tbuckley/cabot-search huggingface dataset:
Continuous positive airway pressure improves blood pressure and serum cardiovascular biomarkers in obstructive sleep apnoea and hypertension
Authors: Macy Mei-Sze Lui, Hung-Fat Tse, David Chi-Leung Lam, Kui-Kai Lau, Carmen Wing-Sze Chan, Mary Sau-Man Ip
Journal: European Respiratory Journal (2021)

Background The impact of treatment for obstructive sleep apnoea (OSA) on reduction of cardiovascular risk is unclear. This study aimed to examine the effect of continuous positive airway pressure (CPAP) on ambulatory blood pressure (BP) and subclinical myocardial injury in subjects with OSA and hypertension. Methods This was a parallel-group randomised controlled trial. Subjects with hypertension requiring at least three antihypertensive medications and moderate-to-severe OSA were enrolled. Eligible subjects were randomised (1:1) to receive either CPAP treatment or control (no CPAP) for 8 weeks. Changes in ambulatory BP and serum biomarkers were compared. Stratified analysis according to circadian BP pattern was performed. Results 92 subjects (75% male; mean± sd age 51±8 years and apnoea–hypopnoea index 40±8 events·h −1 , taking an average of 3.4 (range 3–6) antihypertensive drugs) were randomised. The group on CPAP treatment, compared with the control group, demonstrated a significant reduction in 24-h systolic BP (−4.4 (95% CI −8.7– −0.1) mmHg; p=0.046), 24-h diastolic BP (−2.9 (95% CI −5.5– −0.2) mmHg; p=0.032), daytime systolic BP (−5.4 (95% CI −9.7– −1.0) mmHg; p=0.016) and daytime diastolic BP (−3.4 (95% CI −6.1– −0.8) mmHg; p=0.012). CPAP treatment was associated with significant BP lowering only in nondippers, but not in dippers. Serum troponin I (mean difference −1.74 (95% CI −2.97– −0.50) pg·mL −1 ; p=0.006) and brain natriuretic peptide (−9.1 (95% CI −17.6– −0.6) pg·mL −1 ; p=0.036) were significantly reduced in CPAP compared with the control group. Conclusions In a cohort with OSA and multiple cardiovascular risk factors including difficult-to-control hypertension, short-term CPAP treatment improved ambulatory BP, and alleviated subclinical myocardial injury and strain.
External noninvasive temporary cardiac pacing: clinical trials.
Authors: P MZoll, R HZoll, R HFalk, J EClinton, D REitel, E MAntman
Journal: Circulation (1985)

An external cardiac pacemaker-monitor has been developed that provides safe, effective noninvasive ventricular stimulation that is well tolerated in conscious patients and allows clear recognition of electrocardiographic response. The noninvasive temporary pacemaker (NTP) has now been applied in 134 patients in five hospitals. Stimulation was tolerated well in 73 of 82 conscious patients, and nine found it intolerable. The NTP was effective in evoking electrocardiographic responses in 105 patients; the 29 failures were in the presence of prolonged hypoxia or severe discomfort. The NTP was clinically useful in 82 patients: 43 of 86 were resuscitated from emergency or expected arrest, 38 of 40 were maintained in standby readiness for up to 1 month but did not require stimulation, and one of eight patients with tachycardia obtained some clinical benefit. The NTP was especially useful in 25 patients with complications or contraindications to endocardial pacing and in 57 patients in whom insertion of an endoca...
Myocyte injury and contraction abnormalities produced by cytotoxic T lymphocytes.
Authors: S LWoodley, MMcMillan, JShelby, D HLynch, L KRoberts, R DEnsley, W HBarry
Journal: Circulation (1991)

BACKGROUNDThe mechanisms by which ventricular function is altered during cardiac transplant rejection are not well understood. Therefore, an in vitro model system has been developed to facilitate investigation of lymphocyte-mediated myocyte injury.METHODS AND RESULTSSplenic lymphoid cells were obtained from mice 8-10 days after placement of a vascularized abdominal cardiac allograft and were restimulated in vitro with irradiated donor-type splenocytes for 5 days. Cytotoxic effects of these allogenically stimulated lymphocytes on syngeneic and donor strain fetal cultured myocytes were determined by a 51Cr release assay at different lymphocyte to myocyte ratios. 51Cr release from donor strain myocytes was detectable within 1 hour of exposure, was maximal by 3-5 hours of coincubation with sensitized lymphocytes, and was allospecific. Cell injury manifest by 51Cr release was calcium dependent and was inhibited by pretreatment of lymphocytes with phorbol ester to deplete protein kinase C. Myocyte injury was al...
To Compare The Eus Guided Celiac Plexus Neurolysis With Opoids For Pancreatic Cancer Pain Relief And Quality Of Life. A Prospective Randomized Study From India
Authors: H Raina
Journal: Endoscopy (2021)

Aims EUS guided Celiac plexus neurolysis (CPN) and opoids are commonly used for pancreatic cancer related pain. The aim of this study was to compare the EUS –CPN versus opoid (tapendalol and pentazocine) in controlling the pancreatic cancer related pain and improving quality of life (QOL).
Relation between ventricular and myocyte remodeling with the development and regression of supraventricular tachycardia-induced cardiomyopathy.
Authors: F GSpinale, J LZellner, MTomita, F ACrawford, M RZile
Journal: Circulation Research (1991)

Chronic supraventricular tachycardia (SVT) causes left ventricular (LV) dilatation and dysfunction. Termination of SVT appears to reduce LV size and improve function. However, changes in myocyte structure and morphology that accompany the development and regression of SVT-induced cardiomyopathy have not been studied. Accordingly, we measured LV function using echocardiography and catheterization in three groups of six pigs each: 3 weeks of atrial pacing (SVT; 240 beats/min), 4-week recovery from SVT (PST), and sham-operated controls. At each of these three end points, isolated myocyte dimensions and nuclear number were measured using fluorescence, and the volume percent of myocytes and myofibrils was computed from tissue sections using stereological techniques. SVT resulted in reduced LV fractional shortening (15 +/- 3% versus 31 +/- 2%, p less than 0.05), increased end-diastolic dimension (5.6 +/- 0.8 versus 3.8 +/- 0.2 cm, p less than 0.05), and no change in mass (2.6 +/- 0.1 versus 2.6 +/- 0.2 g/kg, p ...
Plasma arteriovenous cGMP difference as a useful indicator of nitrate tolerance in patients with heart failure.
Authors: TTsutamoto, MKinoshita, YOhbayashi, AWada, YMaeda, TAdachi
Journal: Circulation (1994)

BACKGROUNDThe present study was performed to evaluate the effects of nitroglycerin (GTN) on plasma arteriovenous cGMP production and to compare its hemodynamic effects in patients with congestive heart failure (CHF). We also estimated the potential clinical value of plasma arteriovenous cGMP production as an indicator of nitrate tolerance.METHODS AND RESULTSPlasma arterial and venous cGMP levels, atrial natriuretic peptide level, and hemodynamic parameters were measured before and after GTN infusion in 14 patients with CHF. Although the plasma levels of arterial cGMP and atrial natriuretic peptide decreased immediately after GTN, the plasma level of venous cGMP did not change. GTN infusion caused a dose-dependent increase in plasma arteriovenous cGMP production, and there was a positive correlation between the decrease of pulmonary capillary wedge pressure and the increase of plasma arteriovenous cGMP production immediately after GTN. Hemodynamic tolerance was observed after both 12 and 24 hours, when pla...
Color Doppler assessment of mitral regurgitation with orthogonal planes.
Authors: FHelmcke, N CNanda, M CHsiung, BSoto, C KAdey, R GGoyal, R PGatewood
Journal: Circulation (1987)

We evaluated 147 patients with adequate color Doppler and angiographic studies for mitral regurgitation. Sixty-five patients had no mitral regurgitation by both color Doppler and angiography and 82 patients had mitral regurgitation by both techniques. Thus the sensitivity and specificity of color Doppler for the detection of mitral regurgitation was 100%. Three two-dimensional echocardiographic planes (parasternal long and short axis, apical four-chamber view) were used to analyze variables of the mitral regurgitant jet signals in the left atrium. The best correlation with angiography was obtained when the regurgitant jet area (RJA) (maximum or average from three planes) expressed as a percentage of the left atrial area (LAA) obtained in the same plane as the maximum regurgitant area was considered. The maximum RJA/LAA was under 20% in 34 of 36 patients with angiographic grade I mitral regurgitation, between 20% and 40% in 17 of 18 patients with grade II mitral regurgitation, and over 40% in 26 of 28 pati...
Echocardiographic evaluation of intracardiac pacing catheters: M-mode and two-dimensional studies.
Authors: W CReeves, N CNanda, S SBarold
Journal: Circulation (1978)

Thirty patients with right ventricular (RV) and 15 with coronary sinus (CS) pacing catheters were studied by M-mode echocardiography. RV catheters, detected in 23, appeared as linear echoes in the right ventricle during mitral valve recordings in 12, adjacent or superimposed on the tricuspid valve (TV) in 14, and immediately anterior to aortic root and pulmonary valve echoes in two with a redundant loop in RV outflow. In three with complete heart block, prominent systolic anterior movements of the TV occurred when atrial systole coincided with ventricular systole, probably due to catheter-induced TV buckling or exaggerated TV annular motion. Catheter echoes mimicked TV recordings in three, since its motion pattern was similar, although delayed and mimicked prolapsing right atrial myxomas in two because of multilayered complexes behind TV, while reverberations cluttering the left ventricle simulated structural echoes present in that cavity. CS catheters, detected in 14 as linear echoes in the area of atr...
Value and limitations of programmed electrical stimulation of the heart in the study and treatment of tachycardias.
Authors: H JWellens
Journal: Circulation (1978)

A review is given on the use of programmed electrical stimulation of the heart in patients suffering from tachycardia. The application of this technique makes it possible to evaluate mechanisms of tachycardia directly in the human heart. By repeating the same stimulation program following drug administration the effect of drugs on arrhythmia mechanisms can be studied. There are several factors, however, that influence the amount of information on mechanism and pathway of tachycardia and selection of appropriate therapy that can be obtained during the study. These factors as well as how information obtained programmed electrical stimulation of the heart has resulted in a better use of the 12-lead electrocardiogram as a diagnostic tool are discussed.
Direct actions of cocaine on cardiac cellular electrical activity.
Authors: D APrzywara, G EDambach
Journal: Circulation Research (1989)

The hypothesis that cocaine has Class I-type antiarrhythmic drug effects was tested in tissues isolated from rabbit heart with standard microelectrode methods. Propranolol (1 microM) was used to block beta-adrenergic effects. The actions of cocaine on cellular electrophysiology were concentration- and time-dependent and were reversible. In paced right atrial (RA) and right ventricular papillary (RVP) tissues, cocaine produced a profound prolongation of the effective refractory period (ERP) assessed by either premature stimulation or minimum pacing interval. ERP was increased up to eightfold in RA tissue and doubled in RVP tissue by 60 microM cocaine. This concentration of cocaine depressed action potential phase 0 depolarization 80% in RA tissue and 53% in RVP tissue but had no effect on resting membrane potentials. Automaticity was moderately depressed in sinus node (34% decrease in rate) but not in tricuspid valve cells. Phase 0 depolarization was not altered in these spontaneously active slow-response ...
Differential H1- and H2-receptor-mediated histamine responses of canine epicardial conductance and distal resistance coronary vessels.
Authors: W LMiller, A ABove
Journal: Circulation Research (1988)

The contributions of histamine (H1 or H2) receptor-mediated responses and, therefore, the effects of histamine blocking agents are unclear with regard to regulation of proximal epicardial and distal resistance coronary arteries. This study was designed to evaluate the effects of selective H1- and H2-receptor antagonists on epicardial and resistance vessels in the closed chest dog model. Histamine, diphenhydramine (H1 blocker), and cimetidine (H2 blocker) were infused into the left anterior descending coronary artery (LAD), and responses were studied by quantitative coronary angiography and flow measurements (133Xe washout). Histamine infusion alone produced a significant dilation of the proximal LAD (13% above control) only at the highest dose (45 micrograms/min), while LAD flow was increased by 128%. In the presence of H1 blocker, histamine produced significantly greater epicardial dilation (55% above control). The flow response curve was shifted to the right in the presence of H1 blocker, but the flow a...
Abstract 16193: Myocardial Force-Velocity Accurately Differentiates Amyloid From Hypertensive Cardiomyopathy
Authors: Waddy Gonzalez, Andrea Furlani, Ephraim Leiderman, Mario J Garcia
Journal: Circulation (2019)

Introduction: Novel therapies have been shown to improve survival in patients with Amyloid Cardiomyopathy (AC), particularly when implemented before the onset of advanced heart failure. However, di...
Ventricular arrhythmias in the acute and chronic phases after acute myocardial infarction. Effect of intervention with captopril.
Authors: PSøgaard, C OGøtzsche, JRavkilde, ANørgaard, KThygesen
Journal: Circulation (1994)

BACKGROUNDVentricular arrhythmias (VAs) are independent predictors of mortality in survivors of myocardial infarction (MI), and they are more likely to be induced in dilated hearts with increased wall stress. Angiotensin-converting enzyme (ACE) inhibitors have been shown to prevent progressive dilation of the left ventricle after MI.METHODS AND RESULTSThe effects of captopril were evaluated in 58 patients with left ventricular (LV) dysfunction after MI. Patients were randomized on day 7 to either placebo or captopril (50 mg daily) in a double-blind parallel study over a period of 6 months. Patients were followed up by means of ambulatory ECG monitoring and echocardiography. There was a significant increase in VA in the placebo group (P < .05) in contrast to a significant decrease in the captopril group (P < .05). As a consequence, there was a significant between-group difference after 6 months (P < .05). Furthermore, the number of patients without VA at baseline who presented with this at the completion o...
Chronotropic stimulation: a primary effector for release of atrial natriuretic factor.
Authors: G EBilder, P KSiegl, T LSchofield, P AFriedman
Journal: Circulation Research (1989)

Release of atrial natriuretic factor (ANF) following an elevation in heart rate is thought to be mediated primarily by a change in atrial stretch. To evaluate the direct effect of chronotropic stimulation on ANF release, isolated rat left atria were electrically paced (1-9 Hz) at constant resting tension (0.5-4 g), and the amount of immunoreactive ANF (IRANF) released at each frequency and tension was quantitated with a sensitive radioimmunoassay. Our results show that at controlled resting tensions greater than 1 g, chronotropic stimulation increased IRANF secretion in a manner dependent on the pacing frequency; rapid atrial rates (e.g., 8 and 9 Hz) were necessary to release ANF at tensions of 1 g or less. Resting tension influenced the magnitude of the secretory response to electrical stimulation. Release of IRANF with contraction frequency was transient in nature and, at high frequencies, was associated with a decrease in developed (systolic) tension in accordance with the negative force-frequency rela...
Submucosal dissection of the septum or submucosal tunneling endoscopic septum division: should we wander the free path or follow the tunnel?
Authors: Harshal S. Mandavdhare
Journal: Endoscopy (2021)

See also: Practice patterns, techniques, and outcomes of flexible endoscopic myotomy for Zenker’s diverticulum: a retrospective multicenter studyEndoscopy 2021; 53(04): 346-353DOI: 10.1055/a-1219-4516 See also: Reply to Dr. MandavdhareEndoscopy 2021; 53(04): 456-456DOI: 10.1055/a-1272-3953
Plasma atrial natriuretic factor and cyclic GMP in mitral stenosis treated by balloon valvulotomy. Effect of atrial fibrillation.
Authors: J CDussaule, AVahanian, P LMichel, ISoullier, SCzekalski, JAcar, RArdaillou
Journal: Circulation (1988)

To study the relation between plasma atrial natriuretic factor (ANF) and cardiac pressures, we measured plasma ANF in 24 patients with mitral stenosis 30 minutes before and 20 minutes after balloon mitral valvulotomy. All patients were without physical signs of congestive heart failure. Normal sinus rhythm was present in 15 (group 1), whereas the other nine (group 2) had permanent atrial fibrillation. There were no significant differences between groups for basal mean pressures in right atrium (RA), left atrium (LA), and pulmonary artery (PA). Valvulotomy resulted in a fall in both groups (p less than 0.001) in LA and PA mean pressures, whereas heart rate, cardiac index, and RA and aorta (AO) pressures did not change significantly. Basal ANF was not different in either group in RA (240 +/- 43 vs. 266 +/- 35 pg/ml) or AO (441 +/- 92 vs. 643 +/- 70 pg/ml) but tended to be higher in group 2 in LA (428 +/- 88 vs. 682 +/- 84 pg/ml; p = 0.059) and PA (488 +/- 93 vs. 759 +/- 92 pg/ml; p = 0.057). Plasma ANF was ...
Special Delivery
Authors: Douglas R. Reifler
Journal: JAMA (1989)

"NPC," read the bulletin board—no prenatal care. Good, from the point of view of a medical student waiting to deliver his first baby, because there would be no private obstetrician. Bad, from the mother's standpoint, because of the increased risks. I wrote my initials in the box marked "physician" and entered the room. Mrs Cortez was a very short, bronze-skinned, black-haired woman who seemed to be in her early 20s. Apart from her height she bore physical traits of many of the Mexican women who crossed the border just in time to give birth to new US citizens. She wore tattered jeans that were slightly soiled and rolled at the cuffs. A dusty, knitted shawl draped her broad shoulders. Her fingers were calloused, as if she had long worked in the fields. Her face, which she must have protected from the sun, bore sparkling eyes and rosy skin over gentle
Steroids, the eye, and general practitioners.
Authors: D St Clair Roberts
Journal: BMJ (1986)

economic importance; at worst, they may precipitate serious exacerbations of chronic bronchitis and other illness, so there are clear indications to prevent colds in susceptible people.Rhinoviruses account for only about 40% of colds, however,6 '°and clearly it will not be possible to prevent even all of these, since the source of the virus is not always easily recognised.In busy hospitals and general practice, for example, staff are frequently exposed to acute viral infec- tions, and it would be difficult to define what sort of contact would warrant instituting prophylactic treatment.Interferon sprays would have to be cheap and made freely available so- that treatment could be started soon enough to be effectiveand in view of the effects on the nasal mucosa, long term treatment may need to be discouraged.-Recentevidence suggests that cold viruses are more likely to be transmitted by direct hand to mucosa contact than by inhaled aerosol droplets.615For the future, interferon holds great promise, but for the present perhaps more emphasis should be put on attempts to reduce transmission ofinfection by simple hygienic measures-such as diligent handwashing after every contact.
Diabetes and cardiovascular risk factors: the Framingham study.
Authors: W BKannel, D LMcGee
Journal: Circulation (1979)

The impact of cardiovascular disease was compared in non-diabetics and diabetics in the Framingham cohort. In the first 20 years of the study about 6% of the women and 8% of the men were diagnosed as diabetics. The incidence of cardiovascular disease among diabetic men was twice that among non-diabetic men. Among diabetic women the incidence of cardiovascular disease was three times that among non-diabetic women. Judging from a comparison of standardized coefficients for the regression of incidence of cardiovascular disease on specified risk factors, there is no indication that the relationship of risk factors to the subsequent development of cardiovascular disease is different for diabetics and non-diabetics. This study suggests that the role of diabetes as a cardiovascular risk factor does not derive from an altered ability to contend with known risk factors.
Shall The Journal be Removed to Washington?
Authors: W. B. Porter
Journal: JAMA (1891)

<h3>To the Editor:</h3> —I have read most of the letters toThe Journal, pro and con, in relation to the moving of the same to Washington, D. C., and I have not seen any opinion, as yet, coming from the profession in the old Granite State. But I am sure, that as I have consulted with my confrères thus far, a united voice will come from her hills and valleys: "LetThe Journalremain where it is, unless you wish to asphyxiate its present life powers!" My reasons are the following: As far as I can judge, there are three to one of the members of the Association, regardless of location, who are opposed to its removal. It is much better and safer policy to let the majority rule in the make-up of all organized bodies. If for no other reason, organic law will decide: "Let it remain in Chicago."
Prevalence of Low Count (LC) Monoclonal B Cell Lymphocytosis (MBL) and Serious Infections in a Population-Based Cohort of U.S. Adults Participating in a Large Bio-Repository
Authors: Tait D. Shanafelt, Neil E. Kay, Curtis A. Hanson, Sameer A. Parikh, Sara J Achenbach, Aaron Norman, Kari G Chaffee, Susan Marie Schwager, Timothy G. Call, Susan L Slager
Journal: Blood (2017)
Accumulation and assembly of myosin in hypertrophic cardiomyopathy with the 403 Arg to Gln beta-myosin heavy chain mutation.
Authors: TVybiral, P RDeitiker, RRoberts, H FEpstein
Journal: Circulation Research (1992)

The sarcomeric proteins and organization of cardiac myofibrils appeared intact in multiple unrelated patients with hypertrophic cardiomyopathy. In two subjects demonstrating the missense mutation at position 403 (Arg to Gln) in the beta-myosin heavy chain gene, total myosin and immunoreactive beta-myosin heavy chain levels were similar to those found in other patients with hypertrophic cardiomyopathy and various disease control subjects. No alteration in expression of the cardiac alpha-myosin heavy chain gene was observed. These results are consistent with the examined myosin heavy chain mutation, permitting proper accumulation and assembly of myosin while primarily impairing contractile function. The characteristic myocyte disarray would appear likely to be a secondary consequence of the mutations.