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

摘要:

“True” pulmonary blood volume has been determined by three indicator-dilution methods in 96 subjects. In two methods a right or left ventricular mixing chamber is interposed between the injection and sampling sites while in the third such a mixing chamber is absent. The results strongly suggest that a ventricular mixing chamber is essential for valid determination of true pulmonary blood volume.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Pulmonary diffusing capacity for CO (DL), membrane diffusing capacity (DM), and pulmonary capillary blood volume (Vc) were measured in 44 patients with various forms and severity of pulmonary vascular disease, and these measurements were compared with hemodynamic data obtained at cardiac catheterization, with clinical disability, and, in 27 patients, with the results of corrective cardiac surgery. In 11 of these patients, DL, DM, and Vcwere remeasured up to 8 months after cardiac surgery.In general, the diffusing characteristics and pressure-volume relationships in this larger group confirmed the previously reported findings in mitral valve disease.1DMwas impaired in almost all cases regardless of etiology or severity. Most of the 11 patients restudied showed no change in DL, DM, or Vcup to 8 months after surgery. Reduction in Vccorrelated well both with clinical disability and with surgical results.Two patients with primary pulmonary hypertension and three of the four patients with equally severe pulmonary hypertension due to mitral valve disease had high Vcrelative to pulmonary vascular resistance. If the measurements of Vcare not falsely high, then it appears that the capillary bed makes relatively and absolutely less contribution to the total rise in pulmonary vascular resistance in these patients. This could be explained by intense precapillary vasoconstriction in the presence of a relatively normal pulmonary capillary bed.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

A patient with chronic fibrous mediastinitis presented with bronchial, superior vena caval, and pulmonary venous obstruction, pulmonary hypertension, and pulmonary fibrosis. Pulmonary venous obstruction was confirmed at surgery and explains the hemodynamic findings of elevated pulmonary artery and pulmonary wedge pressures despite low left atrial pressure. Pulmonary function studies showed marked alterations in ventilation-distribution, diffusion, work of breathing, and fixed airway resistance.It is concluded that the pulmonary arterial hypertension was due, in large part, to the pulmonary venous hypertension caused by pulmonary venous obstruction. Unsuccessful surgical intervention has been followed by 10months of observation during which aldosterone inhibition together with use of chlorothiazide has prevented recurrence of heart failure and pleural effusion.The relationship between the physiological abnormalities and the patient's symptoms is discussed along with the possible relationship between pulmonary venous obstruction and pulmonary fibrosis.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

The reactivity of the pulmonary capillary bed during exercise as estimated by change in the pulmonary diffusing capacity (DLco) has been shown to be dependent upon at least two separate mechanisms. The initial (0 to 10 second) DLcorise with exercise appears to be volume-pressure dependent and may be altered by mechanisms influencing these factors in the lungs. The later elevation of DLcowith exercise was demonstrated to be primarily independent of the initial rise and uninfluenced by factors affecting peripheral venous return, that is body position and ganglionic blockade.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

The electrocardiograms before and immediately after cardioversion of 100 consecutive patients with chronic atrial fibrillation treated at the Peter Bent Brigham Hospital have been analyzed. Evidence of digitalis intoxication in the precardioversion tracing was associated with a significant increase in the incidence of serious ventricular ectopic activity following electrical shock. The role of digitalis in post-cardioversion arrhythmias is reviewed. The measures to reduce the incidence and gravity of such arrhythmias are outlined.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

Radiological findings by coronary angiography in 224 patients, 173 males and 51 females, were graded according to the rate of filling of coronary arteries and to the presence or absence of obstruction of vessel lumen. The material was then grouped according to age, diastolic blood pressure, serum total cholesterol, serum glycerides, and smoking habits.Age and diastolic blood pressure were not found to have any influence on frequency of coronary artery changes, presumably because of selection of patients.In the males, elevated total serum cholesterol had only a minor influence on the frequency of coronary artery changes, while elevated glycerides were found in high frequency in patients with obstructed coronary arteries, especially in those with severe obstruction. If patients put on lipid-reducing therapy or diet were added to those with serum cholesterol higher than 280 mg/100 ml, a slight overrepresentation of coronary changes was found when compared with patients with total serum cholesterol equal to or lower than 280 mg/100 ml. The influence of elevated total serum cholesterol was in all instances inferior to that of elevated serum glycerides.Smokers showed the frequency of coronary changes the same as or higher than patients with elevated glycerides. The influence of smoking was evident also within classes of low or elevated serum lipids.While all conclusions must be interpreted with reference to the material selected as the source of our data, the importance of smoking as a causative agent independent of serum lipids appears conclusive.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID

摘要:

The clinical records of 1,000 patients who had adequate selective cine coronary arteriography were reviewed. The clinical diagnoses were made by a physician who had no knowledge of the arteriographic findings. Correlation of the clinical diagnoses with the arteriographic findings was made subsequently.Symptomatic coronary disease was accompanied by arteriographic evidence of significant obstruction of major coronary arteries in most instances. A close correlation existed between the clinical diagnosis of angina pectoris without rest pain and significant arterial obstruction (95%). A similar correlation was found between QRS evidence of myocardial infarction and severe arterial obstruction (99%). The demonstrated arterial obstruction in patients who had angina pectoris almost always was severe and usually almost total or total in one or more major vessels. In myocardial infarction the demonstrated obstruction was always severe and generally almost total or total.The correlation between clinical and arteriographic findings was moderately close in patients who had angina with symptoms at rest. The correlation between the arteriographic findings and less characteristic clinical syndromes (rest pain only, 79%, coronary failure, 78%, and especially atypical angina pectoris, 65%) was not so close. In congestive failure secondary to coronary disease, arterial obstruction was extensive unless ventricular aneurysm, mitral insufficiency, arrhythmia, arterial hypotension, or some other complication was present. Most patients thought to have noncoronary symptoms had no significant obstructive lesions.In 37% of the entire group of patients, almost all of whom had been suspected of having coronary disease by some physicians, no significant arteriographic obstruction was demonstrated; in 27% the arteriograms were normal.Diagnoses, based on appraisal of the clinical records without knowledge of the arteriographic findings, yielded 83% correlation with abnormal arteriographic findings in 700 patients thought to have coronary disease.

ISSN:0009-7322    

出版商:OVID    

年代:1966

数据来源: OVID