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:

Levels of serum cortisol, plasma free fatty acids (FFA), and urinary catecholamines were collected in 31 patients with acute myocardial infarction on the day of admission to the coronary care unit (samples obtained from 15 patients with diseases other than myocardial infarction were considered as controls). These values were correlated with the presence or subsequent development of left ventricular failure, arrhythmias, shock, or death. Sixteen of 17 infarction patients without the above complications had cortisol levels less than 20 μg%; 10 of 12 patients with complications had higher cortisol levels. All of the infarction patients without complications had plasma FFA levels less than 1100 μEq/liter, while six of nine patients with complications had levels of 1100 μEq/liter or higher. Fourteen of 16 patients without complications had urinary catecholamines less than 12.5 μg%, while seven of 10 patients with complications had levels greater than this. Of interest were a few patients without complications on admission, but with elevated cortisol or FFA levels, who developed complications on the following day. The results of the present study suggest that the generalized metabolic stress of acute myocardial infarction results in elevations of cortisol, FFA, and catecholamines as measurable biochemical indicators and/or predictors of the severity of the infarction.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Left ventricular circumferential end-diastolic stress (Sed), peak systolic stress (Sps), and compliance at end-diastole ([dV/VdP]ed) were estimated in 13 subjects with normal left ventricles (N group), nine subjects with inappropriate hypertrophy (IH group), five with aortic valvular stenosis (AS group), and six with congestive cardiomyopathy (CC group). The product of Sed and (dV/dP)ed was employed as an index of “muscle fiber stretch” and related to systolic indices of ventricular performance. Compliance was significantly less than normal in IH (P< 0.001), in AS (P< 0.01), and in CC (P< 0.001), while end-diastolic volumes were smaller than normal (P< 0.05), normal (P= NS), and larger than normal (P< 0.001) in the three groups, respectively. Sed was normal in IH and AS but elevated in CC (P< 0.001), while Sps was decreased in IH and normal in AS and CC. “Muscle fiber stretch,” however, was substantially less than normal in IH (P< 0.001), indicating that the low Sps is due at least in part to short sarcomeres. In CC, despite a markedly elevated preload, “muscle fiber stretch” was normal (P= NS), while work indices of the ventricle were diminished indicating depressed ventricular function. Thus, the product of Sed and (dV/VdP) ed provides a normalized index of “muscle fiber stretch,” which permits one to compare length-tension or length-work relationships in diseased ventricles of varying dimensions and compliance.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Oxygen in high concentration (arterial pO2over 400 mm Hg), administered for 7-10 minutes to six subjects with normal coronary arteries and nine subjects with coronary artery disease caused the following significant changes: The heart rate and cardiac index decreased in both groups. The mean arterial pressure increased in the coronary group. The coronary sinus blood flow fell from 158 ± 11 (mean ± SEM) to 131 ± 13 in the noncoronary and from 151 ± 14 to 138 ± 14 ml/min in the coronary group, due to an increase in coronary resistance. The coronary sinus oxygen tension increased from 19 ± 1 to 22 ± 1 in the noncoronary and from 19 ± 1 to 24 ± 1 mm Hg in the coronary group. The coronary arteriovenous oxygen difference decreased from 13.2 ± 0.6 to 12.5 ± 0.6 ml/100 ml in the coronary group. Left ventricular oxygen consumption fell from 21.5 ± 2.1 to 18.2 ± 2.4 in the noncoronary and from 19.9 ± 2.0 to 16.7 ± 1.7 ml/min in the coronary group. Myocardial lactate extraction increased from 40 ± 9 to 60 ± 4 and from 4 ± 6 to 28 ± 3%, respectively. In four patients with severe coronary artery disease, oxygen breathing reverted myocardial lactate production to extraction. It would appear that oxygen breathing might be beneficial in myocardial ischemia by increasing coronary arterial oxygen tension and reducing myocardial oxygen consumption.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Electron microscopic studies revealed distinctive abnormalities in operatively resected myocardium from the left ventricular outflow tract in 14 patients with idiopathic hypertrophic subaortic stenosis. Bundles of muscle cells were severely disorganized, with cells running in different directions instead of in parallel. Muscle cells were wider and shorter than in hypertrophy due to other causes and showed increased cellular branching, extensive side-to-side intercellular junctions, widened Z bands, and evidence of formation of new sarcomeres. Some myofibrils were oriented obliquely or perpendicular to the longitudinal axes of the cells and some myofilaments that originated from a single Z band inserted into Z bands of other myofibrils. Examination of left ventricular apical myocardium in two patients revealed hypertrophied but normally arranged muscle cells. It is concluded that abnormal architecture of muscle cells is the basic morphologic feature of idiopathic hypertrophic subaortic stenosis.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The clinical diagnosis of the presence and severity of tricuspid insufficiency is difficult and is complicated by the transient nature of this abnormality as well as its usual occurrence in subjects with other valve disease. This paper presents correlative hemodynamic data from 100 consecutive catheterized patients with valvular heart disease in 90 of whom the presence of tricuspid insufficiency was sought by the indicator-dilution technic. Tricuspid regurgitation was present in 28 of the 90 patients. Subjects were grouped into 20 controls without tricuspid insufficiency and those with mild, moderate, and severe tricuspid insufficiency. The hemodynamics of these groups were compared by the analysis of variance to determine which parameters relate most closely to tricuspid insufficiency. The results are interpreted to confirm that tricuspid insufficiency results from those factors which overdistend the right side of the heart, and by permitting blood to escape retrograde from the right ventricle serves as a safety valve preventing progressive overload of the pulmonary circulation.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

In a controlled setting bretylium tosylate was evaluated for efficacy, toxicity, onset, and duration of action in eight patients with frequent premature ventricular contractions (PVC). Four patients received a single im dose of bretylium, 4 mg/kg, with before and after control days; the other four patients received bretylium, 2 and 4 mg/kg, on different days with before and between control days. PVC were quantified from stored continuous ECG tape recordings by an automated arrhythmia-detection system. Five patients had 50% or more reduction of PVC frequency with bretylium 4 mg/kg, and one with 2 mg/kg. Bretylium 4 mg/kg but not 2 mg/kg reduced mean PVC frequency by half beginning at the sixth hour and continuing for 12 hours. Hypotension began within 1 hour. Maximum fall in mean supine blood pressure was 17/6 mm Hg with 2 mg/kg, and 25/12 mm Hg with 4 mg/kg. Plasma bretylium concentration was maximum at about 1 hour with a mean elimination half-life of 10 hours. A controlled quantitative method for evaluation of antiarrhythmic drugs in man demonstrated that bretylium can be effective in suppressing PVC frequency. The dissociation between hypotensive and antiarrhythmic effects of bretylium suggested that its antiarrhythmic effect was independent of adrenergic neuronal blockade.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Nineteen dogs were given131I and later administered appropriate amounts of methimazole or propylthiouracil daily. Over a period of 4-7 years several developed severe clinical features of myxedema. The myocardium and skeletal muscle of these severely myxedematous dogs displayed an array of morphologic changes on an ultrastructural level. Particularly interesting was the two- to threefold increase in the thickness of the myxedematous capillary basement membranes over those of normals. Increased tortuosity, lamination, and perivascular fibrosis were also observed as part of the myxedematous changes. These studies also demonstrated severe microcellular modifications, such as mitochondrial disruption, loss of cristae, lipid inclusions, and the presence of myelin figures, all a part of the diffuse systemic cardiovascular connective tissue pathology in myxedema.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Characteristics of 11,132 men aged 40-59 years and free from coronary heart disease (CHD) at entry were related to follow-up experience, using multivariate analysis. In 5 years among 2,404 U. S. railroad men and 8,728 European men there were 615 cases of CHD, 214 of whom died from CHD or suffered definite nonfatal infarction.With five entry characteristics (age, systolic blood pressure, serum cholesterol, smoking habit, and body mass index), multiple logistic solutions for Europeans and Americans, separately, gave estimates of the individual probability of CHD. Classified by deciled scores for these probabilities, the expected and observed CHD cases were highly correlated (r = 0.930-0.981). Predictions based on European data applied to Americans, and vice versa, gave similar high correlations but American incidence was excessive compared with European experience.Application of the analysis coefficients obtained from data in Europe and in the U. S. railroad to 6,221 other U. S. men 40-59 years of age, CHD-free at entry, gave good prediction ofrelativerisk (r = 0.94) for observed versus predicted cases in deciles of risk score; however, the actual numbers of cases were underpredicted.From single measurements of a few characteristics the multiple logistic solution usefully estimates the relative risk of CHD for individuals. Age, systolic pressure, and serum cholesterol are universally powerful predictors of risk. Variables not measured in this study or not yet identified contribute to the risk of CHD among American men.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID