tbuckley/cabot-search huggingface dataset:
Death and other time-related events after valve replacement.
Authors: E HBlackstone, J WKirklin
Journal: Circulation (1985)

A total of 1533 patients received primary aortic and/or mitral valve replacement, with or without tricuspid valve surgery or other associated cardiac procedures, from January 1, 1975, to July 1, 1979. Actuarial survival at 5 years was 74%. The hazard function (instantaneous risk) of death was highest immediately after operation. Among the incremental risk factors for premature death from any cause were preoperative NYHA class, any valve lesion other than aortic stenosis, aortic cross-clamp time, and combined aortic and mitral valve replacement. Ten modes of death were identified, each with its unique hazard function and risk factors. The commonest mode was cardiac failure. Sudden death was the next commonest, and the early phase of its hazard function peaked about 3 weeks after operation. Seventy-five patients (6.7% of the 1533) had 103 valve reoperations in the follow-up period. Actuarial survival after reoperation was less than that after the primary operation; whether the reoperation was the first, sec...
Myocardial infarction size from serial CPK: variability of CPK serum entry ratio with size and model of infarction.
Authors: J ACairns, EMissirlis, E LFallen
Journal: Circulation (1978)

To study the variability of the fraction of CPK released from the infarcted heart which enters the serum (serum entry ratio, or SER) with size and model of infarction, nine dogs underwent homogeneous infarctions (LAD ligation) of varying sizes, and 10 dogs underwent scattered infarctions (left coronary embolization). In homogeneous infarcts there was an inverse linear relationship of SER to infarct size (IS) (SER = -0.8514% LV + 0.345, r = 0.98). No such relationship was found for scattered infarcts. CPK Kd (exponential disappearance constant for CPK) was not significantly different in homogeneous (-0.00178 min-1) vs scattered infarcts (-0.00195 min-1). Although similar IS was produced in each (homogeneous 19.9% LV, scattered 18.4% LV) cumulative CPK serum entry (CPKr) was much lower in homogeneous (4175 mlU/ml) vs scattered infarcts (7,296 mlU/ml). SER was also much lower in homogeneous (17.7%) vs scattered infarcts (29.0%) (P less than 0.025). Cumulative CPK plateau occurred significantly later in homog...
68Ga-DOTATATE PET/CT Imaging of Refractory Pituitary Macroadenoma Invading the Orbit
Authors: Noah Lybik, Daniel J. Wale, Ka Kit Wong, Eric Liao, Benjamin L. Viglianti
Journal: Clinical Nuclear Medicine (2021)

In addition to gastroenteropancreatic neuroendocrine neoplasms, a wide variety of tumors express somatostatin receptors. Somatostatin receptor imaging, heavily utilized in neuroendocrine oncology, may also have utility in the diagnosis of other neoplasms and raises the possibility of potential therapeutic options. We describe the case of a 60-year-old man who underwent 68Ga-DOTATATE PET/CT, demonstrating an avid invasive pituitary macroadenoma. This mass was persistent and refractory despite traditional treatment options. Because of the avidity, 177Lu-DOTATATE therapy was offered, although not ultimately performed, demonstrating a potential treatment for challenging cases utilizing the principles of theranostics.
Hydrolase activities in the rat aorta. I. Effects of diabetes mellitus and insulin treatment.
Authors: HWolinsky, SGoldfischer, LCapron, FCapron, BColtoff-Schiller, LKasak
Journal: Circulation Research (1978)

Vascular disease in diabetics could arise in part from altered vessel wall catebolism. Specific activities of hydrolases in aortic smooth muscle cells from rats with streptozotocin-induced diabetes were measured. Enyzmes included: neutral alpha-glucosidase, alpha-mannosidase, and lysosomal N-acetyl beta-glucosaminidase, beta-galactosidase, cathepsin C, acid alpha-glucosidase, and acid cholesteryl esterase. After 4,8, and 11 weeks of diabetes, activities of all enzymes studied were decreased significantly in diabetic vessels, decreases ranging from 15% for cathepsin C to 62% for alpha-mannosidase. After 3 weeks of diabetes, insulin treatment for 1 week restored enzyme levels to normal. After 7 weeks of diabetes, 1 week of insulin treatment did not restore enzyme levels fully to normal (acid cholesteryl esterase was unchanged); 4 weeks of insulin did. Acid phosphatase and N-acetyl beta-glucosaminidase activities were reduced markedly in histochemical studies of diabetic aortas at all time periods and were r...
Diastolic sounds and murmurs associated with mitral valve prolapse.
Authors: J YWei, N JFortuin
Journal: Circulation (1981)

Although mitral valve prolapse is often associated with a systolic click or murmur, it is not widely appreciated that a sound or murmur may also occur in diastole. Nine patients with a systolic click or murmur and echocardiographic evidence of mitral prolapse had, in addition, a diastolic sound or an early diastolic murmur best heard at the apex or left sternal border. The sound, which was of high frequency and easily audible, followed A2 by 70-110 msec (mean 94 +/- 5 msec), and coincided with the point where the prolapsed posterior leaflet returned from the left atrium and recoapted with the anterior mitral leaflet. The diastolic sound occurred 40-60 msec (mean 53 +/- 4 msec) before the E point of the echocardiogram and O point of the apexcardiogram, and even longer before the rapid-filling wave. The diastolic murmur, also of high frequency, was brief and decrescendo, and simulated aortic regurgitation in two patients. Thus, mitral prolapse may be associated with a sound or murmur in diastole. When a dia...
Real-time cross-sectional echocardiographic imaging and measurement of the patent ductus arteriosus in infants and children.
Authors: D JSahn, H DAllen
Journal: Circulation (1978)

While echocardiography has been used to noninvasively document indirect effects on the heart of left-to-right shunting through a patent ductus arteriosus, no noninvasive technique has been developed to image the duct itself. In this study, 35 sequential studies were performed on 28 patients with a mechanical sector scanner to image the distal pulmonary artery and its bifurcation by scanning along the axis of the right ventricular outflow tract. Cross-sectional imaging, just superior to the take-off of the right pulmonary artery, provided visualization of the patent ductus as a distal continuation of the pulmonary artery connecting to the descending aorta. Ductal visualization by cross-sectional echo was validated by saline echo contrast observations of right-to-left and left-to-right shunting through the duct in 14 patients, by surgical observations in 11, angiographic observations in 13 and autopsy observations in three. Angiographic size of the ductus arteriosus, whether constricted or widely patent, to...
The effects of nifedipine on myocardial blood flow and contraction during ischemia in the dog.
Authors: W SWeintraub, SHattori, J BAgarwal, M MBodenheimer, V SBanka, R HHelfant
Journal: Circulation (1982)

Nifedipine has been proposed as an agent to preserve viability and function of ischemic myocardium. We studied 23 open-chest dogs that underwent carotid-to-left anterior coronary artery perfusion with flow probe and perfusion pressure monitoring. Segment length was measured with ultrasonic crystals in the ischemic and nonischemic endocardium. Myocardial blood flow was measured with radioactive microspheres. Partial coronary occlusion was performed to 25 mm Hg diastolic perfusion pressure. Ten dogs received intracoronary nifedipine, 10 micrograms, and 13 dogs received i.v. nifedipine, 3 micrograms/kg/min. Nifedipine resulted in an increase in segmental shortening in both groups, but nonischemic zone shortening did not change in either group. Nifedipine did not affect myocardial blood flow in the ischemic zone, but increased flow in the nonischemic zone in the group that received i.v. nifedipine. Thus, nifedipine appears to have a direct beneficial effect on ischemic myocardium.
Bradycardia-dependent triggered activity: relevance to drug-induced multiform ventricular tachycardia.
Authors: JBrachmann, B JScherlag, L VRosenshtraukh, RLazzara
Journal: Circulation (1983)

We used cesium chloride (CsCl) for electrophysiologic studies in canine hearts in vivo and in vitro to examine the mechanisms underlying ventricular arrhythmias that are related to prolonged repolarization. Cesium is known to depress normal ventricular automaticity and some experimental arrhythmias by blocking delayed outward currents and prolonging action potential duration. In 10 dogs in normal sinus rhythm, 1 to 1.5 mM/kg iv CsCl prolonged the QT (QU) interval and induced ventricular ectopy in all, including multiform ventricular tachycardia. In 12 dogs with atrioventricular block, 1 to 1.5 mM/kg iv CsCl produced marked suppression of idioventricular rates (from 45 +/- 6 to 8 +/- 4 beats/min). These low rates were then associated with bigeminy or bursts of multiform ventricular arrhythmia. Pacing at rates of 60 beats/min or more suppressed these arrhythmias. Low doses of tetrodotoxin (1 microgram/kg) also abolished these bradycardia-dependent arrhythmias without affecting the amplitude of ventricular e...
Determinants of renal actions of atrial natriuretic peptide. Lack of effect of atrial natriuretic peptide on pressure-induced vasoconstriction.
Authors: KHayashi, MEpstein, RLoutzenhiser
Journal: Circulation Research (1990)

We have previously demonstrated that atrial natriuretic peptide (ANP) completely reverses norepinephrine-induced afferent arteriolar (AA) vasoconstriction. In the present study we characterized the effects of ANP on pressure-induced vasoconstriction of AA. Chronic unilateral hydronephrosis was induced to facilitate direct visualization of the renal microcirculation. Hydronephrotic kidneys were perfused in vitro, and AA diameters were measured during stepwise alterations in renal arterial pressure. Increasing renal arterial pressure from 80 to 180 mm Hg decreased AA diameter by 22 +/- 2% (from 18.5 +/- 1.0 to 14.4 +/- 1.0 microns, p less than 0.005). In the presence of 100 nM ANP [human ANP-(4-28)], AA vasoconstricted by 23 +/- 4%, indicating that ANP failed to modify the pressure-induced AA vasoconstriction. Furthermore, both nitroprusside (10 microM) and 8-bromoguanosine 3':5'-cyclic monophosphate (30 microM) only partially inhibited pressure-induced AA vasoconstriction (31 +/- 5% and 47 +/- 7%, respecti...
Vascular complications after balloon and new device angioplasty.
Authors: J JPopma, L FSatler, A DPichard, K MKent, ACampbell, Y CChuang, CClark, A JMerritt, T ABucher, M BLeon
Journal: Circulation (1993)

BACKGROUNDDespite their potential advantages, new coronary angioplasty devices may be associated with more frequent vascular complications than noted after standard balloon angioplasty, theoretically due to the larger sheaths and prolonged periods of anticoagulation required by some of these devices. This study sought to identify the incidence, predictors, and clinical outcome of vascular complications after new device angioplasty.METHODS AND RESULTSThe clinical course of 1413 patients was reviewed after balloon or new device angioplasty. Vascular complications were defined as formation of a pseudoaneurysm, arteriovenous fistula, retroperitoneal hematoma, or groin hematoma associated with a > 15-point hematocrit drop or the need for surgical repair. Stepwise logistic regression was used to identify independent predictors for vascular complications. Vascular complications developed after 84 (5.9%) procedures; they occurred more frequently after intracoronary stenting (14.0%) and extraction atherectomy (12....
Non-hydrostatic pulmonary edema after coronary artery ligation in dogs. Protective effect of indomethacin.
Authors: J FRicheson, CPaulshock, P NYun
Journal: Circulation Research (1982)

Pulmonary edema which develops during acute myocardial infarction is generally believed to result solely from pulmonary microvascular hypertension. However, patient with myocardial infarction and pulmonary edema occasionally are found to have normal pulmonary wedge pressure. We report data indicating that pulmonary edema develops after coronary artery ligation despite stable microvascular pressure. Four groups of open-chest dogs were studied: (1) nine dogs with left anterior descending coronary artery ligation, (2) seven dogs with sham coronary ligation, (3) seven dogs ligated after beginning an infusion of indomethacin (5 mg/kg per hr), and (4) five dogs ligated after an infusion of the drug's vehicle was begun. Extravascular lung water and pulmonary blood volume were measured at hourly intervals during the 2 hours before and after coronary ligation or sham ligation. Gravimetric lung water was measured immediately thereafter. Changes of net pulmonary intravascular driving force (the difference of microva...
Three dimensional geometry of acutely ischemic myocardium.
Authors: M LMarcus, R EKerber, JEhrhardt, F MAbboud
Journal: Circulation (1975)

The distribution of coronary flow to small segments of the entire left ventricle (96 per dog; average weight = 0.78 g) was studied in 28 open-chested dogs utilizing 7-10 mu labeled microspheres. Although the flow to large areas of the ventricle was nearly evenly distributed, there was considerable heterogeneity of flow to small adjacent segments of myocardium (average standard deviation of the flow distributions was 17.3 +/- 3.2% of mean lfow). Approximately one-half of the measured heterogeneity of flow could be attributed to various extraneous factors, and one-half appears to be due to inherent heterogeneity of flow in the left ventricular myocardium. In ten of 28 dogs, the mid-circumglex coronary was suddenly occluded, and five minutes thereafter the distribution of left ventricular flow was determined with microspheres labeled with a different isotope. The ischemic regments were separated into three groups: severely ischemic, moderately ischemic, and borderline ischemic. The three dimmensional geometr...
Use Of The Conecct Classification Optimally Identifies Large Superficial Lesions Lacking Submucosal Carcinomas: A Prospective Study On 663 Lesions
Authors: C Brulé, M Pioche, J Albouys, J Rivory, S Geyl, R Legros, F Rostain, H Lepetit, D Sautereau, T Ponchon, E Auditeau, J Jacques
Journal: Endoscopy (2021)

