bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemodynamic advantage of combined administration of oral ibopamine and nitroprusside in patients with ischemic and idiopathic congestive cardiomyopathy
Authors: Dei Cas L. , Fappani A. , Riva S. , Metra M. , Cicogna R. , Manca C. , Visioli O. 
Published: February 2009

AbstractThe hemodynamic efffects of combined administration of ibopamine (Ib) (150 mg orally) with nitroprusside (NP) (50‐150/m̈g/min intravenously) were compared with those of NP alone in 17 patients with severe congestive heart failure due to coronary artery disease (7 patients) or idiopathic cardiomyopathy (10 patients). Hemodynamic measurements were obtained using a Swan‐Ganz thermodilution catheter and a bedside thermodilution cardiac output computer. Nitroprusside alone produced a significant decrease (—12.4%) in mean arterial pressure, mean pulmonary arterial pressure (‐28.3%), and systemic vascular resistance (‐22.6%), and a significant increase in stroke volume index (23.1 %). The administration of combined NP and Ib produced a further significant increase of stroke volume index (20.1 %) with a concomitant and significant reduction of systemic vascular resistance (‐19.4%); heart rate, mean systemic and pulmonary arterial pressures did not change significantly from the values observed with NP alone. Moreover, stroke work index, although not significantly modified with the vasodilator alone, was significantly increased over control values with NP+Ib association. Although NP alone induced similar effects in both the ischemic and idiopathic cardiomyopathies, the association of Ib gave a more favorable, though not significant, hemodynamic response in the subjects with primitive cardiomyopathy than in the ischemic ones. Thus, the association of Ib to NP therapy, in patients with congestive heart failure, further increases stroke volume index and stroke work index with a concomitant reduction of systemic vascular resistance, without any significant change in mean systemic and pulmonary arterial pressures, or heart rate. These results point out the possibility of associating Ib with other orally active vasodilators in the chronic treatment of congestive heart failure.
Ruptured abdominal aortic aneurysms: Experience with 70 cases
Authors: Crew J. R. , Bashour T. T. , Ellertson D. , Hanna E. S. , Bilal M. 
Published: February 2009

AbstractDuring the period 1965–1983, 270 patients underwent resection of abdominal aortic aneurysm. In 70 patients (26%) the aneurysm was ruptured. Overall hospital mortality of patients with ruptures was 34%. Five patients died before the graft could be completed. Common denominators associated with mortality were hypotension, renal failure, cardiac arrest, and postoperative hemorrhage. The average age over the first 10 years was 68, but subsequently, has risen gradually, with a corresponding increase in mortality despite improved surgical technique and postoperative care. Only with more widespread elective resections and earlier diagnosis of rupture followed by prompt operative management, can the outlook for patients with abdominal aortic aneurysm be improved.
Primary sarcoma of the pulmonary trunk: Successful surgical intervention and prolonged survival
Authors: Klinke W. P. , Gelfand E. T. , Baron L. 
Published: February 2009

AbstractWe present a rare case of pulmonary trunk sarcoma in a young male in which the diagnosis was made antemortem. Total surgical removal of the tumor, including replacement of the pulmonary valve, was undertaken. This patient is the longest reported survivor of pulmonary trunk sarcoma and remains free of any signs or symptoms of recurrence. No adjuvant chemotherapy was required.
Myocardial infarction in the diabetic patient
Authors: Kereiakes D. J. 
Published: February 2009

AbstractIt has long been thought that the symptomatology and prognosis of coronary events in patients with diabetes may differ from those in nondiabetic persons. A review of recent data demonstrates a higher mortality during the acute phase of myocardial infarction for diabetic patients than for their nondiabetic counterparts, possibly related to a higher incidence of congestive heart failure and cardiogenic shock. The clinical course of diabetic patients with infarction and the role of insulin in myocardial adaptation to ischemia are both reviewed. Diabetic patients surviving the acute phase of myocardial infarction have a lower survival in follow‐up than nondiabetic survivors, although some improvement in survival has been noted following beta‐adrenergic‐blocker therapy.
Adenosine triphosphate and adenosine: Perspectives in the acute management of paroxysmal supraventricular tachycardia
Authors: Belhassen B. , Pelleo A. 
Published: February 2009

AbstractAdenosine triphosphate (ATP) and adenosine exert strong and transient depressant effects on the sinoatrial and atrioventricular (AV) nodes of the human heart. The AV nodal effects of these drugs explain their high efficacy in either terminating AV re‐entrant supraventricular tachycardia or in slowing ventricular rate during atrial tachyarrhythmias. Their very short half‐life enables repeated administration of increased doses without reaching toxic effects and explains the transient character of their frequent but benign side effects. These agents represent a good alternative to verapamil in the acute management of paroxysmal supraventricular tachycardia both in infants and adults.
Cardiac Amyloidosis: Combined Use of Two‐Dimensional Echocardiography and Electrocardiography in Noninvasive Screening Before Biopsy
Authors: Sivaram C. A. , Jugdutt B. I. , Amy R. W. M. , Basualdo C. A. , Haraphongse M. , Shnitka T. K. 
Published: February 2009

AbstractCardiac amyloidosis (CA) presenting with intractable congestive heart failure, electrocardiographic (ECG) normal or low voltage, and conduction or rhythm disturbances, is rapidly fatal. During life, CA often mimics other cardiomyopathies so that definitive diagnosis depends on demonstration of amyloid on myocardial biopsy. On two‐dimensional echocardiography (2‐D echo), nonspecific features, such as increased ventricular wall thicknesses, predominant diastolic dysfunction, and diffuse myocardial “sparkling,” are consistently found in CA. The combined presence of these 2‐D echo features and normal or low voltage on ECG is highly suggestive of CA, allows differentiation from other cardiomyopathies, and might be useful in noninvasive screening before myocardial biopsy.
Incidence of complex ventricular arrhythmias in asymptomatic patients with recent myocardial infarction
Authors: Cocco G. , Strozzi C. , Pansini R. , Al Yassini K. , Padula A. 
Published: February 2009

AbstractThe incidence of ventricular extrasystoles (VES) was documented in 50 patients with recent uncomplicated myocardial infarction, with a 72‐h two‐channel ambulatory electrocardiogram. All patients were free of symptoms of arrhythmias; unstable angina pectoris and heart failure were absent. A total of 82% of the patients had VES: 23/50 patients had multiform or complex VES, 8/50 patients had ventricular tachycardia. VES were independent of heart rate and stable angina pectoris. Thus, frequent and complex VES are common in asymptomatic patients with uncomplicated recent myocardial infarction. Even in the absence of symptoms, ambulatory electrocardiography is useful. The prognostic significance of asymptomatic complex VES in these patients remains unsettled.
The erythrocyte aggregation value as a measure of the risk of myocardial infarction and arteriosclerosis of peripheral arteries
Authors: Ruhenstroth‐Bauer G. , Porz P. , Boss N. , Lehmacher W. , Stamm D. 
Published: February 2009

AbstractThe erythrocyte aggregation value (AW) has been determined in groups of patients with and without coronary heart disease (CHD) and in a group of apparently normal subjects, using the Metricell apparatus as described by Kachel et al. The following results were obtained: There was a close correlation between the AW and the existence of CHD or arteriosclerosis of peripheral arteries. The precision of the retrospective prediction of CHD by this noninvasive test in male subjects aged over 45 years (total CHD prevalence = 0.494) was: sensitivity = 0.571, specificity = 0.767. The predictive value of positive tests (PVpos) was 0.706, of negative test (PVneg) 0.647. The discriminatory ability of the AW test was superior to that of serum cholesterol determinations or measurement of other CHD risk factors made in the same population. The AW rises exponentially with the total score for risk factors for CHD hazard for the subject. It appears, however, from the insignificant correlations observed that there is no direct connection between the AW and any single risk factor.
Friedreich's ataxia associated with hypertrophic cardiomyopathy and coronary vasospasm
Authors: Sohi G. S. , Drake C. , Flowers N. C. 
Published: February 2009

AbstractA rare patient with Friedreich's ataxia and hypertrophic obstructive cardiomyopathy who showed evidence of coronary artery vasospasm on ambulatory electrocardiographic monitoring is presented.
Purulent meningococcal pericarditis: Chronic percutaneous drainage with a modified catheter aided by echocardiography
Authors: Biancaniello T. M. , Anagnostopoulos C. E. , Bernstein H. E. , Proctor C. 
Published: February 2009

AbstractA 7‐month‐old infant presented with suspected sepsis. On the third day of illness signs of cardiac tamponade developed. Tamponade was relieved by pericardiocentesis, and countercurrent immunoelectrophoresis (CIE) analysis of the fluid was positive for meningococcus group B. Antibiotic treatment was changed to penicillin G. After echocardiography demonstrated reaccumulation of fluid, a modified #16 gauge angiocatheter was placed percutaneously in the pericardial space. When drainage slowed it was repositioned using two‐dimensional echocardiography. After 24 h the catheter was removed and no further accumulation occurred. The antibiotics were continued an additional 10 days and the infant recovered uneventfully. Modification of the catheter and echographic repositioning may decrease the need for surgical drainage in such patients.
Nutrition and atherosclerosis: Some neglected aspects
Authors: Koumans A. K. J. , Wildschut A. J. 
Published: February 2009

AbstractThis article suggests that atherosclerosis is a plurideficiency disease. Increasing only linoleic acid intake in daily nutrition to counteract atherosclerosis has failed to give satisfactory results. The use of lecithin affects the metabolism and transportation of cholesterol in the blood more efficiently than do the polyunsaturated fats. Furthermore, insufficient quantities of vitamins B6 and C in the blood contribute to lesions of the arterial endothelium, which are indistinguishable from the first stages of atherosclerosis. It is recommended, therefore, that these factors should be combined, and that, together with a sufficient quantity of polyunsaturated fatty acids, the daily diet be supplemented with adequate doses of lecithin, vitamin B6 (in B complex), and vitamin C.
Noninvasive evaluation of intracardiac pressures using doppler ultrasound: A case study of panvalvular regurgitation
Authors: Yock P. G. , Popp R. L. 
Published: February 2009

AbstractDoppler velocity signals from regurgitant valve flow can be used to calculate pressure gradients across incompetent valves by a modification of the Bernoulli equation. Analysis of these gradients provides clinically useful, noninvasive information about cardiac chamber pressures. This study presents an unusual case of cardiomyopathy with panvafvular regurgitation which demonstrates the major methods of pressure analysis using Doppler signals from regurgitant valves.
Percutaneous transluminal coronary angioplasty‐effect of the moveable guide wire on the complication rate
Authors: Glanelly R. E. J. , Schweiger M. 
Published: February 2009

AbstractBeginning with the first percutaneous transluminal coronary angioplasty (PTCA) performed at Baystate Medical Center, 152 consecutive procedures were analyzed. Sixty were done using USCI‐G (nonsteerable) series catheters. In two patients both a G and S (steerable) catheter were used. In 90 procedures the S system was used exclusively. Among the attempted angioplasties with the G series catheter, the percutaneous transluminal coronary angioplasty was successful in 47 (78%). Eight coronary occlusions were induced and all these patients underwent coronary bypass surgery. There were no deaths, but three patients (5%) had acute myocardial infarctions (MI). The two patients in whom both G and S catheters were used had occlusions. One went to surgery and died postoperatively of uncontrollable ventricular arrhythmias. The other patient had a myocardial infarction and recovered. Of the 90 attempts with the exclusive use of the steerable system, 75 were successful (83%). Three coronary occlusions were induced in the 90 attempts and two of the patients had coronary artery bypass surgery. None of the three sustained a myocardial infarction. In summary, the proportion of patients requiring emergency surgery was significantly reduced from 13.3% (8 of 60) to 2.2% (2 of 90) (p=0.02), the incidence of myocardial infarction was reduced from 5 to 0%, and there was a slight increase in the siccess rate of the procedure after the introduction of the steerable system. It is concluded that the steerable system increases the safety of PTCA.
Effect of oral alcohol on left ventricular ejection fraction, volumes, and segmental wall motion in normals and in patients with recent myocardial infarction
Authors: Gould L. , Gopalaswamy C. , Yang D. , Patel D. , Klm B. S. , Patel C. , Becker W. H. 
Published: February 2009

AbstractA first‐pass nuclear angiogram and a multiple‐gated acquisition study were obtained in 10 normal physicians and in 10 patients with a 7‐to‐10 day old transmural myocardial infarction. After the scan the subjects drank 2 oz. of whiskey. After 60 minutes, the multiple‐gated acquisition study was repeated. In the normal group the left ventricular ejection fraction was 68% before and 72% after alcohol. The left ventricular end‐diastolic volume increased from 89 to 97 ml while the left ventricular end‐systolic volume decreased from 29 to 27 ml. The stroke volume rose from 61 to 70 ml/beat (p<0.05). The cardiac output increased from 4.0 to 5.0 l/min (p<0.05). In the infarction group, the left ventricular ejection fraction was 58% before and 56% after alcohol administration. The left ventricular end‐diastolic volume fell from 111 to 96 ml, while the left ventricular end‐systolic volume declined from 50 to 44 ml. The stroke volume fell from 61 to 52 ml/beat, while the cardiac output fell from 4.5 to 3.8 l/min. In the left ventricular infarction zones, alcohol produced in 9 of the 10 cardiac patients a decline in the left ventricular regional ejection fraction. In the normal group, alcohol produced no significant changes in the regional ejection fraction. The normal and the postinfarction patients responded differently to alcohol.
Hemodynamic and metabolic effects of enalapril in patients with heart failure
Authors: Chrysant S.G. , Gollub S. , Dunn M.I. , Bal I.S. , Dreiling R. , Konijeti J.R. 
Published: February 2009

AbstractPlacebo and enalapril were added on a double‐blind basis to conventional treatment in 14 patients with congestive heart failure (CHF), New York Heart Association class II‐III. The patients were followed for 14 weeks and their performance was evaluated by a treadmill test, ejection fraction by nuclear scan, cardiothoracic ratio, and Yale Scale score. Metabolic studies were done to test any adverse effects of the drugs. Enalapril decreased arterial pressure and cardiothoracic ratio, and increased ejection fraction. Placebo exerted no significant effects. However, both drugs improved treadmill time and Yale Scale score. No adverse metabolic or clinical effects were observed with either drug. Based on these limited observations we conclude that: (1) Enalapril is a useful ancillary agent to conventional treatment of CHF; (2) it exerts its effects through afterload and preload reduction; and (3) it is safe and well tolerated and has a prolonged duration of action.
Successful management of atrial flutter in a newborn with verapamil
Authors: Casta A. , Wolf W. J. , Richardson C. J. , Sapire D. W. 
Published: February 2009

AbstractVerapamil has become a popular antiarrhythmic drug for the acute management of supraventricular tachycardia in infants and children. A full‐erm, 1‐hour‐old infant presented with supraventricular tachycardia and hypotension that did not respond to vagal maneuvers and direct current cardioversion. After intravenous verapamil, the heart rate slowed and the underlying rhythm was atrial flutter.
Intravenous versus intracoronary streptokinase in acute myocardial infarction
Authors: Lo Y. S. A. 
Published: February 2009

AbstractNine studies specifically dealing with the comparison of intravenous Streptokinase (IVSK) and intracoronary Streptokinase (ICSK) in the treatment of acute myocardial infarction (MI) were analyzed to determine if IVSK is as efficacious as ICSK in achieving thrombolysis. Pooled data from the studies yielded success rates of 73% for IVSK and 72% for ICSK. Considering that the studies which did not perform preintervention angiogram may have overestimated the thrombolytic success rate in IVSK patients, there is a possibility that ICSK may be slightly more effective in achieving acute reperfusion. Bleeding complications were similar, and a systemic lytic state was observed in both treatment groups. No definitive conclusions can be drawn regarding the differences between groups in improvements of left ventricular function and mortality rates. ICSK has the advantage of direct documentation of reperfusion and spares the patient the risk of anticoagulation should the attempt fail. On the other hand, IVSK is cheaper, easier to administer, and can logistically be given earlier (even in the emergency room or ambulance) than ICSK; it is therefore more widely available, and may be the preferred mode of treatment in community hospitals where cardiac catheterization facilities are not readily available, if Streptokinase is to be given at all.
Relationship between electrocardiographically estimated infarct size and morbidity during a two‐year follow‐up
Authors: Herlitz J. , Hjalmarson Å 
Published: February 2009

AbstractIn 587 patients with a first myocardial infarction (MI) the electrocardiographically (ECG) estimated infarct size was related to morbidity during a two‐year follow‐up. Patients with transmural MI (Q‐ or R‐wave changes in standard ECG) were more often treated for heart failure and returned to work less frequently than patients with subendocardial MI (ST‐T‐wave changes only). There were trends indicating a higher reinfarction rate in patients with subendocardial MI, whereas angina pectoris was observed as frequently in both groups. In a subset of patients with anterior MI, infarct size was estimated from the total Q‐ and R‐wave amplitude in 24 precordial leads 4 days after arrival in hospital. A positive relationship was observed between ECG‐estimated infarct size and treatment for heart failure, and patients with smaller infarctions according to ECG criteria returned to work less frequently. A higher reinfarction rate was observed in patients with smaller infarctions. In patients with inferior MI there were mostly weaker correlations between ECG‐estimated infarct size (Q‐ and R‐wave changes in leads II, III, and aVF) and morbidity during the two‐year follow‐up.
Effect of exercise training and diet modification on serum lipids and lipoproteins in coronary artery disease patients treated with thiazides
Authors: Kahrs S. J. , Weinstein C. , Douwes J. , Alexander J. , Weinstein S. 
Published: February 2009

AbstractThe effects of chronic exercise training and diet modification on serum lipids and lipoproteins were measured in 17 hypertensive males and 41 normotensive males with documented coronary artery disease (CAD). Exercise consisted of aerobic activities which were performed at approximately 75‐85% of the symptom‐limited maximum heart rate for 30‐40 minutes, three times weekly for 3 months. Each participant's diet was also controlled, the recommended daily intake of fat and cholesterol was no more than 40 g/day and 200 mg/day, respectively. Significant increases in estimated VO2max and total cholesterol/high density lipoprotein (HDL) and a significant decrease in serum triglycerides were documented after training. Significant differences in serum cholesterol and triglycerides between the nondiuretic and diuretic patients were also noted. No significant changes were found in low density lipoprotein (LDL), HDL, or body weight. Vigorous aerobic training and diet modification can favorably modify the deleterious effects of diuretic medications on serum triglycerides and total cholesterol/HDL in patients with documented CAD.
Flecainide: A new antiarrhythmic drug
Authors: Mueller R. A. , Baur H. R. 
Published: February 2009

AbstractFlecainide acetate is a new class 1 antiar‐rhythmic drug. It slows conduction in the working myocardium and the specialized conduction system and may depress sinus node activity in patients with pre‐existing sinus node disease. Its hemodynamic effects are minimal. The drug is completely absorbed and shows a half‐life of 7–22 hours. Elimination is mainly through the kidneys. Flecainide is highly effective in the treatment of ventricular arrhythmias, pre‐excitation syndromes and AV reentry tachycardias. Side effects are mild and consist mostly of dizziness, visual disturbances, and nervousness. They rarely require discontinuation of therapy. Proarrhythmic effects have been reported. Caution is required in patients with congestive heart failure, AV block, and/or bundle‐branch block or sinus node dysfunction.
Heart involvement in metastatic carcinoid disease
Authors: TöRNEBRANDT K. , Eskilsson J. , Nobin A. 
Published: February 2009

AbstractSixteen patients with metastatic carcinoid tumors of ileal or cecal origin were studied in order to evaluate the frequency and degree of cardiac involvement in a nonselected patient group. We have also studied the correlation between plasma hormone levels (e.g., 5‐hydroxytryptamine (5‐HT) and substance P) and the degree of cardiac involvement. The patients underwent physical examinations, electrocardiograms, chest x‐rays, cardiac catheterization, and echocardiography, Plasma levels of 5‐HT and substance P were analyzed. Carcinoid heart involvement was found in 3 of 16 patients (19%) but no patient had subjective symptoms associated with heart disease. Four patients (25%) had slight pulmonary hypertension. No left‐sided heart lesions were seen. No correlation between blood levels of 5‐HT or substance P and heart involvement was found. Eight patients died during the follow‐up period, but in none of these was the cause of death cardiac failure. Carcinoid heart disease is not as common in our patients as in patients selected on a cardiological basis described in earlier studies. Echocardioraphy appers to be the most efficient technique for detection of even subclinical heart involvement and a useful tool for following its progress.