ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Infarct size was assessed quantitatively in 33 patients with acute myocardial infarction with a new technic based on analysis of serial serum creatine phosphokinase (CPK) changes to determine its relationship to prognosis. We have recently measured infarct size in the conscious dog with this method which takes into account CPK distribution space, fractional disappearance rate, proportion degraded in myocardium, and proportion released into the circulation, and we have validated the method by measurement of myocardial CPK depletion in the same animals. In the present study, CPK activity (determined spectrophotometrically) and isoenzyme profiles (assayed electrophoretically) were measured in patient serum samples obtained every 2 hours. Infarct size was estimated by mathematical analysis of serial CPK changes utilizing the method previously developed in the conscious dog model. CPK isoenzyme profiles demonstrated prominent anodal bands, absent from normal serum, indicating that enzyme elevations reflected CPK released from heart rather than skeletal muscle. In 19 class I-II survivors (New York Heart Association) estimated infarct size was 31 ± 4 CPK-gram-equivalents (CPK-g-Eq). It was significantly larger (P< 0.01), 103 ± 14, in nine patients who died and in four class III or IV survivors (91 ± 8). Estimation of cumulative infarct size differentiated patients with electrocardiographic changes and clinical sequelae from complications such as pericarditis from those patients with extension of infarction. Thus, infarct size can be assessed quantitatively in patients with acute myocardial infarction and provide a useful diagnostic and prognostic index based on the extent of myocardial damage.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Among 681 former Harvard College athletes (lettermen), longevity and cardiovascular mortality differed not by type of sport but by extent of participation. Relative to one-letter and two-letter athletes, men with three or more letters died slightly earlier from natural causes, and significantly more often and slightly earlier from cardiovascular diseases and (specifically) coronary heart disease. The three-or-more-letter athletes differed in physique, being significantly more mesomorphic (muscular, bony) than the other two groups. Further analysis suggested that physique did not account for these differences; other possible explanations were discussed.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The purpose of this study was to evaluate cellular immune responsiveness. in patients with acute rheumatic fever (ARF). Peripheral blood lymphocytes were obtained for culture from patients who had ARF within the past 2-3 months. No patient was receiving steroids at the time of the study. Peripheral lymphocytes were also obtained from normal control individuals.Lymphocyte cultures were maintained for 7 days in minimum essential medium with 10% fetal calf serum in a 5% CO2environment. Cellular responsiveness was checked concomitantly with pokeweed mitogen and/or phytohemagglutinin. Mixed-lymphocyte cultures were studied between patients with ARF and between patients with ARF and normal controls. Normal responses were arbitrarily defined as a threefold increase over baseline counts.ARF cells were capable of stimulating other ARF cells in only three of 14 instances and were able to stimulate control cells in only three of 11 studies. Conversely, ARF lymphocytes were capable of being stimulated by control normal cells in five of 10 experiments. Thus decreased cellular responsiveness and abnormalities in cellular immunity are present in many patients with ARF, since lymphocytes from patients with ARF are usually incapable of stimulating normal or other ARF cells. However, ARF cells are capable of being stimulated by normal control cells in 50% of studies performed.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A patient is described having syncopal attacks on being awakened from sleep by auditory stimuli. The electrocardiogram registered during these episodes showed Q-T-segment changes followed by ectopic ventricular activity and spontaneously ending attacks of ventricular fibrillation. Aside from the attacks, her ECG only showed abnormalities of the S-T segment with marked U waves. Hemodynamic and electrophysiologic studies showed no abnormalities. Coronary angiograms were normal. Following therapy with propranolol and diphenylhydantoin she has been free from syncopal episodes for the past 11 months. The mechanism responsible for the Q-T-segment changes and ventricular tachyarrhythmias is not understood.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

This report describes the clinical, angiographic, and hemodynamic findings in nine patients who manifested nonatheromatous ischemic heart disease induced by chronic industrial exposure to nitroglycerin and subsequent withdrawal. They represent nearly 5% incidence in the group of 200 workers with similar exposure. One patient died suddenly, and the disease was commonly without premonitory symptoms. Of the eight survivors, five were studied and none showed evidence of significant organic obstructive disease. However, in one studied during the withdrawal state, coronary and digital arteriospasm was demonstrated, and was readily reversed by nitroglycerin. Survivors exhibited exercise symptomatology and hemodynamic impairment similar to other patients with myocardial dysfunction from ischemic heart disease. Complete left bundle-branch block with late sudden death occurred in one, and chronic recurrent atrial fibrillation is present in a second.An attractive hypothesis suggests that chronic vasodilatation evokes homeostatic vasoconstriction, the latter persisting during the withdrawal period with cardiac ischemia. A more detailed study of the vasodilator action of organic nitrate and the homeostatic reaction is warranted. In addition, the effect of chronic administration of potent, longacting organic nitrate-based drugs should be examined in the light of this industrial experience.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The relationship of abnormal regional myocardial performance to left ventricular (LV) function 2-12 months following transmural myocardial infarction was investigated in 25 patients by quantitative biplane angiocardiography. Abnormally contracting segments (ACS) (akinetic or dyskinetic) of the LV were identified in 24 patients. Their sites correlated with the electrocardiographic locations of infarction. ACS were expressed as a percentage (ACS%) of the end-diastolic ventricular circumference, and the percentages obtained correlated with ejection fraction (EF) (r = —0.838, P = 0.0001) using a quadratic regression equation. The group of patients (N = 8) with heart failure (paroxysmal nocturnal dyspnea and/or ventricular gallop sound) demonstrated a significantly lower mean value for EF (P= 0.0003) and a significantly larger mean value for ACS% (P= 0.0041) than the group of patients (N = 16) without heart failure. EF sharply separated the two groups. ACS% was a poor separator because in the majority of patients in both groups it was between 14 and 38%. Since EF sharply separated the heart failure and non-heart failure groups but ACS% did not, a theoretic model was developed to assess the contribution of the remaining myocardium to LV function. The curve described by the model did not differ significantly from the curve derived from the quadratic regression equation. Data from heart failure and non-heart failure patients were generally separated by a point (EF = 0.30, ACS = 23%) on the theoretic curve. Abnormal function of the nonakinetic myocardium was considered to be present when observed EF was lower than predicted EF for the observed ACS%.Thus, within the year following transmural myocardial infarction, the relative size of an abnormally contracting region of the ventricle was quantitatively related to impairment of LV function. The spherical model not only provided a framework for relating the clinical status of a patient to both ventricular function and size of the ACS, but also offered a means of estimating the function of the myocardium that appeared angiographically to be nonakinetic.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Atrial standstill secondary to atrial inexcitability or atrial quiescence was diagnosed in 11 patients and atrial standstill, in which atrial excitability was still present though depressed, was diagnosed in two patients during the immediate period following open-heart surgery. Atrial quiescence was successfully treated in six patients and atrial standstill with depressed excitability in both patients by the infusion of small doses of isoproterenol. Atrial quiescence was not treated in the other five patients and reverted spontaneously within 24 hours after surgery. It is suggested that atrial quiescence results from relative depolarization of the atrial membrane and that the success of therapy with isoproterenol results from hyperpolarization of the atrial membrane by this drug.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Aggregated platelets and occlusive platelet thrombi were found in small myocardial vessels of dogs on electron-microscope examination after prolonged infusion of norepinephrine. The etiology of the myocardial necrosis and fibrosis induced by catecholamines in experimental animals and seen in patients with pheochromocytoma and patients after norepinephrine treatment for shock may be related to this intravascular platelet-aggregating effect of catecholamines. The link between stress and acute myocardial infarction may be via catecholamine-induced intravascular platelet thrombosis. If the thrombogenic theory of atherosclerosis is valid, platelet aggregation induced by catecholamines may be the mechanism whereby arteriosclerotic heart disease is related to stress.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A nonselected series of 229 postmyocardial infarction (MI) patients was studied for up to 2 years following hospitalization. Their lipoprotein patterns, serum cholesterol, and triglyceride values were compared to those of a random population sample of men at comparable ages.Hyperlipoproteinemia, cholesterol, and triglyceride elevations were more common in MI patients than in men in the random sample, occurring with greatest frequency in the younger patients. There was a trend toward higher mortality among patients with hyperlipoproteinemia. Types II A and B were very common in young patients.Serum cholesterol values were significantly higher in the youngest patients and serum triglycerides higher than in the controls in age groups ≦ 40, 46-50, and 51-55 years.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID