ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The relationship between external records of precordial movement and ventricular function has been studied in 61 patients with various cardiac disorders by comparing the records of the apical impulse to the left ventricular volume. A significant correlation between external recordings and the volume data was found in patients with normal or increased ventricular volumes: Patients with a normal record in systole usually had normal end-diastolic and left ventricular stroke volumes; those with a hyperdynamic record in systole usually had an appropriate increase in stroke volume for increased end-diastolic volume; and those with sustained records usually had an increased end-diastolic volume without an appropriate increase in stroke volume, indicating poor myocardial function. Patients with a pressure-loaded left ventricle usually had a sustained record, but this appeared to be related to factors other than volume.These studies demonstrate that records of the apical impulse may provide useful information about left ventricular function.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Myocardial force-velocity relationships were studied in 33 children and young people with varying heart lesions. From analysis of left ventricular pressures and consideration of left ventricular geometry, measured from biplane angiocardiograms, maximal contractile element velocity (Vmax) was determined by extrapolation of a stress-velocity plot to zero stress. The value of Vmaxin each patient was compared with the assessment of cardiac function by usual hemodynamic criteria (left ventricular end-diastolic pressure [LVEDP], volume [LVEDV], and ejection fraction [EF]).In general, patients with normal LVEDP, LVEDV, and EF had values for Vmaxabove 3 circumferences/sec. Patients with elevated LVEDP or LVEDV or with EF below 0.5 had lower values for Vmax. Three patients whose usual catheterization data suggested normal ventricular function were found to have low Vmax. In all three, other evidence for myocardial abnormality was found. Several patients with excessive afterloads had impaired function by conventional criteria, yet had normal Vmax.Evaluation of myocardial mechanics in man with measurement of Vmaxappears to aid significantly in evaluating patients with heart disease by giving an index to the state of the myocardium not available from routine catheterization data.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

This investigation was designed to quantify left ventricular and left atrial volume, volume change, systolic output, and ventricular mass in 31 patients with isolated left ventricular pressure overload secondary to aortic stenosis (AS, n = 14) or coarctation of the aorta (n = 17). These parameters were compared with normal standards and with data from a group of nine patients with a combined pressure and volume overload due to aortic stenosis plus aortic or mitral insufficiency (AS + AI or MI). Volumes were calculated from biplane cineangiocardiograms exposed at 60 frames/sec. Left ventricular end-diastolic volume (LVEDV) was significantly lower than normal in patients with AS (57 ± 11 cc/m2), but was normal (73 ± 12 cc/m2) in patients with coarctation. An increase in the ejection fraction (LVEF) was found in both groups averaging 0.73 ± 0.12 in AS patients and 0.69 ± 0.09 in coarctation patients. Patients with AS + aortic or mitral insufficiency (AI or MI) showed elevated LVEDV (103 ± 29 cc/m2), but had a normal ejection fraction. The LV mass was significantly increased in all groups: normal, 82 ± 10 g/m2; AS, 126 ± 41 g/m2; coarctation, 130 ± 44 g/m2; and AS + AI or MI, 168 ± 42 g/m2. The left ventricular systolic index and left atrial maximal volume were both normal in patients with pure pressure overload but were significantly increased in patients with combined pressure and volume overload. The low LVEDV in patients with AS as well as the normal volume in patients with coarctation occurred in the presence of elevated LV end-diastolic pressure and indicates a decrease in LV diastolic distensibility in patients responding to an isolated LV pressure overload by significant muscular hypertrophy without dilatation.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

This study sought to determine whether the electrolyte content of peripheral arteries is altered in experimental congestive heart failure (CHF) and whether such change, if present, would help to explain the abnormal vascular stiffness seen in human CHF. The concentrations of sodium (Na+) and potassium (K+) were determined in samples of aorta (Ao) and femoral arterial branches (FA) of 17 dogs. Six had ascites due to CHF produced by rapid ventricular pacing (left ventricular end-diastolic pressure [LVEDP] 26.2 mm Hg and maximal velocity of myocardial shortening [Vmax] 2.39 circumferences/sec). In the 11 animals in the control group pacing was stopped prior to the onset of CHF or the animals were not paced (LVEDP, 8.8 mm Hg and Vmax, 2.98 circumferences/sec). In CHF, mean Ao Na+was 38.0 ± 2.3 mEq/100 g dry weight and FA Na+was 44.2 ± 3.2 mEq/100 g. These were significantly higher than similar samples taken from the 11 normal dogs (Na+, 31.9 ± 1.6 [P< 0.05] and 31.9 ± 1.8 [P< 0.01] mEq/100 g, respectively). Although the water content tended to be higher and K+tended to be lower in animals with CHF, these values were not significantly different from normal.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Serial measurements of glomerular filtration rate (GFR), independent and simultaneous clearances and extractions of para-aminohippurate (PAH), radiohippuran, and iodopyracet (Diodrast) were made in 11 adults and one child who received renal transplants from living donors. Measurements were made within 3 hours and repeated two to four times during the following 14 days. Immediately after transplantation, PAH clearance averaged 385 ml/min (range, 218 to 510), GFR averaged 54 ml/min (range, 22 to 87), renal plasma flow (RPF) averaged 672 ml/min (range, 309 to 1424), and marked vasodilatation was present with an average renal blood flow (RBF) of 979 ml/min (range, 435 to 2,114). As observed in other studies, immediate diuresis and natriuresis but no glycosuria occurred. Extraction ratios for PAH (EPAH) were below normal, ranging from 0.59 to 0.94, and those for125 (or 131)I-hippuran, and131I-Diodrast were even lower. Extraction ratio for PAH to radiohippuran averaged 1.43 in 17 simultaneous studies. However, RPF measured simultaneously with these agents was the same, indicating a true difference in transport of these substances. The low extraction ratio for PAH,131 (or 125)I-hippuran and131I-Diodrast was not related to depression of the maximal tubular transport of PAH and may have been a consequence of vasodilatation and increased RBF. Another observation made on these kidneys was a low filtration fraction which averaged 0.089. These hemodynamic changes did not appear to relate to circulating factors in the anephric recipient since they persisted throughout the 13-day study period in eight patients. In four patients showing transient rejection, GFR and the clearance of PAH and131I-hippuran decreased proportionately more than RBF. It is concluded that marked vasodilatation and a low filtration fraction are characteristic of uncomplicated renal allotransplantation in man, and that early rejection is expressed by measurable decreases in the clearances of PAH and inulin despite maintenance of RBF. These changes were present prior to clinical evidence of rejection.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Thirty-five patients with clinical evidence of aortic insufficiency were studied by echocardiography. Eleven patients had characteristic diastolic fluttering of the mitral valve (30 to 40 Hz, maximal amplitude 4 mm). In five others the fluttering was classified as equivocal.In a control group of 500 echocardiograms in patients without evidence of aortic insufficiency, there were three examples of equivocal fluttering. Atrial fibrillation also produces diastolic fluttering but of slower frequency.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Intra-arterial pressure in the brachial artery was compared with that in the femoral artery in children. There were no significant differences in systolic, diastolic, or mean pressures. The average auscultatory systolic pressure in the arm, obtained with a cuff 20% wider than the limb, was identical to the average direct systolic pressure in the brachial and femoral arteries. The auscultatory systolic pressure in the leg, using the same criterion for cuff width, was 11 mm Hg higher than the direct pressures. The discrepancy could represent (1) a systematic error in cuff size of inadequate width or length or (2) additional systolic amplification between the femoral and popliteal arteries. Since the femoral pressure is widely used in cardiac catheterization, this pressure is suggested as the standard for calibrating auscultatory technics. For leg blood pressure measurements a cuff at least 25% wider than the average leg diameter and long enough to encircle the limb is recommended.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Isolated systolic hypertension (systolic blood pressure of 160 mm Hg or greater, diastolic blood pressure less than 90) was investigated in the Leisure World population at Seal Beach, California. The prevalence of this condition was 13.9% if the blood pressure at the initial examination was used but dropped to 2.7% if the subsequent two determinations of blood pressure were also reviewed.Seventy-two of the subjects with persistent systolic hypertension were compared with 72 matched normotensive control subjects. Cardiovascular morbidity and mortality were generally more frequent among subjects with systolic hypertension. That this association is causal has yet to be proven.In this elderly population isolated systolic hypertension was a labile, relatively infrequent condition associated with an increased risk of developing cardiovascular complications.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID