ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

Thirteen patients with left ventricular aneurysm due to coronary heart disease were studied by left heart and coronary sinus catheterization, including cineventriculography and measurement of ventricular mechanics and energetics at rest, and in some subjects, during either isoproterenol infusion or supine leg exercise. Eight patients had an aneurysm estimated to comprise greater than 20% of the left ventricular surface area, associated with increased left ventricular end-diastolic volume and pressure and mean systolic force. Average isometric rate of pressure rise and mean fiber shortening velocity and distance were uniformly decreased. Five patients had an aneurysm, estimated to comprise less than 15% of the left ventricular surface, associated with normal or nearly-normal left ventricular end-diastolic volume and pressure and mean systolic force. Average isometric rate of pressure rise was normal, but fiber shortening velocity and distance were moderately depressed. Stroke output and cardiac output were reduced in both groups.Aneurysms exhibited either paradoxical systolic expansion or apparent lack of motion (akinesis), or both. A theoretical analysis presented indicated that when approximately 20 to 25% of left ventricular area is inactivated by any pathological process, the degree of shortening distance required of the myofiber to maintain stroke volume exceeds physiological limits, and cardiac enlargement (Starling mechanism) must ensue to maintain adequate ejection of blood. The magnitude of the salutary response of isoproterenol coupled with an increase in mechanical efficiency during catecholamine infusion suggested that myocardial catecholamines were depleted with additional aggravation of heart failure in this disease.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

The myocardium, all parts of the conduction system, and the S-A node contained iron in six patients with acquired iron-storage disease. The nerve fibers and ganglia contained negligible amounts. No correlation was demonstrated between the amount of histochemically demonstrated iron in the myocardium and conduction system, or the amount of transfused iron, or the amount of quantitatively analyzed myocardial iron and the presence of antemortem arrhythmias and conduction disturbances. The degree of scarring in the S-A node, A-V node, and bundle of His did not parallel the density of iron deposits in these structures.These observations support the theory that factors other than iron alone are responsible for the cardiac rhythm and conduction abnormalities associated with iron-storage disease.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

Right and left heart catheterization, including selective cineangiocardiography, was performed in 20 of the 33 patients examined in a large Negro family. Fifteen had features compatible with the diagnosis of idiopathic hypertrophic subaortic stenosis. Sudden death has not occurred in this family. Many of the patients were young and were totally unaware of the heart disease, although 11 had symptoms of dyspnea on exertion. A large number of individuals in this family were found to be affected by a familial form of heart disease with similar clinical manifestations, but with a wide spectrum of hemodynamic and cineangiocardiographic abnormalities ranging from no obstruction to ventricular outflow and only mild indentation of the ventricular cavity to obstruction and marked narrowing of both ventricular outflow tracts. The patients with obstruction of the left ventricular outflow tract were older than those without obstruction. Therefore, this study provides further evidence that in families with myocardial disease, the presence or absence of outflow tract obstruction is merely a different manifestation of the same basic cardiac disease. This study has also demonstrated distinct left ventricular abnormalities quite early in life suggesting that the disease may be of congenital origin and that obstruction may be a function of the duration of the disease.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

The pressure-gradient technique was used to obtain continuous measurements of both blood pressure and flow in the ascending aorta of eight normal subjects who were performing a standardized Valsalva maneuver. From these recordings the beat-to-beat changes in stroke volume, peak blood flow, peripheral vascular resistance, duration of ejection, and an index of total systolic duration were calculated. Stroke volume and peak blood flow were not changed with the onset of straining (phase I), but were decreased to approximately 50% of control values immediately prior to release (phase II). During the overshoot period (phase IV) stroke volume and peak flow were increased above control levels. Both the duration of ejection and the duration of systole were shortened during straining (phase II). The concomitant changes in blood pressure in these subjects were similar to previously reported pressure recordings. An estimate of the pressure-radius relationships in the ascending aorta of these patients was obtained angiographically. The mean cross-sectional area of the ascending aorta changed by 17% during the Valsalva maneuver.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

A quantitative study of arteriolar structure has been undertaken in 23 individuals with chronic hypertension and 18 normotensive controls. In the hypertensive individuals, some arterioles were found to have an increased, and others a subnormal, mass of medial smooth muscle. Both abnormalities often bear a definite relation to arteriolar sclerotic lesions, those arterioles proximal to sclerotic segments having an increased medial coat and those distal, an atrophic coat. Mean values for mass of arteriolar muscle were often normal in organs of the hypertensive patients. These anatomic features can be correlated with a variety of physiological and clinical observations in the disorder.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

An autopsy study of leg veins in unselected patients was performed in which postmortem venography, complete gross dissection, and microscopic examination were utilized in order to assess the incidence, location, origin, and mode of propagation of venous thrombi in the leg. The incidence of leg vein thrombosis is high; 13 of 27 patients studied (48%) had antemortem thrombi. Thrombosis in the veins of the thigh occurred often (eight patients), but thrombosis in the veins of the calf was even more frequent (12 patients). Thrombi large enough to cause significant pulmonary embolism were found in seven patients. Leg vein thrombi were found in five of the six patients in this study who had pulmonary embolism at autopsy. Initiation of thrombosis was noted in the veins of both the thighs and the calves. The valve pockets were a frequent site of origin of thrombi. Inflammation of the wall of the vein (phlebitis) secondary to thrombosis was found in one patient.Postmortem venography is a useful and simple adjunct for the autopsy study of leg vein thrombosis. It is particularly reliable for the detection of thrombi in the thigh.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

A study of transbrachial digital arteriography led to the development of a technique that includes the use of an intra-arterial vasodilator (tolazoline) measurement of circulation time, direct roentgenographic magnification and serial exposures of long (14 by 35-inch) films in cassettes. This technique permitted study of the fine details of digital arteriograms of 34 patients with clubbing of the fingers or peripheral occlusive arterial disease. The ulnar artery was nonopacified in 13 cases and segmental areas of nonopacification of digital arteries were seen in 17 of the entire group, in many instances in the absence of symptoms of occlusive arterial disease. The technique is recommended for more adequate study of the peripheral microangiopathies.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

In a "blind" study, skeletal muscle biopsies were obtained from the trunk of 13 nondiabetics, eight chemical diabetics, and four overt diabetics of comparable age. On electron micrographs of 20 capillaries from each case, the areas of various components of the capillary structure were measured with a planimeter. The area of the basal lamina was expressed as a percentage of the total vessel area. This method for measuring objectively the relative thickness of capillary basal lamina considered the vessel size, plane of sectioning, and the function state of the vessel. The theoretical validity of the method is discussed.The widths of the basal lamina of the capillaries of the trunk skeletal muscles of both diabetics and nondiabetics were identical. Morphological differences between the two groups were not present. The discrepancies in results of investigations concerned with the quantity of basal lamina in capillaries of skeletal muscle may be due to naturally occurring regional differences, or because capillary beds of different organs or tissues may be affected differently in diabetes mellitus.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID

摘要:

Measurements of pulmonary blood volume (PBV) and pulmonary capillary blood volume (Vc) and hemodynamic studies were made in a series of 106 patients with valvular heart disease (62 with predominant mitral lesions and 44 with predominant aortic lesions). The results were compared with the data obtained from 14 "normal" patients and nine normal subjects. In 14 "normal" patients, the PBV varied from 204 to 315 ml/m2with a mean value of 269 ml/m2, while in nine "normal" patients and nine normal subjects the Vcranged from 39 to 66 ml/m2with a mean value of 54 ml/m2.

ISSN:0009-7322    

出版商:OVID    

年代:1967

数据来源: OVID