ISSN:0098-6569    

DOI:10.1002/ccd.1810090202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractA formal analysis of the error associated with the use of radiographic diameter measurements in estimating the luminal area of an elliptically‐shaped coronary cross‐section was performed. When two views are available, the maximum potential error was found to decrease rapidly as the angle between the views increased to 90°, but this error was small (<25%) for orthogonal views only for mild degrees of ellipticity (major/minor axis ratio<2). Since, for each successive doubling of the number of radiographic views, a stepwise reduction in the potential error by an approximate factor of only one‐half was found, a large number of views is required to eliminate the potential error associated with diameter assessment of highly elliptical

ISSN:0098-6569    

DOI:10.1002/ccd.1810090203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractTiming of the onset and sequence of systollc regional wall motion was examined in the digitized left ventricular cineanglograms of 13 patients with anglographlcally normal coronary arteries and left ventricular function. Distance‐time curves for anterior and inferior wall segments, the aortic valve plane, and apex point were compared to the volume‐time curve in each ventricle. No significant differences were found in the onset of motion for the wall segments or for descent of the aortic valve where the sequence of motion was generally uniform. At the apex point, however, the onset of motion was significantly delayed. In addition, reduced velocity of motion in the first half of systole was followed by high velocity motion in the latter half. This apparent nonuniform apical motion may be explained by a geometric relationship of normally contracting myocardial wall fibers adjacent to a thin apical point which has relatively little or no contractile motion of its

ISSN:0098-6569    

DOI:10.1002/ccd.1810090204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractSince vascular tortuosity or stenosis may preclude placement of the Intra‐aortic balloon, 63 consecutive patients (37 men) having routine Judkins' cardiac catheterization had an aortogram prior to withdrawal of the last catheter. No patient had a history of claudication, palpable aneurysms, pulse deficit, or bruit. No complications occurred.Significant peripheral vascular disease was found in ten patients: three had aortic, one had iliac, and six had femoral stenosis or tortuosity. All were men. The age of patients with peripheral vascular disease was 61.4 ± 7.7 years, while those without were 56.9 ± 9.3 years (P = NS). No difficulty was encountered entering the femoral artery in any patient; there was difficulty advancing the catheter in five of ten (50%) patients with peripheral vascular disease and in three of 54 (6%) patients without (P<0.002). Fifteen patients without peripheral vascular disease had normal coronary arteries, while none with peripheral vascular disease was normal. In patients with coronary disease, the number of vessels involved was the same in both groups.Peripheral vascular disease that might preclude placement of the Intra‐aortic balloon occurs in 14% of patients undergoing cardiac catheterization and 18% of patients with coronary artery disease. Aortography may be safely performed and should be considered during routine cardiac catheterization in patients who may require Intra‐aortic balloon pl

ISSN:0098-6569    

DOI:10.1002/ccd.1810090205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractCoronary arteriographic findings in patients with acute transmural inferior infarction were studied from 57 patients (51 men and 6 women). Their ages ranged from 28 to 72 years with a mean of 50 years. Twenty‐six patients (Group A) had minimal (less than 0.1 mV) or no precordial ST‐segment depression. Thirty‐one patients (Group B) had precordial ST‐segment depression of 0.1 mV or more. The two groups showed consistent differences in frequency of the left anterior descending artery (LAD) stenosis, multivessel disease, mean peak plasma creatinine phosphokinase (CPK, IU/L), and mean ejection fraction. For Group A vs B, these differences were: LAD stenosis, 31% vs 68%, multivessel disease, 35% vs 81%, mean peak plasma CPK, 1283 versus 1904, and mean ejection fraction, 60.5% vs 45.3%. The incidence of abnormal anterolateral and posterobasal wall motion in Group B was more (p<0.01 and p<0.05 respectively) than in Group A. All patients in Group B who had precordial ST‐segment depression of 0.3 mV or greater, had LAD stenosis. There was no relation between the duration of ST‐segment depression and the presence of LAD stenosis. Also, there was no correlation between the presence of collateral circulation and the development of ST‐segment depression. The Group B patients tended to have more complications in the acute phase and in the follow up period (p<0.05) than did those in Group A.It is concluded that precordial ST‐segment depression in acute inferior wall infarction is probably related to anterior injury due to LAD stenosis and these patients were shown to have more severe coronary artery disease, more depression of their ejection fractions, and more myocardial damage than patients without this finding.The earliest recorded ECG is most valuable in identifying the high risk patients. The presence of LAD stenosis in patients with inferior wall infarction who have precordial ST‐segment depression of 0.3 mV o

ISSN:0098-6569    

DOI:10.1002/ccd.1810090206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractTo evaluate the ability of transluminal coronary angioplasty (TCA) to relieve myocardial ischemia, 44 patients with single vessel disease underwent exercise gated radionuclide ventriculography (GRNV) before and 2.8 ± 1.3 days following angiographically successful TCA. Pre‐TCA GRNV was abnormal in 11 of 14 patients with right coronary artery (RCA) stenosis and 24 of 30 with left anterior descending (LAD) stenosis. Following TCA there was an increase in exercise duration from 500 ± 288 sec to 625 ± 273 sec (P<0.001), and in maximum double product from (209 ± 69) × 102to (263 ± 70) × 102(P<0.001). The number of patients with stress‐induced ST‐T abnormalities decreased from 13 to 4 (P<0.05), and the number with chest pain during exercise decreased from 18 to one (P<0.001). Whereas resting ejection fraction was unchanged (0.58 ± 0.10 vs 0.59 ± 0.11) following TCA, the ejection fraction at peak exercise increased from 0.61 ± 0.13 to 0.66 ± 0.12 (P<0.001). Of 24 patients with resting abnormalities, regional wall motion improved in 13. In 22 of 31 patients with stress‐induced asynergy, the wall motion response to exercise improved (P<0.001). Of 19 patients restudied angiographically and with exercise GRNV at 6–12 months, restenosis of ≥ 50% had occurred in six, four of whom had abnormal studies. In six in whom the degree of stenosis of the dilated artery had remained ≥20% the exercise GRNV study remained normal. It is concluded that GRNV is helpful in documenting the improvement in resting left ventricular function and functional reserve in patients with angiographically successful TCA. In the limited number of patients with late follow‐up studies, data suggest that GRNV may be a valuable

ISSN:0098-6569    

DOI:10.1002/ccd.1810090207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractWe report a case of aneurysm of the atrial septum occurring as an isolated abnormality in a patient with atypical chest pain. Apical two‐dimensional echocardiography demonstrated phasic bulging of the fossa ovalis region of the atrial septum into the right atrium. Biplane cineangiography confirmed the presence of a large septal aneurysm in an otherwise normal heart. The incidence, pathogenesis, and complications of this unusual anomaly are briefly discusse

ISSN:0098-6569    

DOI:10.1002/ccd.1810090208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractA case of right subclavian artery to pulmonary circulation fistula is described. A review of the literature surprisingly reveals that until December 1981 only three other cases involving the subclavian artery have been reported. Only one of these and the case described here seem likely to be of congenital origin.

ISSN:0098-6569    

DOI:10.1002/ccd.1810090209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractA severely stenotic, large‐caliber, first septal artery was successfully dilated in a patient with refractory angina and nonsurgical, multivessel coronary artery disease. The success of this dilatation was related to favorable coronary anatomy and to the availability of a guidewire‐directed dilatation catheter. Septal artery stenosis with or without surgically accessible stenoses in other coronary vessels represents a potential indication for percutaneous transluminal coronary angiopla

ISSN:0098-6569    

DOI:10.1002/ccd.1810090210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY

摘要:

AbstractIn two young men subsequently found to have primary pulmonary hypertension, echocardiographic findings suggested an atrial septal defect. Additionally, contrast echocardiography demonstrated right‐to‐left shunting at the atrial level. Cardiac catheterization demonstrated severe pulmonary hypertension with patent foramen ovale. Thus, primary pulmonary hypertension may result in findings similar to atrial septal defect on echocardiography, particularly if a foramen ovale is pres

ISSN:0098-6569    

DOI:10.1002/ccd.1810090211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1983

数据来源: WILEY