ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09667.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.We have collected 23 cases with atrial fibrillation (AF) of 3–29 years' duration with spontaneous reversion to sinus rhythm (SR). We have also identified 22 similar cases in the literature. Several of our patients spent several years with different atrial arrhythmias before a stable SR was established. Of all the 45 cases, 39 had significant rheumatic mitral valve disease. In the majority of these patients the ECG shows first degree AV block after return to SR and a low‐amplitude P‐wave—as if the left atrial P component was lacking. There are no signs of left atrial mechanical activity after re‐establishment of SR in our mitral valve disease group, as judged from phonocardiograms, apexcardiograms, echocardiograms and left atrial pressure recordings in selected patients. Heart muscle biopsy was obtained from two patients who underwent mitral valve surgery. Left atrial specimens showed almost complete lack of all muscle structures. There is thus electrical, mechanical and histological evidence of left atrial muscle deterioration. It is likely that the electrophysiological factors responsible for initiation and maintenance of AF have disappeared with this deterioration, thereby allowing SR to be re‐established. The return of SR might indicate a progress of the heart disease although the patient may benefit from normalization of cardiac rate and regularity. The easy identification of our 23 patients makes us believe that the phenomenon of appearance of late SR is far more common than suggeste

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09668.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.In a prospective trial, 99 patients with a history of AMI of less than 12 hours were allocated at random to treatment with subcutaneous heparin, 5000 IU twice daily, (51 patients) or warfarin (48 patients). In a subsample of 21 patients, 11 in the warfarin group and 10 in the heparin group, fasting FFA analyses were performed before and 2 hours after administration of anticoagulants on days 1 and 2. No measurable increase in FFA concentrations was demonstrated in the heparin‐treated patients, in spite of a significant influence on the thrombin clotting time. The frequency of ventricular arrhythmias as detected by continuous tape recordings was equal in the two groups. It is concluded that subcutaneous heparin, 5000 IU every 12 hours, can be administered to patients with AMI without increasing the risk of arrhythmias as compared with warfarin.AMI= acute myocardial infarctio

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09669.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.The incidence of viral myocarditis was studied prospectively at the Central Military Hospital 1 in Finland in connection with an A1 virus influenza epidemic in Jan. 1978. Of 104 conscripts taken consecutively to hospital because of a sudden respiratory infection, 41 had serologically confirmed influenza A, 37 were serologically negative, while in 26 it was not possible to carry out complete virological analyses. Six of the serologically confirmed influenza patients had acute myocarditis on the basis of serial electrocardiographic ST segment and/or T wave changes, unresponsive to β‐blockade. The incidence of the influenza A myocarditis was thus 9% of the 67 verified and suspected cases of influenza taken together. Multidirectional echocardiography revealed regional myocardial dysfunction in all the influenza patients with myocarditis; the MB‐CK isoenzyme was elevated in 3 of them. The ECG changes found in connection with influenza thus commonly indicate the presence of myocardial involvement, usually a mild

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09670.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.The association between psychological characteristics and ventricular arrhythmias was investigated in 150 men (50 with manifest IHD, 50 with risk indicators of IHD and 50 healthy men). Arrhythmias were recorded with 24‐hour Holter monitoring. Psychological characteristics were assessed by the Emotions Profile Index and the Structured Interview for pattern A behaviour. A depressive emotional state was associated with prognostically severe ventricular arrhythmia in healthy men, but not in men with overt IHD or risk indicators of IHD. When clinical characteristics and age were taken into account, depressiveness was—among healthy men—the second most important factor after high age. The results suggest that—in absence of IHD or other cardiovascular disease—a depressive emotional state may participate in the formation of ventricular a

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09671.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.Subjective assessment of the short‐term outcome and functional state at discharge was made shortly after admission in 200 consecutive patients with acute cerebrovascular disease (CVD) treated in a stroke unit. The assessments proved correct in 59% of the patients. The accuracy of the predictions was not significantly better in patients with a correct preliminary diagnosis than in those with a false. When a known prognostic score for prediction of hospital mortality was tested on 179 of the patients with cerebral haemorrhage or infarction, a correct trend was noted. The score was best applicable in patients with serious symptoms and those with only minor deficit on admission. A high sensitivity of the score was combined with a relatively low specificity. A true comparison between the predictive value of the score and the quality of the subjective assessments was difficult as the latter, in addition to prediction of mortality, also included prediction of the patient's functional state at discharge. The degree of neurological deficit rather than the type of cerebrovascular lesion seemed associated with the short‐term outcome. Improvement of the quality of prognostic assessments in CVD is warran

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09672.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.The therapeutic efficacy of clonidine as an antihypertensive in a b.i.d. schedule 150–300 μg daily was evaluated. The blood pressure reduction in patients with essential hypertension was satisfactory on this regimen and the steady‐state plasma concentrations were within the BP‐lowering concentration range at the end of a dosage in

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09673.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.Eighty‐seven patients with an acute myocardial infarction and a pulse rate of ≥80/min on admission were randomly allotted to one group given cardioselective β‐blockade, a second group given diazepam, and a third group given placebo. The three groups were comparable in age, sex distribution, previous history of ischemic heart disease, initial pulse rate, blood pressure, pain index, enzyme values, and degree of ST elevation. The acute mortality (within 10 days) did not differ between the groups. The drug treatment elicited no reduction of infarct size, as judged from enzyme levels, degree of reduction of ST elevation, or physical exercise capacity. The reasons for this negative result are discussed. One possibility is that in routine clinical practice the therapeutic intervention starts too late after onset of symptoms. A beneficial effect on mortality among the patients whose treatment started early after onset of symptoms supports this conc

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09674.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.Muscle blood flow (MBF) was determined in 11 patients on chronic overdoses of ergotamine tartrate and in 12 controls, using the local133xenon clearance method. The difference in MBFs between the groups was insignificant, 59.7±21.4 and 61.6±10.8 ml/100 g/min, respectively. Six patients taking ergotamine in doses exceeding 0.25 mg/kg/week showed a significant (p<0.01) reduction of MBF (45.2±10.7 ml/100 g/min). This reduction could be measured before the manifestation of symptoms or signs of circulatory insufficien

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09675.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

ABSTRACT.During 1 1/2 years, 768 patients—905 admissions, 342 with acute myocardial infarction (AMI), 563 with other diagnoses—were treated in the CCU at Serafimerlasarettet. On admission, both the AMI and the non‐AMI group had significantly lower serum magnesium levels than a reference group. The incidence of serious VEBs, VT and VF on admission was significantly higher in the hypomagnesemic patients with AMI. AV blocks and SVB were more frequently observed in the hypermagnesemic patients, both in the AMI and in the non‐AMI group. The incidence of AF and SVT was higher in the hypomagnesemic p

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1980.tb09676.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY