摘要:

ABSTRACT.The magnitude of the peak systolic pressure gradient (PSPG) over the aortic valve was often the determining factor when deciding for or against operation of the congenital aortic stenosis. The impression that PSPG alone was an inadequate parameter for assessment of the degree of stenosis was supported by the present retrospective analysis of 32 patients operated upon for this anomaly. A gradient of 75 mmHg or more indicates a tight stenosis but a lower value does not exclude a pronounced constriction of the orifice, any more than does absence of symptoms or signs of left ventricular hypertrophy (LVH) on the ECG. It is probably not only the size of the stenotic orifice that determines the prognosis in aortic stenosis but also other factors, e.g. function of the left ventricular myocardium. A hypothesis was put forward by one of us (M. V.) that the location of the valvular ostium, central or peripheral, can be of importance and that turbulence‐induced vibrations of the left ventricular wall may depress the myocardium. Differences in the pathoanatomy of the stenotic aortic valves did not explain the poor correlation between e.g. symptoms or LVH and PSPG or the size of the remaining orifice in the present stud

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14822.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Among a series of consecutive patients treated with permanent pacemaker between 1965 and 1976, 43 had sinoatrial disease with paroxysmal tachycardia (group A), 30 sinoatrial disease without tachycardia (group B) and 165 atrioventricular block (group C). A retrospective study showed systemic vascular events compatible with embolism in 35%, 7% and 10% in groups A, B and C, respectively. The groups were comparable as regards age, other diseases and duration of pacemaker therapy. Because of the high incidence of embolism in group A, anticoagulant therapy should be evaluated in patients with the brady‐tachycardia syndrom

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14823.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.The effect of 10 days of total energy deprivation (fasting) on ECG reactions was evaluated in 14 healthy normal‐weight males. The heart rate and the ratios between QRS and T wave amplitudes in leads I and II decreased significantly, as did body weight and blood glucose levels. The urinary excretion of adrenaline increased. It is concluded that other hormonal (e.g. thyroidal), neural and metabolic mechanisms are of greater significance for the heart than the sympatho‐adreno‐medullary activity during fasting. T wave abnormality without an abnormal Q wave and without other clinical symptoms was noted in one subject on the 8th day of starvation and remained abnormal for more than a

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14824.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.There are indications that subjects of Lappish ethnic origin have a lower incidence of coronary heart disease than subjects of Norse or Finnish descent, despite their having a similar coronary risk factor status as assessed by serum lipid concentrations, BP and cigarette consumption. The possibility that this reflects a more favourable serum lipoprotein pattern in Lapps has been examined in 116 non‐fasting male subjects of Norse, Finnish and Lappish descent matched for age (mean age 39 years) and level of habitual physical activity. No significant differences between the three ethnic groups were observed, however, in either the serum total cholesterol concentration or the distribution of serum cholesterol between the high density (HDL, density (d) 1.063–1.21 g/ml) and lower density (<1.063 g/ml) lipoprotein classes. In view of recent evidence of an association of several coronary risk factors with a low HDL level in other populations, the relationship of HDL cholesterol concentration to other variables was explored by stepwise multiple regression analysis. As in other communities, HDL cholesterol was inversely related to thed<1.063 cholesterol concentration. HDL cholesterol showed no significant correlation, however, with either relative body weight, cigarette consumption or BP. Any relationship of these variables to coronary risk in the Tromsø population must operate, therefore, through mechanisms unrelated to

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14825.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Associations between smoking and selected factors supposed to promote coronary heart disease (CHD) were studied in 1832 healthy men, 809 of whom were smokers. Triglycerides were 7% higher in smokers; the heaviest smokers had the highest levels. Unfavourable changes were not seen in the other parameters in smokers. There was no trend indicating an influence of smoking on total and HDL cholesterol in the individuals who had abstained from smoking for a few hours just before the examination. Body mass index and weight, blood pressure and resting heart rate were lower in smokers, whereas heart volume, glucose tolerance, thyroid function and ECG findings did not differ significantly in smokers and non‐smokers. The present study indicates that smoking promotes the development of CHD independently of the commonly accepted CHD risk factor

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14826.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.The short‐term prognostic value of routine electroencephalography (EEG), carried out on the days after cardiac arrest, was evaluated in a consecutive study of 185 patients with acute myocardial infarction together with an episode of clinical cardiac arrest. The individual EEGs were classified on a 5‐grade scale. Of the 89 patients who survived, 18 had signs of anoxic brain damage; 96 patients died, 76 as a result of cerebral anoxia. Only 2 patients survived out of the total of 72 for whom the first EEG was classified as grades III‐V. The EEGs of both these patients were recorded within a few hours after the cardiac arrest. None of the patients with an EEG of grade I died of cerebral anoxia, while all degrees of brain damage were otherwise observed in connection with EEGs of both grades I and II. It is concluded that an EEG of grades III‐V indicates a fatal outcome, provided it has been recorded more than 24 hours after the cardiac arrest. A grade III‐V EEG that is recorded within 24 hours after a cardiac arrest should be repeated some days later. It is not possible, on the basis of a single EEG, to predict the extent of the anoxic bra

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14827.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.A woman was noted to have chronic progressive external ophthalmoplegia, pigmentary degeneration of retina and third degree AV block. She was admitted to hospital because of syncopes and was successfully treated with a permanent pacemaker. Since 1958, 12 similar cases have been noted. Three of 7 patients without pacemaker treatment died, and 5 were successfully treated with pacemaker. The disturbances in AV conduction are not thought to be a mere coincidence to the ocular disorder. Cardiomyopathy has been suggested.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14828.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Minoxidil has been administered to 16 patients with severe hypertension and renal failure. In every patient the indication for minoxidil treatment was resistance to conventional drugs. The final dose of minoxidil was 2.5–30 mg (average 20) and it was combined with aβ‐blocking agent and a diuretic (or dialysis). The therapy was given for 1–27 months (average 12). The average supine BP fell from 200/130 to 164/96 mmHg and the upright BP from 200/120 to 152/90 mmHg. No hypotensive reactions occurred. In most patients the progression of hypertensive organ changes was arrested. No major vascular complications have occurred during the 16 years of treatment. Prickling of the skin and hirsutism were common side‐effects. The other side‐effects observed were oedema in five patients and development of latent diabetes in three. In four patients minoxidil treatment was discontinued for following reasons: successful reconstruction of the renal artery after stenosis, renal transplantation, severe oedema and hirsutism. The risk of hirsutism is a contraindication to prolonged minoxidil administration in most female patients. Minoxidil is especially indicated in uncontrolled renal hy

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14829.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.In 164 consecutive patients with essential hypertension, serum immunoglobulin (Ig) levels of IgA, IgG and IgM classes were determined, using single radial diffusion techniques, and compared with 80 healthy normotensive subjects without any family history of hypertension. Of 80 untreated and 84 treated patients, IgA and/or IgG were significantly increased in 40% and 37%, respectively. IgG correlated positively to BP in untreated patients (p<0.0008), as well as in insufficienctly treated males (p<0.004). No correlations were found between Ig and duration of hypertension. The increase in Ig was not associated with any particular drugs. A family history of hypertension was found in 19.6% of the patients with elevated Ig and in 9.7% of those with normal Ig (p<0.10). The study provides further evidence for involvement of immune mechanisms in essential hypertension, and suggests a possible genetic predisposition.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14830.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

ABSTRACT.Using the indirect immunofluorescence method, autoantibodies (AB) of IgG and IgM classes were investigated in sera from 161 consecutive patients with essential hypertension and compared with those from 78 healthy normotensive subjects of the same composition by age and sex, and without any family history of hypertension. The frequency of one or more AB was as high in 78 untreated (15.3%) as in 83 treated patients (13.0%) and was in the controls 9.0% (n.s.). In the treated patients, the AB were associated with heart involvement (p<0.02). In the untreated patients, antinuclear antibodies of IgG class were associated with BP (p<0.01) and fundus grading (p<0.005). A family history of hypertension was found in 23.5% of the hypertensive males with AB and in 9.0% of the normotensive males (p<0.10). These results are discussed in relation to reports of an association of AB with cardiovascular diseases. It is concluded that the presence of AB in essential hypertension is not necessarily due to drug induction.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1978.tb14831.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY