bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary artery and saphenous vein graft remodeling: A review of histologic findings after various interventional procedures—part V
Authors: Waller Bruce F. , Orr Charles M. , Van Tassel James , Peters Thomas , Fry Edward , Hermiller James , Grider Larry D. 
Published: February 2009

AbstractCatheter balloon angioplasty is a well accepted form of nonsurgical treatment of acutely and chronically obstructed coronary artery vessels. It is also the centerpiece for various new intervention techniques. Their morphologic effect on the site of obstruction has been termed “remodeling.” Part V of this six‐part series focuses on remodeling effects of balloon angioplasty on obstructed young (≤ 1 year) and old (> 1 year) saphenous vein bypass grafts.
Percutaneous transvenous mitral commissurotomy versus surgical commissurotomy in the treatment of mitral stenosis
Authors: Lau Kean‐Wah , Ding Zee‐Pin , Hung Jui‐Sung 
Published: February 2009

AbstractThere is no doubt that percutaneous transvenous mitral commissurotomy (PTMC) in experienced centers is associated with a low risk of major complications and yields excellent immediate and long‐term outcome. Although previous observational studies on both PTMC and surgical commissurotomy have indicated similar outcome between the two treatment strategies in terms of valve area improvement and risk of major complication (death, thromboembolism and significant resultant mitral regurgitation), it was not until recently that several prospective randomized trials comparing the two procedures and involving >470 patients with favorable valve characteristics (pliable, noncalcified valve with mild sub‐valvular disease and no or mild mitral regurgitation), have confirmed that PTMC is indeed just as, if not more, effective as surgical commissurotomy. The late restenosis rate at up to 3‐year follow‐up appears comparable. Furthermore, PTMC has other additional benefits. It is nontraumatic, may be repeated without additional risk, and has been shown to be an extremely useful and efficacious palliative tool in those with end‐stage mitral stenosis or with unfavorable valve anatomy who refuse surgery, and in certain subset of patients at high surgical risk because of medical comorbidities.
Safety of a new transpulmonary echocontrast agent (albunex®) in repeated echocardiographic studies in patients
Authors: Geny B. , Piquard F. , Haberey P. , Bischoff P. , Müan B. , Lambrechs M. , Juelsrud‐Vebner A. , Thiranos J. C. , Epailly E. , Eisenmann B. 
Published: February 2009

AbstractBackground and hypothesis: Multiple contrast‐enhanced echocardiographic studies are to be expected in patients with cardiac ischemic disease, but the sonication process used to produce the echocontrast agent Albunex® may result in new epitopes that could cause an immunogenic response.Methods: Repeated exposures to intravenous Albunex over a period of time long enough to allow development of an eventual immune reaction were performed in 12 patients while monitoring for lymphocyte transformation, microsphere specific IgE and IgG antibodies, and systemic, pulmonary artery, capillary wedge, and right atrial pressures, as well as cardiac output, left ventricular fractional shortening, and blood gases.Results: No significant 3H‐thymidine incorporation and thus no specific blastic transformation of the patients' lymphocytes were observed either for high or low Albunex concentrations, corresponding to the expected hepatic and plasma concentrations of microspheres. No formation of micro‐sphere‐specific IgE and IgG antibodies was observed after the first or second Albunex exposure. Furthermore, no clinically significant hemodynamic or respiratory adverse reactions were observed in any patient.Conclusion: These results suggest that repeated exposures to intravenous Albunex induce no adverse effect on the cellular and humoral immune systems and on left and right heart hemodynamics in patients.
Unexplained chest pain: When is it panic disorder?
Authors: Fleet Richard P. , Beitman Bernard D. 
Published: February 2009

AbstractNoncardiac chest pain is a common costly phenomenon in the cardiology setting. Recent research suggests that panic disorder, a highly distressful yet treatable anxiety disorder, occurs in a significant proportion of noncardiac chest pain patients. This article reviews research on the prevalence of panic disorder in patients seen in cardiology settings for unexplained chest pain. Financial, psychosocial, and historical aspects of noncardiac chest pain are described. Panic disorder and the potential consequences of its nonrecognition by physicians are examined. Current psychological and pharmacologic treatments are reviewed. Recommendations on the management of panic patients in the cardiology setting are provided.
Alcohol, ischemic heart disease, and the french paradox
Authors: Constant Jules 
Published: February 2009

AbstractMany studies have shown either an inverse relation between alcohol intake and ischemic heart disease or a U‐shaped curve in which the equivalent of two drinks per day of any kind of alcohol is associated with a decreased incidence of coronary disease compared with no drinks, while higher doses result in an increased risk of infarction and stroke. Although the cardioprotective effects of most alcoholic beverages are probably due to an elevation of high‐density lipoprotein as well as the ability of alcohol to prevent platelet aggregation and increased fibrinolysis, there is an increased favorable effect of red wine. The unique cardioprotective properties of red wine reside in the action of flavonoids which are absent in white wine (with the exception of champagne) and sparse in beer (with the exception of dark beers). The best researched flavonoids are resveritrol and quercetin, which confer antioxidant properties more potent than alpha‐tocopherol. Grape juice has about half the amount of flavonoids by volume as does red wine.
Determinants of coronary vascular disease in patients with type ii diabetes mellitus and their therapeutic implications
Authors: Schneider David J. , Sobel Burton E. 
Published: February 2009

AbstractCardiovascular morbidity and mortality are increased 4‐ to 6‐fold in patients with type II diabetes. The high prevalence is multifactorial and reflects in part the adverse influence of covariate, cardiac risk factors such as hypertension and hyperlipidemia. Type II diabetes is characterized by insulin resistance, hyperinsulinemia, and altered carbohydrate and lipid metabolism resulting in hyperglycemia, increased concentrations in blood of very low‐density and low‐density lipoproteins, and decreased blood high‐density lipoproteins. Abnormalities seen predispose to vasculopathy through lipid deposition into vessel walls associated with monocyte infiltration, vascular smooth muscle cell proliferation, arterial mural fibrosis, and thrombosis. Conventional therapy for cardiovascular disease such as angioplasty and bypass surgery are of only limited efficacy. Thus, retardation of progression of atherosclerosis is essential. In addition to focusing on coexistent cardiac risk factors such as hypertension, therapy for patients with type II diabetes should reduce or reverse insulin resistance, improve metabolic control, and, ideally, do so without exacerbating hyperinsulinemia. Diet and exercise are central, and novel orally active hyperglycemic agents such as the biguanides and the thiazolidinediones that sensitize diverse tissues to insulin offer particular promise.
Double‐blind randomized multicenter study on the efficacy of trapidil versus isosorbide dinitrate in stable angina pectoris
Authors: Raubach K.‐H. , Vlahov V. , Wolter K. , Bussmann W.‐D. 
Published: February 2009

AbstractBackground: Trapidil is an inhibitor of phosphodiesterase I‐IV with resulting positive lusitropic, vasodilating, and antiplatelet effects.Hypothesis: This study was undertaken to compare the antianginal efficacy of trapidil with that of isosorbide dinitrate (ISDN) in patients with stable angina pectoris.Methods: We studied 95 patients with stable angina pectoris who were randomized into a double‐blind parallel group study with either oral trapidil or ISDN. After a 1‐week run‐in period and a 2‐week wash‐out phase, the patients received either trapidil 200 mg t.i.d. (n = 48) or ISDN 20 mg t.i.d. (n = 47) for 12 weeks. All antianginal medication, except sublingual glyceryl trinitrate (GTN), was discontinued during the study. Patients underwent an exercise electrocardiogram on an ergometer bicycle according to a modified Bruce protocol before and at 6 and 12 weeks during treatment.Results: The workload capacity increased from 583 ± 281 W‐min before treatment to 833 ± 444 W‐min after 12 weeks of treatment in the trapidil group (p<0.01) and from 555 ± 276 W‐min to 827 ± 361 W‐min in the ISDN group (p<0.01). The anginal attacks per week as well as the use of GTN decreased significantly in both groups. After 12 weeks of therapy, the cumulative ST‐segment depression during exercise decreased by 67% in the trapidil patients and by 23% in the ISDN patients. Compared with baseline, the double product at the 75 W level was reduced in both groups after 12 weeks of treatment. Blood pressure and heart rate at rest remained nearly unchanged. Overall, no statistical difference was found between the two study groups. The tolerability was good.Conclusion: Oral trapidil therapy is safe and effective in stable angina pectoris and is equivalent to standard therapy with ISDN.
QT dispersion ratio in patients with unstable angina pectoris (A new risk factor?)
Authors: Cin V. G. , Celik M. , Ulucan S. 
Published: February 2009

AbstractBackground: QT dispersion has been shown to be associated with fatal arrhythmias and sudden death in coronary artery disease. A recent study indicated that marked QT dispersion in electrocardiograms (ECGs) obtained during acute ischemia demonstrated a significant correlation with ventricular fibrillation.Hypothesis: This study investigated the ECG parameters for repolarization (QT dispersion, corrected QT, corrected QT dispersion, and QT dispersion ratio) and their interrelation with acute ischemia.Methods: QT parameters as well as a newly developed repolarization index, QT dispersion ratio l(QT dispersion/RR interval) × 100] were calculated digitally during rest and ischemia in 32 patients with coronary artery disease (rest angina, Braunwald class III). Results were correlated with clinical consequences, mainly arrhythmias, within a follow‐up period of 5±2days.Results: While most patients had an increase in all four parameters, only the QT dispersion ratio showed a significant difference when correlated with ventricular arrhythmias (p < 0.001, F ratio = 38).Conclusion: QT dispersion ratio appears to be a new and promising parameter in predicting ventricular arrhythmias in patients with acute ischemia.
Contemporary issues in rate‐adaptive pacing
Authors: Barold S. Serge , Barold Helen S. , Camm A. John 
Published: February 2009

AbstractThis review addresses a number of questions pertaining to contemporary rate‐adaptive pacemakers that include the role of dual sensor systems, sensor blending and cross‐checking, automaticity, nonrate‐related sensor functions, prevention of arrhythmias, and several other areas of clinical importance.
Hyperglycemia‐induced angina pectoris in a patient with diabetes mellitus
Authors: Lickerman Alex , Grover‐Mckay Maleah , Dellsperger Kevin C. 
Published: February 2009

AbstractA patient with diabetes mellitus and coronary artery disease presented with recurring episodes of worsening angina not associated with angiographic changes. Correlation with blood sugars demonstrated that angina would occur during episodes of hyperglycemia. During cardiac catheterization, coronary vascular responses including coronary flow reserve and responses to atrial pacing were measured with a Doppler flow wire before and following a glucose challenge. Coronary microvascular responses were impaired by hyperglycemia.
Rapid myoglobin analysis to assess coronary artery reperfusion after acute myocardial infarction
Authors: Lee Hai Shiang , Cross Stephen J. , Jennings Kevin 
Published: February 2009

AbstractBackground: Coronary artery reperfusion significantly improves outcome in patients with acute myocardial infarction. A noninvasive method for assessing reperfusion in the early stage of infarction should be helpful in patient management.Hypothesis:We sought to assess whether release pattern of myoglobin is helpful in identifying patients with and without reperfusion following thrombolytic therapy for myocardial infarction.Methods: Myoglobin was measured before thrombolysis, half hourly for 4 h, then every 2 h for 10 h. Myoglobin was analyzed using a ward‐based “rapid” and automated analyzer that yielded quantitative results within 10 min of blood collection.Results: In the 15 patients with coronary reperfusion, the time from thrombolysis to peak myoglobin levels (mean ± SD, 2.4 ± 1.5 h) was significantly lower than in nonreperfused patients (5.1 ± 2.9, p < 0.01). As an indicator for reperfusion, a doubling of myoglobin 1 h after streptokinase achieved a sensitivity of 80%, a specificity of 80%, and a predictive accuracy of 80%.Conclusions: The difference in myoglobin release kinetics is useful in identifying patients without coronary reperfusion and should aid in their management.
Retroperitoneal fibrosis and infection of an aortic graft prosthesis: Diagnosis and therapeutic problems
Authors: Cuny C. , Chauffert B. , Lorcerie B. , Martin F. 
Published: February 2009

AbstractThe occurrence of a retroperitoneal fibrosis (RPF) after an aorto‐bifemoral bypass is unusual. A case of RPF as a complication of an infection of the graft prosthesis is reported. Computed tomography and magnetic resonance imaging prove useful in diagnosing graft infection: they may reveal periprosthetic gas or perigraft fluid persisting for several months after surgery. However, they may fail when they are performed too early, and repeat performance is suggested.
Echocardiographic characteristics and causal mechanism of physiologic mitral regurgitation in young normal subjects
Authors: Mishiro Yuichiro , Ishimoto Takeo , Oki Takashi , Iuchi Arata , Tabata Tomotsugu , Yamada Hirotsugu , Manabe Kazuyo , Fukuda Kazuyo , Abe Miho , Onose Yukiko , Ito Susumu 
Published: February 2009

AbstractBackground: It has become evident that mitral regurgitation (MR) is not uncommon in healthy subjects, and Doppler color flow mapping is a technique that imparts important information relevant to its detection.Hypothesis: Using transthoracic echocardiography, this study evaluated the mechanism of physiologic MR in young normal subjects using transthoracic echocardiography.Methods: The study population consisted of 48 young normal subjects (mean 21 ± 5 years) with MR (physiologic MR group), 40 age‐matched young normal subjects (mean 20 ± 5 years) without MR (control group), 45 patients (mean 41 ± 15 years) with mitral valve prolapse with MR (MVP group), and 27 patients (mean 59 ± 13 years) with ruptured chordae tendineae (rupture group).Results: Men were predominant in the rupture group, whereas there were no significant gender differences in the other three groups. Left ventricular end‐diastolic dimension and left atrial systolic dimension were slightly smaller in the physiologic MR group than in the control group, but were significantly smaller than those in the MVP and rupture groups. The ratio of the maximum anteroposterior diameter to the maximum transverse diameter on chest radiography and the ratio of the short‐ to long‐axis diameter of the left ventricular cavity at end diastole, determined from two‐dimensional short‐axis echocardiogram, were significantly lower in the physiologic MR group than in the other three groups. Mitral regurgitation occurred more frequently at the posteromedial commissural site in the physiologic MR and MVP groups, whereas there was no preference for location in the rupture group. Early systolic MR was often observed in the physiologic MR group, whereas pansystolic MR was common in the MVP and rupture groups.Conclusion: As a causal mechanism for physiologic MR detected in young normal subjects, “flattening” of the thorax during growth may cause morphologic abnormalities of the left atrial and ventricular cavities, resulting in spatial imbalance of the mitral complex and resulting in malcoaptation of the valve.
Isolated right ventricular infarction presenting as anterior wall myocardial infarction on electrocardiography
Authors: Porter Avital , Herz Itzhak , Strasberg Boris 
Published: February 2009

AbstractIsolated right ventricle infarction is extremely rare, and its electrocardiographic (ECG) signs may be misinterpreted or even missed, especially when a typical clinical picture is lacking. This paper describes a case of isolated right ventricle infarction, recognized only by echocardiography. The patient presented with ST‐segment elevation in left precordial leads together with minimal ST‐segment elevation in inferior leads on a 12‐lead ECG. Angiography revealed the culprit right coronary artery, which was small and non‐dominant. No significant obstructions were found in the left anterior descending artery. This case demonstrates that the ECG appearance of isolated right ventricle infarction may mimic anterior wall infarction and can be easily missed if not suspected.
Rapid hemostasis of arterial puncture sites with collagen in patients undergoing diagnostic and interventional cardiac catheterization
Authors: Silber Facc Sigmund , 
Published: February 2009

AbstractDespite the continuous reduction of sheath sizes in diagnostic and interventional cardiac catheterizations and the discontinuation of coumadin use after coronary stent implantation, a challenging role remains for hemostatic devices in the sealing femoral puncture sites. Since the introduction of the vascular hemostatic device (VHD) in 1991 and the hemostatic puncture closing device (HPCD) in 1992, numerous studies investigating these devices have been published. The deployment success rates reported in 2,292 patients for VHD is 97%, ranging from 88 to 100%. For HPCD, the mean deployment success rate resulting from 622 published patients leads to an identical result of 97%, ranging between 91 and 100%. For time to hemostasis, data have been analyzed according to the four different clinical situations, depending on level of anticoagulation (none or full) and the time of sheath removal (immediate or delayed). In randomized studies, when compared with the manual control groups, both devices revealed a statistically significant reduction in time to hemostasis: 12 to 16 minutes less for diagnostic catheterization and 14 to 30 minutes less for PTCA. As for minor local complications, no clinically relevant differences seem to exist. None of these devices has been proven to reduce major local complications. Prospective trials addressing early mobilization after percutaneous transluminal coronary angioplasty and the cost effectiveness of arterial closure devices in defined subgroups are warranted.
Myocardial bridge as a cause of thrombus formation and myocardial infarction in a young athlete
Authors: Agirbasli Mehmet , Martin Gregory S. , Bunker Stout J. , Jennings Henry S. , Lea John W. , Dixon John H. 
Published: February 2009

AbstractWe report here a young male athlete who had an acute myocardial infarction after strenuous exercise. Coronary angiography clearly demonstrated thrombus formation within a prominent myocardial bridge. Periarterial resection surgery was performed, which resulted in resolution of the angiographic “milking” effect of muscle bridge. Our observation. along with previous reports, suggests that myocardial bridges should be added to the list of known causes of sudden death or myocardial infarction in young persons after strenuous exercise. Thrombus formation within a myocardial bridge may be a potential mechanism whereby this anatomic curiosity may cause a tragic clinical event.
Evaluation of left atrial filling using systolic pulmonary venous flow velocity measurements in patients with atrial fibrillation
Authors: Oki Takashi , Tabata Tomotsugu , Yamada Hirotsugu , Wakatsuki Tetsuzo , Fukuda Kazuyo , Abe Miho , Onose Yukiko , Iuchi Arata , Ito Susumu , Fukuda Nobuo 
Published: February 2009

AbstractBackground: The pattern of pulmonary venous flow velocity is useful for understanding the hemodynamic relationship between the left atrium and left ventricle in patients with a variety of diseases, and the systolic flow wave, in particular, is considered a clinically important parameter that reflects left atrial filling.Hypothesis: The study was undertaken to determine whether systolic pulmonary venous flow velocity patterns can be used to evaluate left atrial filling in patients with atrial fibrillation.Methods: We performed transesophageal pulsed Doppler echocardiography and cardiac catheterization in 34 patients with chronic atrial fibrillation (10 with hypertrophic cardiomyopathy, 5 with dilated cardiomyopathy, 7 with previous myocardial infarction, and 12 with isolated atrial fibrillation) and 15 normal controls in sinus rhythm.Results: Mean pulmonary capillary wedge pressure, V‐wave height in the pulmonary capillary wedge pressure curve, and left ventricular end‐diastolic pressure were significantly higher in the hypertrophic cardiomyopathy and dilated failing heart (previous myocardial infarction and dilated cardiomyopathy) groups than in the isolated atrial fibrillation and normal groups. The peak velocity and time‐velocity integral of the systolic pulmonary venous flow velocity, and percent left atrial emptying fraction were significantly lower in the dilated failing heart group than in the isolated atrial fibrillation, hypertrophic cardiomyopathy, and normal groups. The peak velocity and time‐velocity integral of the systolic pulmonary venous flow velocity, percent left atrial emptying fraction, and V‐wave height were comparatively constant when the preceding R‐R intervals were relatively stable in the isolated atrial fibrillation group and in 4 of the 10 patients with hypertrophic cardiomyopathy. However, changes in these variables correlated with the preceding R‐R interval in all patients with dilated failing hearts and in 6 of the 10 patients with hypertrophic cardiomyopathy.Conclusion: Transesophageal pulsed Doppler echocardiographic measurements of systolic pulmonary venous flow velocity are valid indicators of left atrial filling in patients with atrial fibrillation.