ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08515.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.During the 12‐year period from 1970 to 1981 662 patients have had an elective coronary bypass operation at our institution with a hospital mortality of 1,9%. Selected randomized subsets of the series have been subjected to detailed postoperative studies to elucidate the effects on morbidity, employment, and mortality, in particular. Other studied variables include graft patency, progression of coronary atherosclerosis, and left ventricular function.Exercise tolerance is markedly improved especially in patients with complete revascularization (+98%, p<0.001) in contrast to unchanged data in medically managed patients. This improvement persists for at least 2 years and has an impact on employment. Sixty per cent of the surgical patients were at work 2 years after operation in contrast to 26% of the similar medically managed patients (p<0.05). Annual mortality during a follow‐up of 5 years has been 0.9% in surgical patients compared with 4% in randomized medical patients (p<0.05).Unsettled topics include the surgical management of patients with unstable angina pectoris and patients with modest or no symptoms but a multivessel coronary artery disease. Further problems are the possible surgical management of high risk patients at discharge after myocardial infarction and the final position of non‐surgical coronary artery manipula

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08516.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Data are presented on patients referred for ambulatory ECG recording because of syncope or dizziness during a 2‐year period. Of the 272 consecutive patients subjected to the recording, 107 (39.3%) had syncope or dizziness as the main indication for referral. Sixteen of these patients (14.9%) experienced the presenting symptom during the recording, and in 8 (50%) of these the simultaneous ECG finding was interpreted as causative.In patients who were symptom‐free during the recording, sinus arrests exceeding 2.5 seconds seemed to be a valuable finding to support the cardiac aetiology of the syncopal symptoms, whereas the diagnostic value of second degree AV block with either Wenckebach or Mobitz II like patterns, as such, and of ventricular tachycardia remained mostly unsett

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08517.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.The occurrence of ventricular arrhythmias was studied in 25 healthy young men, with the aid of ambulatory ECG monitoring, during maximal bicycle tests, short term running, exhausting route marches, and during a 16 h period after brief and long term exercise. The bicycle test allowed prediction of 4 out of the 12 cases (33%) with ventricular premature beats (VPB) during running. The bicycle test combined with ambulatory ECG monitoring over a 16 h period allowed prediction of 12 out of the 14 cases (86%) with VPBs during marching. All 9 subjects who became exhausted during marching had VPBs, whereas 5 out of the 16 who were not exhausted had VPBs (p<0.001). In men with VPBs during all three exercise tests, the heart rates at the time of the VPBs were lowest during exhausting route marching. In conclusion, VPBs can be regarded as a physiological phenomenon if they occur only when exhaustion ensues.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08518.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Four patients with ventricular arrhythmias due to sotalol intoxication were successfully treated with overdrive pacing. In three patients the reason for sotalol overdose was a suicidal attempt and in the fourth patient the reason was unknown. In all cases a prolongation of the Q‐T interval was seen, which is a typical feature of sotalol overdose. Other features of beta‐blocker intoxication like bradycardia were found in all patients and hypotension in two patients. Three of four patients received lidocaine, but with no effect on multiple ventricular premature beats (VPB) or ventricular tachycardia (VT) of »torsade de pointes»‐type. Overdrive pacing abolished immediately VPBs and VTs in three patients, and in the fourth patient there was apparent decrease in dysrhythmia. Temporary overdrive pacing is suggested as treatment of ventricular arrhythmias in association with prolonged Q‐T interval caused by overdose o

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08519.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.In 497 consecutive cases of fatal or non‐fatal primary myocardial infarction and sudden coronary death, occurring on the area of Helsinki city, survival and reinfarction rates during 3 years after the attack were analyzed in relation to the level of off‐the‐job and on‐the‐job physical activity of the victims prior to the attack. High previous on‐the‐job physical activity had no influence on the survival and reinfarction rate after the primary acute ischaemic attack. High off‐the‐job physical activity consisting of sports or heavy work at least 4 hours weekly (24 cases) was associated with significantly lower overall and coronary mortality during two first years after onset of the primary attack as compared with medium‐level (187 cases) or low‐level (286 cases) physical activity. The difference was apparent already during the early hours of the attack. In subjects with high‐ vs. low‐level previous leisure‐time physical activity the respective first day survival figures were 88 and 75%, the 2 years figures 88 and 62%, and the 3 years figures 75 and 58%. Previous cardiovascular diseases particularly hypertension, as well as previous heavy smoking in earlier asymptomatic men, worsened the prognosis. There were no significant differences in reinfarction rate between subjects with different previous physical activity, but there was a trend to higher reinfarction rate in the group of high physical activity and to lower rate in the low‐activity group. The findings support the view, that previous high leisure‐time physical activity consisting of sports of heavy work at least four hours weekly possess in cases of the first acute myocardial infarction some fatality reducing power, which probably operates

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08520.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.The value of hyperuricemia as a risk factor for cardiovascular mortality was investigated in 3 195 men and 3 160 women aged 40–69 years in Finland. Hyperuricemia was associated with obesity, impaired glucose tolerance, hypertension and history of heart disease. The total mortality of hyperuricemic men and women in 5 years was significantly higher than the mortality of normouricemics. Cardiovascular mortality was not higher in hyperuricemics than in normouricemics. However, in hyperuricemic women without known heart disease cardiovascular mortality was significantly increased in the follow‐up period between 5 and 12 years. Total and cardiovascular mortality rates were significantly higher in hyperuricemic men with known heart disease than in corresponding normouricemic men. A rise of serum uric acid may be secondary to more advanced atherosclerosis. Thus, hyperuricemia may be associated with more advanced heart disease and it is not an independent cause of cardiovascular disea

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08521.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.A total of 41 male patients (age range 29–50 years; mean 44) with previous myocardial infarction (MI) and their 134 first‐degree relatives including 5 fathers, 11 mothers, 45 brothers, 26 sisters, 22 sons and 25 daughters, (age range 9–72 years), were examined for the presence or absence of the ear‐lobe crease (ELC) in an attempt to study the heritability of this sign which has been reported to be associated with coronary heart disease (CHD). ELC was present in 24 MI patients (59%) and absent in 17 (41%). They had 74 and 61 relatives, respectively. All relatives with CHD in each group also had ELC, which was also found in approximately half of the parents without clinical CHD and about one quarter of the healthy brothers of both patient groups. The healthy sisters of MI patients with ELC showed the ear sign remarkably often (31%), but it was found in only 1 sister of the MI patient without ELC. None of the children had ELC. The present findings support an association between ELC and CHD and may reflect, in addition, a connection between ELC and clinically silent coronary atherosclerosis in these selected families. The results do not indicate that ELC is an inheritable sign as such. Rather, it develops together with CHD as has been supposed pre

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08522.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Capillary diffusion capacity (CDC) and muscle blood flow (MBF) were determined from the anterior tibial muscle in 25 normal subjects by measuring the simultaneous clearance of133xenon and sodium131iodide. The subjects were divided into two groups: one with a mean age of 31 years and the other with a mean age of 51. The older group had a significantly lower MBF (54.6 ± 9.0 vs. 64.2 ± 9.5 ml/100 g/min; p<0.05) and a significantly greater CDC (7.6 ± 1.2 vs. 6.1 ± 1.3 mol/min; p<0.01) than the younger group. There was a significant correlation between the CDC increase and the age of the subjects (r = 0.61; p<0.01). Furthermore, MBF decreased with increasing age (r = 0.48; p<0.05). No differences were found in MBF or CDC between female and male subjects. The mechanisms of increased capillary permeability are discus

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08523.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Seven patients suffering from hepatic haemangioma were investigated by sonography and computed whole‐body tomography (CT). In addition, percutaneous fine‐needle biopsy was performed in 3 cases. All the patients had typical angiographic features of hepatic haemangioma. Histological confirmation was obtained in five cases.Sonography showed lesions of sonodense and mixed predominant sonolucent features. CT showed typical peripheral post‐contrast enhancement. Fine needle biopsy was successful and diagnostic in two cases. No complications occurred with the procedure. Sonography overlooked one tiny lesion, and CT two. It seems that sonographic appearances are not reliable in the diagnosis of hepatic haemangioma, though CT may be diagnostic. In doubtful situations other diagnostic procedures, such as angiography and/or fine‐needle biopsy, may be ne

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb08524.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY