ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10673.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTThe mortality in pacemaker‐treated patients is due to underlying disorders, and is increased in patients with ischemic heart disease, congestive heart failure, diabetes and renal dysfunction. We have recently shown that the HLA B27‐associated inflammatory disease process is the probable underlying cause in 15–20% of permanently paced men. Consequently, we undertook this study to evaluate any impact on mortality of HLA B27 and associated rheumatic disorders. The mortality among pacemaker patients was compared with that of the general population. Comparisons were also made between pacemaker patients with and without HLA B27 and associated disorders. We did not find any influence on mortality associated with the immunogenetic marker HLA B27 or with HLA B27‐associated rheumatic di

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10674.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTTherapeutic decisions in patients with angina pectoris are traditionally based on the history reported by the patient, since objective evidence of myocardial ischaemia during daily life is often not available. In this study, ambulatory ST segment monitoring was performed in 60 patients with a history of chronic stable angina pectoris, positive exercise test and/or positive coronary angiography, and a correlation was made between the episodes of chest pain and ST segment change. The patients were grouped according to the results of exercise testing and coronary arteriography, and one group was studied with and without antianginal medication. Overall, 195 episodes of angina were noted, only 94 of which (48%) were accompanied by ST segment depression. Pain and ST segment changes were best correlated in patients with a positive exercise test, positive angiography and who were not receiving antianginal medication. In 101 episodes of chest pain, ST segment change could not be identified; in 18 (18%) there was sinus tachycardia, in 12 (12%) ventricular premature beats, and in 71 (70%) sinus rhythm solely. Thus, anginal pain appears not to be the reliable indicator of transient myocardial ischaemia as was previously thought, a finding which supports the use of objective methods in identifying episodes of transient myocardial ischaemia in daily life.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10675.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTThe selective 5‐HT2‐receptor‐blocking agent ritanserin is an analogue of the antihypertensive agent ketanserin. By evaluating the antihypertensive effects of ritanserin the aim of this investigation was to indirectly elucidate the mechanism of action of ketanserin. Thirteen patients with essential hypertension were treated with placebo and ritanserin, 10 mg bid., in a double‐blind, cross‐over design (4‐week periods). At the end of the treatment periods blood pressure as well as plasma concentrations of ritanserin were evaluated for 24 hours. Despite high steady state and peak plasma concentrations of ritanserin the compound did not lower the blood pressure compared with placebo. Since chronic selective 5‐HT2‐receptor blockade by means of ritanserin did not lower the blood pressure, it is concluded that the 5‐HT2blocking properties of ketanserin cannot alone be responsible for the antihypertensive effe

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10676.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTTo evaluate thallium scintigraphy in predicting coronary artery bypass graft patency, exercise thallium scintigraphy and selective graft and native vessel angiograms were performed in 22 asymptomatic and 29 symptomatic consecutive patients three months after coronary artery bypass grafting (CABG). Twelve out of 22 asymptomatic patients (55%) had reversible thallium defects on postoperative images; in 10 patients the postoperative scans were normal. The graft patency was significantly lower in asymptomatic patients with abnormal thallium perfusion compared to those with normal perfusion after CABG (68% vs. 91%.p<0.05). The rate of graft patency in symptomatic patients was 66/87 (76%). Thallium scintigraphy was 77% sensitive and 78% specific in detecting one or more stenosed or occluded bypass grafts in patients without angina (accuracy 77%). When data from exercise electrocardiography were combined with scintigraphy, all but one patient with incomplete revascularization could be detected (positive predictive accuracy 92%). In symptomatic patients, thallium scintigraphy accurately predicted the presence or absence of graft occlusion in 24/29 (83%) cases. Thus, abnormal myocardial perfusion due to stenosis or occlusion of bypass grafts is common in both asymptomatic and symptomatic patients after CABG. Thallium scintigraphy together with exercise electrocardiography appear to be useful non‐invasive methods in detecting painless myocardial ischemia and in predicting bypass graft occlusion after CAB

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10677.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTPossible risk factors for cardiovascular disease were studied in 52 type II diabetic subjects, 19 with and 33 without a history of coronary heart disease (CHD). None of the recognized risk factors, such as hypertension, hyperlipidaemia, smoking and blood glucose imbalance, could be related to CHD. However, all female patients with CHD were lacking a family history of diabetes, while seven of nine female diabetic subjects without a history of CHD had diabetes in the family (p<0.02). This was confirmed in a second study of 150 type II diabetic subjects; CHD was more common among female patients without compared to those with diabetes in the family; 9/38 and 1/28, respectively (p<0.03). Diabetes increases the risk of CHD, and it does so for women more than it does for men. The finding of a possible low CHD risk in female diabetic subjects with diabetes in the family supports the hypothesis of genetic factors being important for the pathogenesis of cardiovascular disease in diabetes mellitus.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10678.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTEighty consecutive newly diagnosed non‐insulin‐dependent diabetic patients were randomly allocated into two groups to compare two different patient education regimens. One group received individual dietary instructions by a nurse and the other a short, written leaflet given by a doctor. The principal aim of the dietary instructions was weight reduction. A significant weight loss and improvement in the control of diabetes occurred in both groups, and these changes were similar in the two groups. At the end of one year's follow‐up, however, only 25% of the patients were satisfactorily controlled (fasting blood glucose ≤6.0 mmol/l). The degree of weight loss correlated only weakly with the improvement in the metabolic control. The degree of obesity and insulin secretion capacity as measured at the beginning of the study did not predict the improvement of glycaemic control during the study. At the end of the study a significant improvement was observed in serum lipids of patients with good control (fasting blood glucose ≤6.0 mmol/l) or weight loss (>5 kg). In conclusion, both brief, written and individual dietary instructions induced a significant weight loss as well as improved glucose and lipid metabolism in newly diagnosed non‐insulin‐dependent diabetic patients, but satisfactory metabolic control was achieved only in a minority of

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10679.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTAlbumin excretion rate was determined by radioimmunoassay in overnight urine from 102 normotensive patients with insulin‐dependent diabetes mellitus of more than 10 years' duration. Based on two samples, 16 patients (16%) exhibited microalbuminuria, defined as a mean excretion rate>20 μg/min. Microalbuminuric patients were significantly younger at onset of diabetes but did not differ from normoalbuminuric patients concerning age or duration of diabetes. Nonetheless, diastolic and mean arterial blood pressures were significantly higher in the microalbuminuric group. The existing glycemic control, assessed by glycosylated hemoglobin (HbA1C) was better in normoalbuminurics, but not significantly so. The albumin excretion rate in microalbuminuric patients correlated significantly (p<0.01) to diastolic (r=0.69) and to mean arterial blood pressure (r=0.69), but did not correlate to HbA1C. Thus, it is concluded that even normotensive patients with signs of early diabetic nephropathy, i.e. microalbuminuria, exhibit small, but significant increases in blood pressu

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10680.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTFourteen insulin‐dependent diabetics with symptoms and signs of delayed gastric emptying were treated with a new prokinetic agent, cisapride. In a placebo‐controlled cross‐over trial no significant differences from placebo was found regarding overall symptomatic effects and effects on gastric emptying of a mixed solid/liquid isotope marked test meal. Solid emptying was most markedly delayed in diabetics compared with healthy controls, but the emptying rate was not correlated to the severity of symptoms as observed for liquid emptying. During active tratment with cisapride the amelioration of symptoms was correlated to increased emptying rates assessed by combined measure of liquidsolid gastric emp

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10681.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTEsterification of plasma free cholesterol is mediated by lecithin: cholesterol acyl transferase (LCAT). The free cholesterol of plasma high density lipoproteins (HDL) is considered to be the preferred substrate for LCAT. It therefore appeared as a paradox that plasma cholesterol esterification, both in vivo and in vitro, is normal in fish eye disease and Tangier disease, two familial conditions with extremely low plasma HDL levels. Fish eye disease plasma, however, was shown to have LCAT activity primarily acting on combined very low (VLDL) and low (LDL) density lipoproteins, denominated β‐LCAT, while it lacked LCAT activity esterifying HDL cholesterol (α‐LCAT). Here we show that Tangier plasma, in contrast, has both α‐ and β‐LCAT. Thus, in both fish eye and Tangier diseases it is β‐LCAT that explains the apparent normal plasma cholesterol estenfication. We also show that Tangier plasma, having α‐LCAT activity, normalizes the low cholesteryl ester content as well as the abnormally small size of fish eye disease HDL particles

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb10682.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY