摘要:

ABSTRACTThe occupational status of a group of 70 male patients, 30 to 65 years of age, operated with aortocoronary bypass surgery, were studied and related to left ventricular function, number of patent grafts, and exercise ECG using a bicycle ergometer, in connection with a re‐study on an average of 14 months after operation. The patients consisted of two series of males: one series (n = 39) consisted of subjects unable to work (

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02594.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTRenal biopsies were performed on 14 patients with active rheumatoid arthritis and proteinuria of whom 7 patients had reduced creatinine clearance.Glomerular hypercellularity was found in six and amyloid in seven biopsies. Immunofluorescence microscopy revealed glomerular deposits of immunoglobulins and complement in 10 of 12 biopsies, indicating an active immunologic process causing the impaired renal function.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02595.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYTwohundred and eighteen patients aged 13 years or more at operation for coarctation of the aorta were selected for a long‐term postoperative follow‐up study. The mean age at operation was 25,3 years, range 13 to 62 years, and the mean follow‐up period was 13 years, range 2 to 28 years.The surgical mortality rate was 1,4%, all 3 patients being in their fourth decade. There were 35 late deaths (16,3%), 26 having cardio‐vascular disease as the causation; 3 patients developed a dissecting aneurysm of the ascending aorta, and 11 died suddenly of unknown cause. Persisting hypertension was found in approximately one third of the patients. A highly significant correlation was demonstrated between the systolic blood pressures before and after surgery. Aortic valve disease occurred in 31 patients (14,2%).Coarctation of the aorta should be operated on in childhood, and a close postoperative long‐term follow‐up in all patients is

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02596.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTFiftythree patients with chronic atrial fibrillation participated in a randomized cross‐over trial in order to compare the ability of two drug regimens to establish and maintain sinus rhythm. The patients were given orally either sustained release quinidine 0.4 g twice a day or verapamil 80 mg three times a day. Thirtyone patients tried both regimens. Quinidine was found to have a greater ability to induce conversion to sinus rhythm by drug alone (p<0.05) and also a greater ability to maintain sinus rhythm after conversion (after 3 months p<0.05). There was, however, also a significantly larger proportion of patients on quinidine who were Withdrawn from the study due to side effects and two patients on quinidine died outside hospital.The study indicate that quindine is somewhat superior to verapamil both in the establishing and preserving of sinus rhythm in subjects who are able to tolerate the dru

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02597.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTThe series comprised 479 consecutive patients from all parts of Norway operated on in the period 1955–1976. Only 8% were less than 7 years at surgery. Dominating preoperative symptoms were dyspnea and increased fatique. The follow‐up period ranged from 2 to 21 years, mean 10,28 years. There were 4 early deaths (within 30 days after surgery), and at follow‐up further 5 patients had died. Excluding a man who died in a traffic accident the total mortality is 1,7%. Of the 470 surviving patients 81,7% were improved, 17% were unchanged and 1,3% had deteriorated. In patients with symptoms dyspnea and palpitations were common complaints. Different types of arrhythmia were found in 31 patients. One third were paroxysmal tachy‐arrhythmias, and 9 patients had atrial fibrillation. Only 3 of the 31 patients had some type of preoperative arrhythmia, and 26 were more than 20 years of age at surgery. Seven patients were reoperated because of a residual left to right shunt, 5 of them were initially operated in hypothermia and inflow occlusion. During the follow‐up period 10 patients had late cardiovascular

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02598.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTThe effect of antiarrhythmic drugs on myocardial refractoriness may be due to changes either in Vmaxof phase 0 or the phase of repolarization of the AP or both. By using programmed electrical stimulation in combination with MAP recordings at different pacing rates in the intact dog heart, it was possible to classify and to a certain extent to elucidate the mode of action of various cardioactive drugs in vivo.Vaughan williams (68, 69) has proposed that antiarrhythmic drugs possess one or more of four main classes of action. The first class of action (quinidine may be regarded as the prototype) is a direct membrane effect which restricts the fast sodium current (the fast component) and thereby Vmaxof the AP in the absence of significant changes in MDP (30, 32, 67, 73). The second class causes β‐adrenergic receptor blockade, the third class increases the AP duration (amiodarone may be regarded as a prototype (62)) and the fourth class modifies the inward calcium current during the excitation period (6, 20, 21, 33). Classification of antiarrhytmic drugs have been based primarily on their effects on AP duration and amplitude, Vmax, membrane responsiveness (the relationship between MDP and Vmax), conduction and refractoriness in vitro and in vivo (56).The duration of the AP has been regarded as a valuable determination of the refractory period (28, 72) and it has been shown that the ERP of isolated dog Purkinje fibres ends when the repolarization has restored the transmembrane AP to a value of ‐55 to ‐65 mV (28). However, the correlation between the process of repolarization and the reactivation of the sodium carrying system is not always constant, and the effects of certain antiarrhythmic agents have been attributed partly to a change in this relationship (67). Thus, drugs with first class action shift the values relating Vmax(ordinate) to MDP (abcisse) to the right, indicating that fewer sodium carriers are available at all membrane potentials (61, 73).In assessing the mode of action of cardioactive drugs on the myoardium, it is therefore necessary to combine different experimental techniques and procedures. The present work was carried out to study the effects of different drugs on the refractoriness of the right ventricle of the dog heart and to see if any changes were correlated to alterations in the duration of the MAP. For this purpose we used programmed electrical stimulation in combination with MAP recordings at different pacing

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02599.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTThe presence of ventricular septal defect can be diagnosed noninvasively by Doppler ultrasound. Care must be taken to distinguish between VSD and infundibular pulmonary stenosis. VSD was easily differentiated from other cardiac lesions. In 55% of the patients a pressure drop across the VSD, comparable to that present, could be calculated from maximal velocity recorded. In the remaining patients velocity and pressure drop were underestimated, probably due to a too large angle between ultrasound beam and velocity. Pulmonary artery systolic pressure was correctly estimated from Pc‐Tointerval and heart rate, and RPEP/RVET indicated whether normal or raised diastolic pressure was present in most patient

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02600.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTIn 1832 healthy men aged 40–59 years subjected to a near maximal bicycle exercise test, physical fitness declined with age. Higher levels of physical fitness were in all agegroups associated with lower cigarette consumption, blood pressure, serum triglycerides, hemoglobin and with better pulmonary function. Serum cholesterol, however, was independent of changes in physical fitness. In view of the beneficial effect of high physical acitivty on the well‐known coronary risk factors, it is surprising that it has proved so difficult to show a protective effect of increased physical fitness and activity on coronary heart disease and its manifestati

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02601.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTwe wanted to study changes in the inotropic and electrophysiologic effects of digoxin after a single dose and to correlate them to serum digoxin concentrations.Furthermore we wanted to compare data obtained in the present study to results obtained in a similar study after digitoxin.Six pentobarbital anaesthetised Labrador dogs were given 1.0 mg digoxin intravenously. Left heart catheterization and His bundle recordings were performed.Pacing and programmed electrical stimulation were used to determine heart rate independant changes in dP/dt, intra‐atrial, AV‐nodal, His‐Purkinje and intraventricular conduction times. The effective (A‐ERP) and the functional (A‐FRP) refractory periods of the atrium, the functional refractory period of the AV node (AV‐FRP) were measured. Serum digoxin concentrations were determined with radio‐immu‐noassay.Median serum digoxin half‐time (T/2) was 4.2 hours. dP/dt increased after digoxin with maximum values after 1 1/2 hour. Digoxin concentrations correlated linearly with inotropic response. Heart rate fell significantly within 2 minutes and remain below control values for 3 hours concomitant with an increase in A‐H time and AV‐FRP. A‐ERP and A‐FRP did not change.A significant positive correlation was observed between decrease in AV‐FRP and serum concentrations in the elimination phase, while no obvious relationship existed between the other electrophysiological variables measured and serum concentrations.Digoxin and digitoxin differed in their electrophysiological effects. while digitoxin increased atrial refractoriness, no effect was observed after digoxin. Digitoxin (2.0 mg) caused more pronounced late effect on heart rate and AV nodal conduction and refractor

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02602.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTEncouraged by the effective prevention of arterial thromboembolism with a combination of ASA and anticoagulants (9), the present study was done in 77 patients with a single Starr‐Edwards aortic ball valve. They received one gm. of ASA daily, then the dose of anticoagulants was reduced gradually and the drug discontinued on average five weeks later. Six arterial embolic episodes occurred in five patients, the incidence being 14.5 complications per 100 patients per year. Five emboli were cerebral, none of them serious, and one was removed from a femoral artery. Four of the embolic episodes occurred in three of the 11 patients with continuous arrhythmia, probably from venous thrombi that developed in the left atrium. The occurence of only two embolic complications in the 66 patients with sinus rhythm suggests some prevention of arterial thrombus formation on the prosthetic valves. The results indicate that ASA is inferior to anticoagulants in patients with arrhythmia, while it may represent an alternative to anticoagulation in individuals with sinus rhythm. we prefer, however, the combined thereapy in patients with aortic valve prostheses because of the strong anti‐thrombotic effect achieved by this treatm

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1981.tb02603.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY