bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiarrhythmic and proarrhythmic properties of diazepam demonstrated by electrophysiological study in humans
Authors: Kumagai Koichiro , Yamanouchi Yoshio , Matsuo Kunihiro , Tashiro Noritami , Hiroki Tadayuki , Arakawa Kikuo 
Published: February 2009

AbstractWe evaluated the electrophysiological parameters before and after the intravenous infusion of diazepam (0.2 mg/kg) in 20 cardiac patients to investigate the drug's antiarrhythmic effect. Diazepam did not significantly change the arterial pressure. After the intravenous infusion of diazepam, the sinus cycle length significantly shortened from 847±132 to 747±155 ms (p>0.01). No significant change in the maximal sinus node recovery time was noted. The AH interval at the atrial pacing length of 600 ms shortened significantly from 140±40 to 127±39 ms (p>0.05). However, there was no significant change after the administration of diazepam in the longest atrial pacing rate associated with Wenckebach conduction in the atrioventricular (AV) node, effective and functional refractory periods of the AV node, HV interval, and QRS width during ventricular pacing at the cycle length of 600 ms. The atrial and ventricular effective refractory periods remained unchanged after the administration of diazepam. Six of the eight patients who showed dual AV nodal refractory period curves in the control study did not demonstrate them after diazepam administration by increasing the atrial or AV node effective refractory period. Thus, diazepam showed significant electrophysiological effects of the heart including shortening of the sinus cycle length, improvement in AV node conduction, and no significant effect on the His‐Purkinje or intraventricular conduction and refractoriness of the atrium, AV node and ventricle. On the other hand, diazepam may influence the inducibility of supraventricular reentrant tachycardia incorporating the AV node.
Malignant myxoid emboli as the presenting feature of primary sarcoma of the aorta (myxoid malignant fibrous histiocytoma): A case report and review of the literature
Authors: Tejada Eduardo , Becker Gary J. , Waller Bruce F. , Waller Bruce 
Published: February 2009

AbstractPrimary sarcomas of the aorta are rare vascular tumors. About 26 cases have been reported between 1973 and 1989. They are seldom diagnosed antemortem. The present report describes a patient with a myxoid malignant fibrous histiocytoma arising in the intima of the lower thoracic aorta, which was diagnosed premortem in metastatic peripheral emboli. The clinical and pathologic features of this patient along with a summary of the 29 primary aortic tumors previously reported (26 malignant and 3 benign) are discussed. Although few of these tumors have been described histologically as benign, all of them behave as malignant tumors.
Diffuse Embolization Following Percutaneous Transluminal Coronary Angioplasty of Occluded Vein Grafts: The Blush Phenomenon
Authors: Margolis James R. , Mehta Sameer , Chen Cheng‐Yun , Krauthamer Dan , Mogensen Lars 
Published: February 2009

AbstractSummary: Percutaneous transluminal coronary angioplasty (PTCA) was performed on 146 saphenous vein grafts in 116 patients. In 29 patients, 31 grafts were totally occluded. Myocardial staining lasting over 5 minutes—“the blush phenomenon”—followed the opening of the occluded grafts in 9 of these patients. In 5 of these 9, enzyme release suggested infarction. A sixth patient died within a few hours of PTCA, with suspected infarction. Autopsy demonstrated diffuse and extensive distal coronary arterial embolization of grumous material, including cholesterol crystals, platelets, and fibrin. The blush phenomenon was not seen following PTCA in the remaining 20 patients with total occlusions, nor in any of the 87 patients with stenosed grafts. We have not observed the blush phenomenon following PTCA of more than 3300 coronary arteries. Of the 9 patients demonstrating the blush phenomenon, 6 had a recent history of myocardial infarction or unstable angina pectoris, compared with 4 of the remaining 20 patients with occluded grafts. We now approach occluded grafts with injection of intragraft thrombolytic agents or with atherectomy prior to PTCA. Future approaches may include atherectomy or laser angioplasty.
Prazosin in Chronic Congestive Heart Failure Due to Ischemic Heart Disease
Authors: Antani J. A. , Antani Nirmal J. , Nanivadekar A. S. 
Published: February 2009

AbstractSummary: Oral prazosin hydrocholoride (2–20 mg/day) was administered to 38 patients with chronic congestive heart failure due to ischemic heart disease for 6–18 months. Half (19) of the patients were hypertensive and half (19) nonhypertensive. All were receiving furosemide (80 mg/day, orally) and 19 were receiving digoxin (0.25–0.5 mg/day, orally) in addition to prazosin. Clinical radiological, mechanocardiographic, echocardiographic, and biochemical observations were made initially, at peak response, and at the end of 6 months. Prazosin improved left ventricular function indexes at rest, relieved symptoms and signs of congestion, and remained effective for 6–18 months with little or no increase in dose. There was no reflex tachycardia, tension‐time indexes fell in all patients, angina was relieved in 8 patients who complained of it, and dyskinesia of left ventricular wall was corrected in 8 of 13 patients. The New York Heart Association functional class improved in all patients, but to a greater extent in hypertensive patients and in those not receiving concomitant digoxin. Mild, transient side effects occurred in 6 patients.
Outpatient Cardiac Catheterization: A Report of 3,000 Cases
Authors: Clements Stephen D. , Gatlin Sara 
Published: February 2009

AbstractSummary: A total of 3000 patients have had cardiac catheterization in the Andreas Gruentzig Cardiovascular Laboratory of the Emory Clinic. The purpose of this presentation is to describe the patient population selected for this procedure and our experience with this group. The concept of catheterization as an outpatient is attractive from the standpoint of cost savings and time conservation. Safety has been questioned. We have found that this technique can be performed safely in carefully selected outpatients. Careful selection attempted to eliminate those with unstable symptoms, recent myocardial infarction, severe diabetes, and renal failure. Small catheters were used to minimize the potential for bleeding. Excellent opacification of vessels was obtained with these catheters. Despite careful screening we found 2.2% had significant left main obstruction, 10.8% had triple‐vessel disease, 16.0% had double‐vessel disease, and 23.5% had single‐vessel disease, and a similar percentage had normal coronary arteriograms. Our patients experienced ventricular fibrillation on five occasions, there were two small cerebral emboli with reversible neurologic defects, two episodes of pulmonary edema, and two episodes of severe allergic reactions. Only three patients had significant groin bleeding at home that required compression of the site. We subsequently did angioplasty on 323 patients, performed cardiac surgery (mostly coronary bypass) on 187 patients, and admitted 18.2% of the entire group. We conclude that this procedure can be done safely in this carefully designed setting and it saves time and offers cost savings. Patient selection is very important to minimize potential emergency situations and complications. The laboratory must be carefully set up and provide a close relationship with a hospital capable of attending to any unexpected emergency.
The atrioventricular plane displacement as a means of evaluating left ventricular systolic function in acute myocardial infarction
Authors: Alam Mahbubul 
Published: February 2009

AbstractDisplacement of the atrioventricular (AV) plane toward the cardiac apex in systole was studied quantitatively by echocardiography in 37 patients with first‐time acute myocardial infarction (MI) in order to evaluate left ventricular systolic function. The amplitude of AV plane displacement was recorded from the apex at four different sites corresponding to the septal, lateral, anterior, and posterior walls of the left ventricle from apical 4‐ and 2‐chamber views. The patients had a decreased displacement of the AV plane compared with controls which was more pronounced at the sites of infarction. The mean value of the AV plane displacement (AV mean) correlated linearly with the left ventricular (LV) ejection fraction calculated by radionuclide angiography (r = 0.87, p<0.001, SEE= 6.2). An AV mean of 10 mm or more had a high sensitivity (95%) and specificity (82%) in defining a normal ejection fraction (2 50%). A high correlation coefficient was found between LV wall motion index and the AV plane displacement. Thus, in acute MI the LV function can be assessed noninvasively using AV plane displacement.
High‐energy catheter ablation of cardiac arrhythmias: An outmoded technique in the 1990s
Authors: Cunningham David 
Published: February 2009

AbstractCatheter ablation has become an accepted technique for creating complete heart block in patients with drug refractory supraventricular tachycardias. However, it remains experimental for other indications, such as ablation of accessory pathway or ventricular tachycardia. The use of high energy defibrillator discharges is associated with adverse effects which greatly contribute to the limitations of the technique. Advances in technology have led to newer methods, such as radiofrequency and low energy capacitive discharge, which hold significant advantages over the conventional high energy technique, to the extent that the use of defibrillator discharges should now be considered outmoded and potentially damaging. Radiofrequency is the technique of choice for accessory pathway ablation and modification of AV conduction, and low energy capacitive discharge is the preferred method for creation of complete heart block. There are currently no acceptably safe and efficacious catheter techniques for treating ventricular tachycardia, and more research needs to be done in this area. The potential for the success of these techniques depends to an extent on the creation of new standards of practice for catheter ablation. There has been no unbiased comparative assessment of the different techniques, and consequently no consensus exists on the preferred technique and technologies which should be used. Only within the framework of these standards can the technique achieve significant clinical utility.
Left ventricular function during transient coronary occlusion: Digital subtraction left ventriculograms during coronary angioplasty
Authors: Kitazume, Hidemasa , Kubo, Ichirou , Iwama, Toru , Ageishi, Yoshio , Suzuki, Akio 
Published: February 2009

AbstractThe impact of transient myocardial ischemia on left ventricular function was examined by digital subtraction left ventricular angiography. Contrast medium was injected into the right pulmonary artery before, at 60 seconds of balloon inflation, and 10 minutes after balloon deflation. A total of 69 patients completed the study. In 52 patients, the left anterior descending artery (LAD) was involved, and in 17, the right coronary artery (RCA) was the focus. Ejection fraction (EF) declined by balloon inflation and returned to baseline value after deflation of the balloon. There was tendency toward a lower EF and wider akinetic area for LAD dilatation. The linear correlation between resting EF and EF during balloon inflation suggested that the effect of momentary coronary occlusion on left ventricular function appears to be additive to preexisting left ventricular dysfunction, and resting ejection fraction is an important parameter for estimating the degree of diminished left ventricular function during myocardial ischemia.
Relationship of auscultatory fourth heart sound to the quantitated left atrial filling fraction
Authors: Homma Shunichi , Bhattacharjee, Dulal , Gopal, Aasha , Correia, Joaquim 
Published: February 2009

AbstractThe fourth heart sound (S4) has been associated with vigorous atrial contraction. However, the presence of S4 has not been previously correlated with quantitated left atrial filling fraction. In this study, the presence of an auscultatory S4 was compared with the Doppler echocardiographically quantitated left atrial filling fraction in 41 consecutive patients in whom S4 was judged to be present or absent according to the consensus of cardiologists. Left atrial filling fraction in patients with S4 was 49% and was significantly greater than 33% found in patients without S4 (p<0.005). Using atrial filling fraction of 35% as a dividing line, S4 had a sensitivity of 84% and a specificity of 75% for determining left atrial filling fraction ≥ or <35%. Furthermore, of 25 patients with S4, 21 (84%) had atrial filling fraction ≥35%, and of 16 patients without S4, 12 (75%) had atrial filling fraction <35%. Thus, the presence or the absence of S4 is quantitatively related to the left atrial filling fraction and appears to predict atrial filling fraction ≥ or <35% reasonably well.
Familial recurring cardiac myxoma
Authors: Herbert Haught, W. , Alexander, James A. , RichardConti, C. 
Published: February 2009

AbstractA 34‐year‐old woman presented with her fourth occurrence of an atrial myxoma and a right lower lung field mass. Her surgical history was extensive. In addition to resection of three previous atrial myxomas, she had undergone resection of her adrenal glands as a teenager because of Cushing's syndrome, and a hysterectomy at age 26 revealed a myxoid leiomyoma. Family history was remarkable as a maternal uncle and daughter died from embolic complications of left atrial myxomas and her sister previously had a left atrial myxoma resected. The patient underwent uncomplicated removal of the myxoma, and resection of the lung mass revealed a granuloma. A review of typical and atypical aspects of cardiac myxomas is provided including a rare and recently described syndrome of familial cardiac myxoma associated with Cushing's syndrome, spotty skin pigmentation and other myxoid tumors.
Life‐threatening ventricular tachycardia as the presenting symptom of metastatic cardiac disease
Authors: Mager, Aviv , Strasberg, Boris , Zlotikamien, Bruria , Kaplinsky, Chaim , Sclarovsky, Samuel 
Published: February 2009

AbstractWe present 2 cases in whom repetitive rapid ventricular tachycardia (VT) was the initial manifestation of metastatic cardiac disease. In one patient, repetitive VT appeared during chemotherapy for stage IV paratesticular rhabdomyosarcoma which led to the diagnosis of cardiac metastases. In the other, it led to the diagnosis of malignant pericardial effusion 17 years after successful therapy for a breast carcinoma. In conclusion, in patients with present or past history of malignancy, the appearance of life‐threatening VT should raise the suspicion of cardiac metastases.
Coronary vasospasm as a potential cause of myocardial infarction and paroxysmal atrial fibrillation in a relatively young woman
Authors: Horimoto, Masashi , Igarashi, Keichi , Takenaka, Takashi , Anbo, Tomonori 
Published: February 2009

AbstractVasospasm‐related myocardial infarction in young women with normal coronary arteries has infrequently been reported and vasospasm‐related paroxysmal atrial fibrillation (PAF) has rarely been described. We present a 33‐year‐old woman with old inferior myocardial infarction and postinfarction angina at rest; the angina was accompanied by PAF and electrocardiographic ST‐segment elevation in the inferior leads. Coronary angiography revealed normal coronary arteries and intracoronary acetylcholine provoked an intense and diffuse spasm of the right and left coronary artery. The spasm of the right coronary artery was associated with PAF and ST‐segment elevation in the inferior leads. Frequently documented PAF, accompanied by chest discomfort and ST‐segment elevation in the inferior leads, was more effectively removed with isosorbide dinitrate than with disopyramide. These data suggest that coronary vasospasm is a likely cause of myocardial infarction and even PAF, although the precise mechanism leading to PAF remains unknown.
Influence of minimal angiographic visible collateral circulation on myocardial function during PTCA
Authors: Dim M. , Prachar H. , Enenkel W. 
Published: February 2009

AbstractThe potential protective role of angiographically visible minimal collateral circulation in diagnostic angiograms, not reaching or filling the target vessel (RENTROP class 1), on myocardial function during percutaneous transluminal coronary angioplasty (PTCA), was studied in two groups of patients undergoing elective PTCA of the left anterior descending artery (LAD). In the first study group consisting of 22 patients, influence of collateral circulation class 1 on left ventricular regional function was evaluated. In this group, 14 patients showed no angiographic collaterals and 8 patients showed collateral circulation class 1 in diagnostic angiograms. Increase of end‐diastolic and end‐systolic volume indices as well as decrease of global left ventricular function was not significantly different inpatients with and without such minimal collateral circulation. In patients without collaterals, the decrease of regional left ventricular function was significantly more pronounced in the left anterior length segment (p<0.05) and a trend was observed in the anterolateral (p = 0.059) and apical (p = 0.053) segments. In a second group, consisting of 29 patients, hemodynamic parameters were measured and, in addition to grading of collateral circulation in diagnostic angiograms, angiographically visible collateral circulation was estimated during occlusion of the LAD by injecting contrast materials into the right coronary artery. An increase of angiographically visible collaterals during the ischemic period of various degrees was documented in 26 (90%) of 29 patients. Combining patients of both study groups, increase in left ventricular end‐diastolic pressure during ischemia was significantly higher (p<0.05) in patients without collaterals on diagnostic angiography (n=34) than in patients with collateral circulation class 1 (n = 14). For all patients decrease of dP/dtmax as well as decrease of dP/dtmin during ischemia was statistically highly significant (p<0.001). No significant differences could be documented comparing patients without (n = 34) and with collateral circulation class 1 (n = 14). Our results indicate that, in the case of acute definitive vessel occlusion during PTCA, collateral circulation class 1 in diagnostic angiograms may not protect from extensive myocardial damage. Improvement of collateral circulation during ischemia caused by acute transient vessel occlusion is common, of rapid onset but in most cases of only minimal degree.
Relationship between electrocardiographic patterns and angiographic features in isolated left circumflex coronary artery disease
Authors: Shen Wei Feng , Tribouilloy Christophe , Lesbre Jean‐Philippe 
Published: February 2009

AbstractThe relation of electrocardiographic (ECG) patterns to clinical and angiographic features was assessed in 89 patients with isolated left circumflex coronary artery (LCx) disease (46 with and 43 without myocardial infarction). ECG abnormalities were present in 75 patients; there were isolated Q waves in 20, an abnormal R wave in lead V1 with or without inferior and/or lateral Q waves in 21, and isolated ST‐T wave changes in 34 cases. Inferior abnormalities on the electrocardiogram were similar in patients with proximal or distal stenoses of the LCx, but an abnormal R wave in lead V1 correlated with proximal LCx stenosis (p<0.01). Lateral abnormalities were more common in stenoses of the obtuse marginal branch and proximal LCx than in distal stenosis (all p<0.01). Compared with patients without myocardial infarction with or without ST‐T‐wave changes and those with infarction without an abnormal R wave in lead V1, patients with LCx‐related infarction and an abnormal R wave in lead V1 associated with inferior and/or lateral Q waves had larger left ventricular end‐diastolic and end‐systolic volumes, lower ejection fraction, higher incidence of total occlusion of proximal LCx without collateral vessels, and more cardiac events during follow‐up. This study suggests that an abnormal R wave in lead V1 associated with lateral abnormalities on the standard electrocardiogram may be clinically useful in predicting proximal LCx stenosis and identifying a subset of postinfarction patients with left ventricular dysfunction due to a large infarct size.
Exercise performance and beta‐adrenergic blockade in patients with complete heart block treated with ventricular inhibited pacing
Authors: Wikner Johan , Larsen Flemming F. , Nordlander Rolf , Pehrsson Kenneth , Åström Hans 
Published: February 2009

AbstractThe effect of beta‐adrenergic blockade (propranolol) on exercise performance was studied in 15 patients (12 men and 3 women, mean age 70 years) with complete heart block treated with a ventricular‐inhibited pacemaker (VVI). In a double‐blind procedure, the patients were randomly given either 0.1 mg/kg of propranolol or saline solution i.v. before a first exercise test and vice versa before a second test. The interval between the tests was 24 hours. Nine patients were in sinus rhythm, 4 patients had atrial flutter, and 2 others had atrial fibrillation. The exercise capacity was on an average 11% lower with propranolol than with placebo (p<0.001). The most marked reductions (20 and 33%) were found in the two patients with atrial fibrillation. The atrial rate in patients with sinus rhythm was significantly lower with propranolol than placebo both at rest (68 vs. 83 beats/min, p<0.001) and at maximal work load (91 vs. 141 beats/min, p<0.001). The present findings show that beta blockade has negative effects on exercise capacity in patients with complete heart block treated with VVI pacemakers. This finding should be considered in the selection of drug treatment in patients with fixed rate pacing and concomitant hypertension and/or ischemic heart disease.
Catheter balloon valvuloplasty of stenotic porcine bioprosthetic valves: Part II: Mechanisms, complications, and recommendations for clinical use
Authors: Waller Bruce , Vantassel James , Mckay Charles , Allen Marcus 
Published: February 2009

AbstractDuring the last several years dilating balloons have been applied in the treatment of stenotic cardiac valves. This interest has been extended to stenotic porcine bioprosthetic valves. Part I of this review discusses the pathologic changes producing stenotic porcine prosthetic valves. Part II of this review describes an in vitro study of porcine prosthetic valve valvuloplasty defining the mechanisms, complications, and clinical applications. Results of this study indicate a limited and cautious role in balloon dilation of stenotic bioprosthetic valves.