Aims Endoscopic characterization is a fundamental step to predict lesion histology in order to choose the best resection modality between piece-meal EMR and ESD for large superficial colorectal lesions. CONECCT classification (COlorectal Neoplasia Endoscopic Classification to Choose the Treatment) grouped overt and covert sign of carcinoma in an all-in-one classification including all previous published criteria. CONECCT IIC subtype correspond to lesions at risk of submucosal cancer requiring absolute endoscopic en-bloc resection including pit or vascular abnormalities (SANO IIIA, JNET IIB types) and macroscopic worrisome features (LST-NG type; a macronodule larger than 1cm; a depressed area [Paris 0-IIc area]).
Treatment of canine permeability pulmonary edema: short-term effects of dobutamine, furosemide, and hydralazine.
Authors: W DMolloy, K YLee, LGirling, R MPrewitt
Journal: Circulation (1985)

The effects of treatment of oleic acid pulmonary edema with dobutamine, furosemide, and hydralazine on cardiopulmonary function in 24 dogs were investigated. Pulmonary capillary wedge pressure (PCWP) was adjusted to approximately 7 mm Hg; 45 min after oleic acid (0.08 ml/kg), dogs were randomly divided into a control group, in which PCWP was maintained at approximately 7 mm Hg, and into treatment groups as described above. Mean time-averaged PCWP was 2.3 mm Hg in dogs treated with dobutamine, 4.1 mm Hg with furosemide, and 4.4 mm Hg with hydralazine. Four hours of treatment with dobutamine and furosemide significantly (p less than .01) reduced accumulation of lung water compared with the control and hydralazine groups. Qs/Qt was lower (p less than .05) with dobutamine and furosemide compared with the other groups. In dogs given hydralazine, cardiac output (CO) and systemic vascular resistance (SVR) remained constant over the 4 hr treatment interval. In contrast, in all other groups, SVR increased and CO d...
Prognostic determinants in hypertrophic cardiomyopathy. Prospective evaluation of a therapeutic strategy based on clinical, Holter, hemodynamic, and electrophysiological findings.
Authors: LFananapazir, A CChang, S EEpstein, DMcAreavey
Journal: Circulation (1992)

BACKGROUNDPatients with hypertrophic cardiomyopathy (HCM) frequently have arrhythmias and hemodynamic abnormalities and are prone to sudden death and syncope. An important need exists for improved risk stratification and definition of appropriate investigation and therapy.METHODS AND RESULTSThe relation of 31 clinical, Holter, cardiac catheterization, and electrophysiological (EP) variables to subsequent cardiac events in 230 HCM patients was examined by multivariate analysis. Studies were for cardiac arrest (n = 32), syncope (n = 80), presyncope (n = 52), ventricular tachycardia (VT) on Holter (n = 36), a strong family history of sudden death (n = 9), and palpitations (n = 21). Nonsustained VT on Holter was present in 115 patients (50%). Sustained ventricular arrhythmia was induced in 82 patients (36%). Seventeen cardiac events (eight sudden deaths, one cardiac arrest, and eight syncope with defibrillator discharges) occurred during a follow-up of 28 +/- 19 months. The 1-year and 5-year event-free rates ...
Digitalis in the pre-excitation syndrome. Analysis during atrial fibrillation.
Authors: T DSellers, T MBashore, J JGallagher
Journal: Circulation (1977)

The effect of digitalis in 21 patients with Wolff-Parkinson-White syndrome was anlayzed with respect to the ventricular response during atrial fibrillation and antegrade and retrograde refractory periods of accessory pathways. Digitalis shortened the cycle length of the most rapid ventricular response (shortest R-R) (i.e., increased the ventricle response) in 6/21 patients, increased the cycle length in 7/21 patients, had no effect on the cycle length in 5/21, and could not be determined in 3/21. Digitalis could be directly related to the onset of ventricle fibrillation resulting from atrial fibrillation in 9/21 patients. Each of these patients had shortest R-R intervals (220 msec or less) during atrial fibrillation in the control data. The results of this study indicate that no a priori prediction about the effect of digitalis on the antegrade conduction of accessory pathways can be made. By elective induction of atrial fibrillation it is possible to separate WPW patients into groups at high and low risk...
Aortic input impedance in heart failure.
Authors: C JPepine, W WNichols, C RConti
Journal: Circulation (1978)

The input impedance of the systemic circulation was calculated from recordings of pulsatile pressure and flow in the ascending aorta of 20 patients. Ten patients had clinical and hemodynamic evidence of heart failure. The other 10 subjects had no clinical evidence of heart failure and were used as a control group. In the heart failure patients, both input resistance and characteristic impedance (index of aortic distensibility) were significantly increased compared to pressure- and age-matched control subjects. Oscillations of impedance moduli, represented by the difference between maximum and minimum moduli, were also significantly increased in the heart failure patients compared with the control subjects. The increased characteristic input impedance in these heart failure patients suggests that the human aorta is stiffer in heart failure, and the larger oscillations in the impedance spectrum indicate an increase in pressure and flow wave reflections. From reflected wave theory in elastic tubes, reflected...
Ultrastructure of crista supraventricularis muscle in patients with congenital heart diseases associated with right ventricular outflow tract obstruction.
Authors: MJones, V JFerrans, A GMorrow, W CRoberts
Journal: Circulation (1975)

Ultrastructural studies were made of operatively resected crista supraventricularis muscle in 59 patients with congenital heart diseases, or whom 54 had obstruction to right ventricular outflow. Relationships of anatomic diagnosis, age, peripheral arterial oxygen saturation (PAO2), peak right ventricular systolic pressure gradient and right ventricular end-diastolic pressure (RVEDP) to hypertrophic changes, abnormalities of cellular and myofibrillar orientation, and degenerative alterations were determined. Changes directly related to hypertrophy were: cell diameters greater than 20 mu, irregular cell shape, lobulated nuclei, multiple intercalated discs, dilated T tubules, abnormal Z bands, and increased numbers of ribosomes. Abnormalities of cellular or myofibrillar orientation were focal in distribution and occurred in 12 patients, most of whom had elevated RVEDP, decreased PAO2, markedly enlarged cells, and interstitial fibrosis. Interstitial fibrosis was prominent in 19 patients and was associated wit...
Pressor responses to norepinephrine in rabbits with 3-day and 30-day renal artery stenosis. The role of angiotensin II.
Authors: SIchikawa, J AJohnson, W LFowler, C GPayne, KKurz, W FKeitzer
Journal: Circulation Research (1978)

Pressor responses to norepinephrine (NE) infusions were examined in normal rabbits, in rabbits with renal artery stenosis of over 30 days' duration (chronic renal hypertensive rabbits), and in rabbits with renal artery stenosis of 3 days' duration (3-day clipped rabbits). The 3-day clipped rabbits did not have hypertension, but they showed the same increased pressor responses to NE as did the chronic renal hypertensive rabbits, which was about 2.5 times that of the normal rabbits. Plasma renin activity (PRA) was the same in the 3-day clipped rabbits as in the normal group, but in the chronic renal hypertensive rabbits the PRA was significantly below normal. Infusions of angiotensin II (A II) in either subpressor or pressor amounts potentiated the pressor responses to NE in normal rabbits, whereas, in 3-day clipped rabbits and chronic renal hypertensive rabbits, A II in subpressor or pressor doses did not alter the pressor responses to NE. Infusion of the A II antagonist, [1-sarcosine, 8-isoleucine]angiote...
Stimulation of renin by acute selective chloride depletion in the rat.
Authors: H EAbboud, R GLuke, J HGalla, T AKotchen
Journal: Circulation Research (1979)

To determine whether acute chloride depletion per se stimulates renin, we produced selective chloride depletion without sodium depletion in rats by peritoneal dialysis (PD) against 0.15 M NaHCO3 or 0.15 M NaNO3. Control rats were dialyzed against 0.15 M NaCl. Plasma renin activity (PRA) was measured before (PRA1) and 105 minutes after (PRA2) PD. Plasma volume was expanded after PD by infusion of salt-free albumin and was measured immediately after PRA2 by [131I]albumin. In experiment 1, rats were prepared on a normal diet. PRA2 (7.0 +/- 1.0 ng/ml per hr, mean +/- SEM) was increased (P less than 0.05) over PRA1 (4.7 +/- 0.7 ng/ml per hr) in Cl-depleted but not in control rats (PRA1 = 5.3 +/- 0.7, PRA2 = 6.1 +/- 0.7, P = NS). In experiment 2, to produce greater chloride depletion, all rats were prepared for 2 weeks on a low salt diet. PRA2 (47 +/- 5 ng/ml per hr) was increased as compared to PRA1 (24 +/- 2 ng/ml per hr, P less than 0.005) in the Cl-depleted group but not in the control group (PRA1 = 24 +/- ...