摘要:

Serum cholesterol, serum glyceride, blood glucose, relative weight, physical activity, percent calories from fat, percent calories from carbohydrate, and polyunsaturated/saturated fatty acid (P/S) ratio were determined in 1780 rural and 4023 urban fasting men aged 45-64 years being followed prospectively to ascertain reasons for the low prevalence of coronary heart disease mortality in Puerto Rico as compared to other countries. Lipid and glucose levels and relative weight were higher and physical activity lower in urban men. Glyceride was positively correlated with cholesterol, glucose, and relative weight, and negatively correlated with physical activity. Cholesterol was positively correlated with glyceride, glucose, and relative weight, and not correlated with physical activity. Percent calories from fat and P/S ratio were significantly higher and percent carbohydrates from starch significantly lower in urban men. These variables taken together were not significant in predicting the differences between urban and rural serum cholesterol or glyceride values. Relative weight was the most significant variable in explaining urban-rural differences in serum glyceride and cholesterol levels. These findings confirm the importance of weight control in dietary management for reduction of serum lipids.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Eleven patients with arteriographically confirmed coronary artery disease and normal arterial oxygen saturation were studied. The angina threshold was determined first by successive elevation of heart rate at increments of 10 and 5 beats/min by right atrial pacing while the patients were breathing air via a close-fitting mask. The mask was then connected to an oxygen tank without the patient's knowledge. After 5 min of oxygen breathing, the heart rate was again raised to the previously determined threshold level. In nine of 11 patients angina did not recur. The absence of angina was associated with improvement in myocardial lactate extraction from −17 ± 15 to +18 ± 10% (P< 0.025), in S-T abnormalities in six of seven patients, and in pulsus alternans in three of five patients.The pacing rate was then raised at increments of 5 beats/min until angina recurred. With oxygen breathing, angina developed at higher pacing rates (129 ± 7 beats/min with air and 137 ± 6 beats/min with oxygen, on the average;P< 0.005), at higher rate-pressure product (18.0 ± 0.8 and 19.5 ± 0.9 × 103mm Hg/min, respectively;P< 0.01), and at higher left ventricular oxygen consumption (21.3 ± 1.1 and 24.6 ± 1.1 ml/min, respectively;P< 0.005). The results indicate that oxygen breathing permits the heart to do more work before coronary insufficiency develops.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Eleven patients underwent selective coronary and left ventricular cineangiography during intraaortic balloon pumping for acute myocardial infarction and cardiogenic shock. Studies were performed when the clinical and hemodynamic trend predicted in-hospital death. Angiograms were reviewed by dividing the left ventricle into six segments, each with its characteristic coronary perfusion. No patient with avascular and akinetic segments survived with or without surgery. One patient with residual perfusion of all segments showed massive necrosis at operation that eventually led to his death. In four patients the findings of residual contraction and perfusion of most segments suggested reversible ventricular dysfunction. Three of these underwent coronary surgery with two excellent survivors.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Male subjects (N = 68), under age 51 years, with previous myocardial infarction, who participated in a program of graduated exercises over a 7-year period (1964-71), have been compared with a control group (N = 131) for incidence of nonfatal recurrence and cardiac death. The controls fulfilled the criteria to enter the exercise program, but did not. Of the 68 exercising subjects, 66 were traced in January 1971. Two (3.0%) had had a nonfatal recurrence. Of the 131 control subjects, only 117 gave valid information concerning possible recurrence. Thirteen (11.1%) had suffered a nonfatal recurrence (P< 0.10). The incidence of cardiac death (7.6%) was significantly lower (P< 0.05) in the exercising subjects than in the 127 control subjects (four of the 131 could not be traced).In 1969 a separate comparison of recurrence and survival over a 5-year period was made between 77 exercising subjects who had remained in the program for a minimum of 3 months and 127 control subjects in Toronto. One (1.3%) of the exercising subjects had had a nonfatal recurrence, and 31 (27.9%) of 111 Toronto control subjects (16 others were alive but information on recurrence was lacking) gave a history of nonfatal recurrence (P< 0.001). There were three (3.9%) deaths in the exercise group and 15 (11.8%) deaths in the Toronto control group (P< 0.10).Variables affecting prognosis, but not included in the study, were blood pressure, prior angina, and current angina. Although results of this investigation suggest that an exercise program in a selected group may favorably affect prognosis following recovery from myocardial infarction, they should be interpreted cautiously. One or more variables not related to the exercise program per se may have been operative in producing the apparent benefit.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Radionuclide angiography provides a reliable and extremely rapid technic for assessing the physiologic and pathologic features of cardiovascular malformations. Eighty-six infants and children and seven adults have been studied after intravenous infusion of99mtechnetium with a scintillation camera coupled to a computer-tape storage system. Pulmonary vascular isotope-dilution curves detected the presence or absence of left-to-right intra- or extracardiac shunts with great sensitivity. Therefore, the method has especially widespread applicability in the distinction between organic and innocent heart murmurs, in the evaluation of postoperative patients, and in the assessment of the natural course of selected, specific malformations. Moreover, also without resorting to cardiac catheterization, scintillation scanning is capable of defining great artery orientation and position, cardiac chamber position, approximate chamber volumes, and the distribution of pulmonary arterial blood flow. The method described is technically simple, without known risk, is easily applicable to large numbers of patients, and provides clinically important information concerning many forms of congenital heart disease.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A promising new operation-coronary bypass-has been developed for the treatment of coronary heart disease. However, because of the nature of the underlying disease and the minute size of the vessels to be anastomosed, its long-range prospects are in doubt. At this point in time there is no evidence that the operation either prevents infarction or prolongs life, and great caution is urged in applying it, reserving it for those who have life-threatening coronary artery disease, are clearly recalcitrant to optimum medical management, and have apparently normal coronary vessels distal to the point of stenosis.There is an urgent need for a better definition of the indications for operation in patients with coronary artery disease based on a study of the natural history of this coindition. Prophylactic operation for patients with a compromised coronary circulation with or without angina must await long-term results of therapeutic operation.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The available experimental and clinical data still leave many unanswered questions concerning the role of digitalis therapy after acute myocardial infarction. It seems clear that little is to be gained by glycoside administration to patients with uncomplicated infarctions who do not have cardiomegaly. The precise role of digitalis therapy in the treatment of cardiogenic shock remains undefined on the basis of the available data. However, until evidence to the contrary appears, its use should be continued on the basis of experience with experimental cardiogenic shock and the presumption that this state, when observed clinically, is a form of extreme left ventricular failure.Digitalis appears to be indicated in the treatment of atrial fibrillation with rapid ventricular rate complicating acute myocardial infarction. Other supraventricular arrhythmias, such as atrial flutter and ectopic atrial tachycardia, frequently require larger doses of the glycoside, and other means of therapy, such as antiarrhythmic agents or electrical conversion, may be preferable in such instances.Digitalis is commonly utilized early in the treatment of congestive heart failure and cardiomegaly complicating acute myocardial infarction, despite the paucity of experimental and clinical evidence in support of such therapy. Whether the digitalis glycosides should continue to be used routinely in such patients is an important subject for clinical investigation.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID