Authors: Rauch Bernhard , Zimmermann Rainer , Kapp Michael , Haass Markus , Von Molitor Stephen , Neumann Franz Josef , Kübler Wolfgang , Dietz Rainer , Tillmanns Harold , Smolarz Adalbert 
Published: February 2009

Abstract: The benzimidazol analogue BM 14.478 is a phosphodiesterase inhibitor with both vasodilator and positive inotropic properties. Hemodynamic parameters and plasma hormone levels of 8 patients (1 female, 7 male) with chronic congestive heart failure NYHA Classes II‐IV (1 patient with coronary artery disease, 7 patients with primary dilated cardiomyopathy) were assessed before and until 6 h after the intravenous application of 1.0 mg BM 14.478. There was a significant decrease of mean pulmonary artery pressure (28±11 vs. 23±11 mmHg; p>0.05), mean right atrial pressure (8.6±5.2 vs. 5.0±4.7 mmHg; p>0.02), and systemic vascular resistance (1651±484 vs. 1206±252 dynes$$s$$cm–5; p>0.05) as early as 10 min after injection of BM 14.478. Pulmonary vascular resistance also was reduced (128±86 vs. 61±39 dynes$$s$$cm–5, 30 min after injection; p>0.02). Simultaneously there was a significant increase of cardiac index (2.3±0.7 vs. 3.1±0.8 1$$min–5$$m–2, 10 min after injection; p>0.02), and stroke volume index (28.8±11.7 vs. 33.9±8.5 ml$$min–1$$m–2; 30 min after injection; p>0.05). Although mean heart rate did not change significantly, some patients reacted with a transient increase. There was also a slight but insignificant increase of the double product. No serious side effects were observed.The hemodynamic improvement was followed by a delayed reduction of plasma levels of epinephrine (51±20 vs. 41±21 pg/ml; p>0.02; 30 min after injection) and atrial natriuretic peptide (229±283 vs. 121±168 pg/ml; p>0.05; 1 h after injection). Mean levels of plasma norepinephrine, however, did not change significantly and individual responses showed large variations, which could not be predicted by the behavior of the hemodynamic parameters. Three of eight patients (2 of these with elevated baseline filling pressures) even showed a marked increase of plasma norepinephrine levels after BM 14.478. Response of plasma renin activity and plasma vasopressin levels to BM 14.478 also was heterogeneous.According to the results of this study, acute administration of the phosphodiesterase inhibitor BM 14.478 has an immediate beneficial hemodynamic effect in patients with severe congestive heart failure by reducing both preload and afterload, and by increasing cardiac index and stroke volume. However, this improvement of hemodynamic parameters is not necessarily accompanied by a favorable short‐term response of plasma hormones, and therefore does not allow any conclusions on survival of these patients.
Progression of cardiac disease in emery‐dreifuss muscular dystrophy
Authors: Bialer Martin G. , Mcdaniel Nancy L. , Kelly Thaddeus E. 
Published: February 2009

AbstractEmery‐Dreifuss muscular dystrophy (EDMD) is a rare X‐linked muscular dystrophy characterized by early contractures, progressive muscle weakness, and atrial arrhythmias. Recent reports suggest that there may be additional cardiac problems in affected males and that carrier females may also show ECG abnormalities. We restudied two large families with EDMD in order to determine the extent of these problems. We examined 10 affected males and interviewed 2 others. The 3 affected males less than 20 years old had no ECG changes. All affected men of 35 years or older had arrhythmias. One had more severe arrhythmias when asleep, indicating the usefulness of continuous 24‐h ECG monitoring in the evaluation of males affected with EDMD. Two required pacemakers, 4 had already had a pacemaker placed, and 4 other affected men with pacemakers had died prior to this study. One affected man with a pacemaker developed ventricular bigeminy and another developed congestive heart failure. Thus of 10 affected males with pacemakers, 6 had additional cardiac symptoms and 4 have died. Males with EDMD may survive longer with a ventricular pacemaker, but this may increase the likelihood that they will develop cardiomyopathy and ventricular arrhythmias. Of 34 carrier females examined, 6 had arrhythmias typical of EDMD. Two required a pacemaker. The risk of arrhythmia increased with age. Results from one family should be extrapolated to another with caution, as there appears to be significant interfamilial variation. We suggest careful cardiologic follow‐up of EDMD patients and regular cardiac evaluations for older carrier females.
Prolonged qt interval: A marker of sudden infant death syndrome?
Authors: Perticone Francesco , Ceravolo Roberto , Mattioli Pier Luigi 
Published: February 2009

AbstractA prospective electrocardiographic study was performed in 1830 newborns to evaluate the predictive value of QT interval for sudden infant death syndrome (SIDS). Standard ECG, with babies asleep, was recorded at the ages of 4 days, 2, 4, 6 months, and 1 year. The QTc (±SD) was 392±22 at 4 days, 410±16 (p>0.0001) at 2 months (n=1256), 404±16 at 4 months (n= 1015), 400±16 at 6 months (n=895), and 398±15 at 1 year (n=890). QTc values longer than the mean plus 3 standard deviations were considered prolonged. Heart rate values (beats/min) were 138±19 at 4 days, 141±13 at 2 months, 134±13 at 4 months, 133±13 at 6 months, and 128±14 at 1 year. In 34 babies the QT interval was prolonged (mean + 3SD) and 3 of these died suddenly: the first, at 3 months (QTc = 470 and HR = 147 at 4 days); the second after 7 weeks (QTc = 514, HR = 115); the third at 3 months (QTc = 464 and HR = 140 at 4 days).
Is surgery for ventricular tachycardia too risky?
Authors: Van Hemel Norbert M. , Camm A. J. 
Published: February 2009

AbstractThere is strong evidence that recurrent symptomatic ventricular tachycardia (VT) after acute myocardial infarction is associated with a poor prognosis (1‐year mortality varying from 12% to 54%). When successive drug trials fail to suppress VT, cardiac surgery is considered but its therapeutical value appears disputable. Recent studies show inhospital mortality after surgery varying from 5% to 23%, and the 5‐year actuarial survival ranging from 33% to 71%. However, using the quality of the residual left ventricular function as criterion for operability, our recent inhospital mortality diminished to 1.3%, while the 4‐year actuarial survival was 85%. Arrhythmia freedom without drugs after 4 years after surgery is nowadays about 75%. These findings show that cardiac surgery might be a very acceptable alternative therapy in surgical candidates, in particular when one or more risk factors become apparent after acute myocardial infarction. This article describes the current position of arrhythmia surgery in relation to drug therapy and the implantable automatic defibrillator.
Diagnosis of recurrent left ventricular pseudoaneurysm by echocardiography with color flow imaging
Authors: Lasorda David M. , Dianzumba Sinda B. , Casaday Floyd M. , Joyner Claude R. 
Published: February 2009

AbstractLeft ventricular pseudoaneurysms are a rare complication of myocardial rupture. The diagnosis is paramount because of the propensity of pseudoaneurysms to rupture. Color flow imaging has been reported to be an aid in the diagnosis of pseudoaneurysms. We recently studied a patient with a myocardial infarction who developed a left ventricular pseudoaneurysm. Diagnosis was made by two‐dimensional imaging with color flow imaging. He subsequently had a repair procedure with a gortex graft. One week after repair, repeat echocardiography with color flow imaging showed flow into the aneurysmal sac at multiple sites, consistent with recurrence of the pseudoaneurysm. Echocardiography with color flow imaging provides a safe noninvasive diagnostic tool for evaluating pseudoaneurysms preoperatively and in assessing the competency of the repair postoperatively.
Acute myocardial infarction after simultaneous thrombosis in normal right and left coronary arteries
Authors: Serrano Carlos V. , Ramires José A. F. , Gebara Otavio C. , Cesar Luiz A. M. , Lage Silvia 
Published: February 2009

AbstractA 32‐year‐old male patient with clinical and electrocardiographic evidence of acute myocardial infarction underwent coronary angiographic study. We observed nonocclusive thrombosis simultaneously in right and left anterior descending coronary arteries, without confirmation of spasm or obstructive artery disease in other coronary branches. Documentation of coronary thrombosis in more than one artery is rare, and its pathophysiology is still unknown. With the advent of thrombolytic therapy and immediate coronary angiographic studies in patients with evolving myocardial infarction, it has been possible to confirm the presence of thrombus and the type of coronary disease. In this case, we observed total lysis of both thrombi and the final aspect of “normal” angiographically reperfused coronary arteries.
The Monophasic Action Potential in Clinical Cardiology
Authors: Patterson Eugenii , Jackman Warren M. , Scherlag Benjamin J. , Lazzara Ralph , Camm A. John 
Published: February 2009

AbstractSummary: For more than 30 years, the monophasic action potential has been used as an experimental tool for the study of myocardial repolarization. With recent improvements in catheter design, the utility of the tool as a means to identify the bases for ventricular arrhythmias in humans has been greatly improved. Abnormalities of repolarization leading to ventricular arrhythmia formation can be identified and specific pharmacologic therapies may be evaluated. Further evaluation of the technique by cardiac electrophysiologists may improve both the diagnosis and the treatment of ventricular arrhythmias dependent upon afterdepolarization formation (acquired and familial long QT syndromes).