ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02736.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTLeft ventricular ejection fraction (EF) was determined by means of radionuclide ventriculography (RNV) in 477 patients 8‐12 days after an acute myocardial infarction (AMI). EF was correlated to infarct size and clinical and radiological parameters of congestive heart failure (CHF). The 138 patients (29%) who had signs of CHF had a mean (±SD) EF of 35 ±14% and a relative heart volume of 597 ±112 ml/m1compared to 51 ±14% and 487±88 ml/m2among those without CHF. The 52 patients who also had radiological signs of CHF had a mean EF of 27±12% versus 35±14% among those with clinical signs and symptoms of CHF. Presence of CHF was positively correlated to the size of AMI and to the reduction of EF. CHF was seen with increasing frequency from 16% in small to 46% in large first infarctions. Patients with reinfarctions showed the same correlation between these parameters, however, with subsequently more depressed EF values and more frequent presence of CHF due to previous myocardial damage. CHF was seldom (8%) observed in patients with EF>50%. In contrast, 67% of the patients with EF<35% had CHF. Thus patients with an EF<35% represent a high risk group with regard to development of CHF and should be followed closely. It is suggested that radionuclide measurement of EF adds important clinical information in patients with diagnostic uncertaint

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02737.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTWe studied the exercise stress test and the coronary artery tone in two groups of angina patients with comparable coronary atherosclerosis. Group I (20 males and 5 females, mean age 53.5 years) with a positive, and group 11 (22 males and 3 females, mean age 52.5 years) with a negative response to the hyperventilation test (HVT). A positive exercise stress test (ST depression ≥1 mm) was found in 24 patients in group 1 vs. 15 in group II (p<0.01), despite a lower maximal rate pressure product (198±11.2 vs. 236±10.1,p<0.05) and maximal work load (110 W±7.1 vs. 136±7.4 W,p<0.02) in group I. A high coronary artery tone (dilatation (DIL %) of the coronary arteries after nitroglycerin ≥ 10%) was found in 18 patients in group I and in 4 in group II (p<0.01). DIL % was 22.6±3.8 vs. 5.8±1.4 in groups I and II, respectively (p<0.005). DIL% was significantly related to persistence of ST depression after exercise (r=0.36,p<0.05), and 21 of 22 patients with high tone had a positive exercise stress test vs. 18 of 28 with low tone (p<0.05). These findings suggest that the coronary artery tone influences the response to exercise in some patients with angina. Since the patients in group I were identified by HVT, our results underline the clinical relevance of

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02738.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTThe clinical course of angina pectoris was studied in a follow‐up study of 427 patients with angina from a general population sample. The subjects were men aged 56‐65 years at the time of follow‐up. After a mean follow‐up time of 5.8 years. 55% were still suffering from angina pectoris, 15% had died and a further 19% were either free from chest pain or had chest pain considered to be of different origin. In the group with definite angina pectoris at follow‐up (n= 236), 29% had sustained a myocardial infarction. 23% had symptoms of intermittent claudication, 36% were treated for hypertension and 15% had diabetes. Many of the angina patients suffered from other chest conditions in addition to anginal symptoms, Most of the patients (56%) had infrequent attacks (a few times per month or less often) and were not severely incapacitated by their symptoms. Only one fifth worked full time compared with more than half of those in the same age groups in the general population. Only 16 of those interviewed had undergone bypass surgery and a further 16 had disabling angina but, for various reasons, they had not been operated on. The implications are that most angina patients do well on pharmacological treatment alone even though they are limited socially as well as physically. Precipitating factors other than physical activity were also investigated and associations were found between susceptibility to cold, early morning angina, angina at rest and attacks of long duration, possibly indicating a mechanism of vasospasm superimposed on a fixed

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02739.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTChanges in the segmental blood pressures (BP) in the legs after five years of follow‐up and factors related to the changes were studied in 93 non‐operated non‐diabetic patients with intermittent claudication. Independent variables affecting the ankle/arm BP index (ABI) in the more affected leg were the initial ABI, smoking, duration of claudication and location of the stenoses (whether single or multiple). ABI was stable in non‐smokers but decreased in smokers. It also decreased in patients with multiple stenoses at the initial examination but not in those with single stenoses. The correlation between subjective changes in claudication and changes in the ankle BP was poor. In the less affected leg, ABI decreased both in smokers and non‐smokers but stenoses in legs without signs of stenoses initially developed to a greater extent in smokers than in non‐smokers. Smoking is an important risk factor for progression of the occlusive atherosclerotic disease in intermittent claudication. Patients with multiple stenoses seem to have a more progressive occlus

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02740.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTTwenty‐four hour profiles of free insulin and blood glucose were determined in 12 healthy controls and 10 insulin‐dependent diabetics treated with insulin regimens based on intermediate‐acting insulin injected subcutaneously once or twice a day. The diabetics were ambulatory and in a good glycemic control, i.e. without hyperglycemic symptoms or frequent hypoglycemias and with HbAI<9% (reference value 5.9‐7.8%). Body weight was normal and median age (32 years) was the same in both groups. Free insulin was determined after polyethylene glycol precipitation of antibody‐bound insulin. The controls had a low basal insulin level (median fasting value 3.9 mU/1) and postprandial peaks with a maximum within 30‐60 min. There was no rise in plasma free insulin or blood glucose in the early morning hours. The free insulin profiles in the diabetics were highly unphysiological with hyperin‐sulinemia between the meals and during the night. The highest plasma free insulin value during the 24 hours was reached before lunch (approximately 5‐fold compared to normals,p<0.01). Postprandially the free insulin concentrations did not reach the peak levels of the normals. After breakfast, blood glucose rose considerably in the diabetics (p<0.02 compared to normals) while the rise after lunch and dinner was not higher than in the healthy controls. The difficulties in glycemic control in the diabetic group, i.e. a blood glucose rise after breakfast and hypoglycemias in some patients, could largely be explained by the unphysiological i

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02741.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTThe effects of continouos ambulatory peritoneal dialysis (CAPD) on serum lipids and lipoproteins over the initial year of therapy were studied in 23 uremic patients. Lipoprotein abnormalities typical for the uremic dyslipoproteinemia were present at the start of CAPD. During the first months of CAPD these abnormalities were accentuated. The concentrations of very low density lipoprotein (VLDL)‐cholesterol (CHOL), low density lipoprotein (LDL)‐CHOL, serum CHOL and serum triglycerides (TG) increased significantly. However, after one year of CAPD only the VLDL‐CHOL and serum CHOL levels remained significantly higher than the baseline values. VLDL‐TG, VLDL‐CHOL and serum TG, and the changes of these variables over the study period, correlated with the amount of glucose in the dialysates. We conclude that the continuous peritoneal absorption of glucose (100‐200 g/24 h) during CAPD contributes to potentially atherogenic changes in serum lipids and lipoproteins. However, some of the changes are transitory, indicating an adaptation to the peritoneal g

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02742.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTTwenty‐seven patients with hypertriglyceridaemia were given dietary supplementation either with evening primrose oil rich in gammalinolenic acid (GLA, 18: 3 n‐6) (n=13) or a marine oil concentrate containing n‐3 fatty acids (n=14) in a double‐blind cross‐over design during 8+8 weeks with olive oil as placebo. During GLA supplementation, increases in GLA and dihomogammalinolenic acid (20: 3 n‐6) were found in plasma lipid esters and platelet phospholipids, whereas platelet function and serum lipoproteins were unaffected. During supplementation with n‐3 fatty acids there was a significant decrease in triglycerides in all lipoprotein fractions with a slight increase in high density lipoprotein and low density lipoprotein cholesterol. A marked increase in the long‐chain n‐3 fatty acids was found both in plasma and platelets, mainly at the expense of the n‐6 fatty acids. No pronounced effects on platelet reactivity could be demonstrated. Our results confirm a triglyceride‐lowering effect of n‐3 fatty acids, whereas no such effect of GL

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02743.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTIn the deteriorating group of sarcoidosis patients, progress towards pulmonary fibrosis is a major problem. In order to benefit from corticosteroids, it is important for the treatment to start early. We studied a group of 45 patients with sarcoidosis. Most of them were newly detected patients and none were under or had currently received corticosteroid therapy. The patients were followed for at least six months. We found that increased amounts of polymorphonuclear neutrophils (PMN) or lysozyme‐positive macrophages (Lys+MF) and mast cells (MC) in bronchoalveolar lavage (BAL) could implicate a bad prognosi

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02744.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACTHypocalcemia was found in 122 (1.6%) of the patients attending a large oncological center. In 10% of the cases, hypocalcemia was caused by hypoparathyroidism and/or uremia, in 12% it was related to a major infection. Osteoblastic metastases were responsible in 4% of the cases and in 74% hypocalcemia accompanied an impairment of the general condition due to the malignancy or its treatment, usually in the terminal stage of the disease. The most common cause of hypocalcemia in this group of patients seemed to be hypoproteinemia. Correction of serum calcium for variations in serum albumin concentration, however, indicated that a small proportion had a decreased ionized calcium value as well, the mechanism of which remained obscure. The hypocalcemia was usually relatively mild, especially after correction for albumin variations. Tetanic symptoms were not seen. Hypocalcemia thus seems to be a fairly common complication of malignant disease, the clinical relevance of which, however, appears to be relatively small in most cases.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb02745.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY