ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Five children, including two siblings, with clinically similar primary myocardial disease, were studied. One of the siblings expired 3 years after the onset of symptoms, and autopsy showed features of “cardiovascular collagenosis (endocardiomyopathy).” Moderate-to-severe pulsus alternans was present in all cases and persisted even after control of cardiac failure and return to moderate physical activity. No electrical alternans or bigeminy was observed.Cardiac catheterizations were performed on all patients. Left ventricular volume was radiographically determined in the siblings. Left ventricular end-diastolic volume was calculated as greater, and end-systolic volume smaller, for large beats as compared with small beats. Though alternating, end-diastolic volume was abnormally large, preceding both small and large beats. End-diastolic pressure alternated in the same way. Beat to beat (R-R) interval, alternating by as much as 0.09 second, was equalized by pacing in the right atrium and right ventricle, with persistence of pulsus alternans to a lesser degree. Isovolumetric contraction time was prolonged preceding small beats in spite of the large preceding end-diastolic volumes.The data appear to be consistent with Starling's law but suggest that impaired contractility, possibly due to alternate deletion of contractile elements, is an additional etiological factor.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

A quantitative, morphological study was undertaken on pulmonary arteries of 45 infants dying with ventricular septal defects; all but one were less than 3¼ years in age at death. All but four had large septal defects and most had evidences of severe pulmonary arterial hypertension. In the first 2 postnatal months, about half of the infants had a near normal mass of pulmonary arterial smooth muscle which correlates with clinical observations of a decreasing pulmonary vascular resistance during this period. Subsequently, almost all had a greatly increased mass of muscle in small pulmonary arteries which was mainly due to hypertrophy of individual smooth muscle cells. This correlates with an increased pulmonary vascular resistance reported in infants with large defects at this age. Finally, infants older than 6 months of age with septal defects had a high incidence of pulmonary arterial thrombi, and intimal proliferative and sclerotic lesions. These latter lesions were probably at an irreversible stage in one 2-year-old and one 3-year-old infant.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Obstruction within pulmonary arteries is a well-known cause of pulmonary hypertension in patients with congenital heart disease, but dilatation of the pulmonary vessels is less well understood. The present report has shown that the technique of microradiography is well suited to the study of dilation of the pulmonary microcirculation because (1) vessels as small as capillaries are resolved, (2) whole capillary networks are seen in relation to the arteries feeding them and to the alveoli, and (3) the radiographed tissue may[see Figure in the PDF file]then be sectioned and stained for direct comparison of the histological and microradiographic aspects. The present study demonstrated the technique in a case of normal lungs, one of pulmonary hypertension and a high pulmonary blood flow, and in one of pulmonary hypertension and high pulmonary vascular resistance. Dilated capillaries were demonstrated in both patients with pulmonary hypertension. Greater distortion of the microvascular pattern was seen in the patient with high vascular resistance. Correlation of radiographic and histological examination provides an additional tool for study of the normal and abnormal pulmonary circulation.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Cardiac catheterization and angiocardiography through the umbilical artery and vein were performed in the first 10 days of life on 50 infants with serious congenital heart lesions. This procedure has been diagnostically effective and presents minimal risk to the critically ill newborn. The methods, effectiveness, advantages, limitations, and complications of this procedure are discussed.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Left atrial volume and volume change during the heart cycle were determined and compared with left ventricular stroke volume and forward, or effective, stroke volume in 57 patients who were grouped as follows: normal, primary cardiomyopathy, aortic valve disease, predominant mitral insufficiency, predominant mitral stenosis, and combined aortic and mitral valve disease.In this study left atrial cyclic volume change averaged 41% of the left ventricular stroke volume and was in no case more than 72% of the left ventricular stroke volume, regardless of the type of heart disease. Some patients with aortic valve disease or primary cardiomyopathy have left atrial maximum volumes as large as those seen in many patients with mitral stenosis. Three features of left atrial volume and volume change per heart beat were observed in patients with mitral insufficiency: (1) a large left atrial volume (all patients with a left atrial volume greater than 365 ml had mitral insufficiency), (2) a large left atrial cyclic volume change, and (3) a left atrial volume change per beat equal to or greater than the forward, or effective, left ventricular stroke volume. It was also demonstrated that the left atrial cyclic volume change in patients with atrial fibrillation may be large and in this study showed no significant difference from values observed in patients with normal rhythm.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Ideal measurements are both simple and precise. The subjective circulation time has provided more simplicity than precision to three generations of physicians attempting to analyze cardiac function. Other more complex and less available measurements have displaced the circulation time from its prior vogue, probably because of the wide ranges of normal circulation time values. Yet, no other bedside measurement of cardiac function reflects both cardiac output and central blood volume with a single result.The peripheral arrival characteristics of radioisotope-labeled albumin are described in 15 normal subjects and in 13 patients with heart failure. These circulation-times are compared with the taste end point of the saccharin indicator simultaneously injected.Taste threshold, a variable not dependent on cardiac status, determines a significant proportion of the circulation time in both normal and failing circulations.The wide availability of instruments which measure radioactivity, dye density, or thermal change as a function of time could reinvest the circulation time with a new precision, in return for a modest loss of simplicity. Bypass of the noncardiac variable taste threshold may be added to the other well-described advantages of an objective circulation-time measurement by use of the time of half-peak concentration as the end point in recording the circulation time.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID