ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The cardiovascular area is one of several fields of US-USSR Exchange in the Field of Medical Science and Public Health, in which cooperative research programs are being developed in accordance with the Agreement between the Government of the United States of America and the Government of the Union of Soviet Socialist Republics. This agreement was signed in Moscow on May 23, 1972. The National Heart and Lung Institute, the US coordinating institution for the cardiovascular portion of the agreement, is currently developing collaborative efforts between American and Soviet scientists in the following areas: Pathogenesis of Arteriosclerosis, Management of Ischemic Heart Disease, Myocardial Metabolism, Congenital Heart Disease, Sudden Death, and Blood Transfusion, Blood Components and Prevention of Hepatitis with Particular Reference to Cardiovascular Surgery. In addition, an artificial heart research and development program is being developed under a separate agreement which was signed June 28, 1974 in Moscow. During the first two years of cooperation, there has been a substantial exchange of scientists, delegations, techniques, publications and information. One of the objectives of the exchange program is to explore ways to increase the utilization of Soviet medical literature by American clinicians and scientists, and vice versa. It was decided that one way to accomplish this exchange of information would be for Soviet scientists to furnish the US side with abstracts of recent and important papers dealing with cardiology. These would then be edited by the National Heart and Lung Institute and published as a regular feature in Circulation, the official Journal of the American Heart Association. The abstracts would thus reach all the readers of Circulation, which includes virtually all the cardiovascular investigators in the United States. The choice of articles to be distributed, and the content of the abstracts is the prerogative of the Soviet investigators. The following ten abstracts are the second set to be submitted to the National Heart and Lung Institute for publication from the Soviet side.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Two autopsy-proved cases are presented of a rare form of congenital heart disease, anatomically corrected malposition {S, D, L}. Anatomically corrected malposition means that despite the abnormal relationship between the great arteries, the aorta arises nonetheless above the anatomically left ventricle and the pulmonary artery originates above the anatomically right ventricle. {S, D, L} briefly indicates the segmental set or combination: situs solitus of viscera and atria (S), ventriculard-loop (D), andl-malposition of the great arteries (L). These are the first cases of anatomically corrected malposition (ACM) in whom the presence of a subaortic muscular conus only has been documented pathologically. This establishes that ACM can occur with a subaortic conus, as well as with a bilateral conus. From the diagnostic standpoint, the distributions or epicardial courses of the coronary arteries are recommended as a helpful approach to ventricular identification. This diagnostic method has widespread angiocardiographic and surgical applications. Symbolic terminology, exemplified by anatomically corrected malposition {S, D, L} is brief and accurate. This approach may conveniently be applied to many other forms of complex congenital heart disease, and it considerably facilitates computer data processing.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A longitudinal study was made of 62 patients with dextro-transposition of the great arteries. The patients were managed with balloon atrial septostomy (BAS), palliative surgery if any operation was needed in the first year of life, and Mustard intra-atrial baffle repair after one year of age. Of the 47 patients with intact ventricular septum (IVS) treated in this manner, 41 (87%) were living at three months of age, 36 (77%) at one year, and 31 (66%) at two years of age. Survival rates were lower at each age for patients with associated ventricular septal defect (VSD). In relation to therapeutic interventions in the 62 patients, there were six medical deaths within one week of BAS, three deaths during palliative operations, and eight deaths associated with 31 Mustard procedures. Three patients with IVS and five with VSD developed pulmonary vascular obstructive disease, and two patients suffered strokes. In view of the relatively low mortality rate after the neonatal period and our good results with palliative surgery, we continue to defer the Mustard procedure to the second year of life. This is in contrast to the policy of some centers which now advocate elective intracardiac repair in the first year of life.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Ultrastructural studies were made of operatively resected crista supraventricularis muscle in 59 patients with congenital heart diseases, of whom 54 had obstruction to right ventricular outflow. Relationships of anatomic diagnosis, age, peripheral arterial oxygen saturation (PAO2), peak right ventricular systolic pressure gradient and right ventricular end-diastolic pressure (RVEDP) to hypertrophic changes, abnormalities of cellular and myofibrillar orientation, and degenerative alterations were determined. Changes directly related to hypertrophy were: cell diameters > 20&mgr;, irregular cell shape, lobulated nuclei, multiple intercalated discs, dilated T tubules, abnormal Z bands, and increased numbers of ribosomes. Abnormalities of cellular or myofibrillar orientation were focal in distribution and occurred in 12 patients, most of whom had elevated RVEDP, decreased PAO2, markedly enlarged cells, and interstitial fibrosis. Interstitial fibrosis was prominent in 19 patients and was associated with cellular hypertrophy, elevation of RVEDP, and increased age of the patients. Degenerative changes (myofibrillar lysis, abnormally small mitochondria, myelin figure formation, and proliferation of sarcoplasmic reticulum) in cardiac muscle cells occurred in six patients and correlated with increased age, decreased PAO2, and elevated RVEDP. Mitochondria containing glycogen deposits were present in 17 patients, most of whom had decreased PAO2. The variability of morphologic manifestations of chronic cardiac hypertrophy and the relationships of hypertrophic changes to orientation abnormalities and degenerative alterations are discussed.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Two cases with conduction disturbances in the His bundle are described. In each it was not possible to obtain both components, H and H′, of the "split" His bundle potential at one time from a single bipolar electrode catheter with an interelectrode distance of 10 mm. Initial failure to record the proximal His component (H) led to the incorrect diagnosis of block located within the atrioventricular (A-V) node, of third degree, in patient A, and of first to second degree in patient B. However, careful withdrawal of the catheter resulted in the appearance of proximal components (H), accompanied by disappearance of the distal components (H′) of the His bundle potential. Apparently the lesion in the His bundle and the recording electrodes were spatially related in such a way that the bipolar electrode could not override the lesion. In view of these findings it is advocated that in patients with A-V conduction disturbances the His bundle catheter should be withdrawn carefully, if the initial recording reveals His bundle potentials bearing a time relation to the ventricular complexes, or advanced carefully, if these His potentials are related to the atrial activations, in order to demonstrate the (co)existence of a lesion in the His bundle. Search for a proximal His potential by withdrawal of the catheter should be done, if possible, while the atrium is paced at a rate in excess of the spontaneous sinus rate since the H potential may be obscured by the atrial complex if the A-V nodal transmission time is short at the spontaneous rate, as was the case with patient A. In patient B the not yet described phenomenon of bradycardia-dependent block within the His bundle was observed.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Three patients with recurring attacks of supraventricular tachycardia and no electrocardiographic evidence of the Wolff-Parkinson-White syndrome (WPW syndrome) were studied using intracardiac recordings and atrial stimulation. The findings are interpreted as evidence of a concealed WPW syndrome. In all patients there was antegrade block of the anomalous atrioventricular (A-V) pathway while retrograde conduction was unimpaired and allowed the initiation of the observed reciprocating tachycardias. The diagnosis was based on the assumption that the ventricular myocardium was an essential link in the re-entry circuit. The three most important findings to support this assumption are: 1) retrograde conduction time, measured by the Q-A′ interval (Q in ECG to atrial echo), and the rate of tachycardia were dependent on the mode of intraventricular conduction; 2) the first Q-A′ interval of the tachycardia was independent of the A-H interval (initiation of atrial impulse to first activation of the His bundle) of the initiating premature atrial depolarization(PAD); 3) there was retrograde conduction following a ventricular premature beat during tachycardia at a time when the A-V node and/or the bundle of His would be refractory.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

To examine the effects of acute myocardial infarction on mitral valve diastolic velocity, echocardiograms were performed in 18 patients on admission, daily in the Coronary Care Unit, and at 3-day intervals during the remainder of hospitalization. These patients were divided into three groups based on the time interval between onset of symptoms and initial echocardiogram. Five of six patients admitted within 5 hours of onset of myocardial infarction had a triphasic response of mitral valve diastolic velocity with a transient rise above initial values, followed by a fall to below initial values, and then a slow rise during recovery. Seven of eight patients admitted 1-2 days after onset of myocardial infarction had a biphasic response, i.e., a fall from initial values and then a slow rise. Four patients admitted later in the course of myocardial infarction had a monophasic response, i.e. low initial velocity followed by a slow recovery. We conclude that in patients with myocardial infarction the mitral valve diastolic velocity following myocardial infarction shows a triphasic response which may appear biphasic or monophasic depending on the interval between myocardial infarction and admission. The temporal pattern of mitral valve diastolic velocity changes may reflect the dynamic alterations of myocardial function and compliance that are occurring after acute myocardial infarction and during the recovery period.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The echocardiogram of the anterior leaflet of the mitral valve (ECHO) was compared to hemodynamic and cineroentgenographic data to evaluate its accuracy in timing mitral valve (MV) opening and closure, and to validate it as an indicator of MV motion. The ECHO, high speed cineroentgenography at 250 frames/sec, and/or measurement of intracardiac pressures allowed accurate timing of the events of MV motion in dogs on right heart bypass. The intersection of left ventricular and left atrial pressures in early diastole preceded the onset of rapid anterior motion of the ECHO (D′ point) by 17 to 33 ± 7.6 msec;r= 0.98. The onset of left ventricular systole occurred before the termination of final rapid posterior motion of the ECHO in end diastole (Copoint) by 25 ± 10 msec;r= 0.96. Radiopaque clips were attached to the free edges of both leaflets of the MV. Cineroentgenographically determined plots of clip distance from the ultrasound transducer were morphologically similar to the simultaneously recorded ECHO. A delay of 23 ± 3 (0 to 40) msec was observed in the ECHO peaks of diastolic anterior excursion compared to clip motion. Contrast medium advances beyond the free edges of MV leaflets mixing with left ventricular blood 43 ± 3 msec after initial separation. These cineroentgenographic studies elucidate nonuniformity of leaflet motion responsible for ECHO delays.Thus, ECHO D′ and Cocorrelate well with hemodynamic indicators of MV opening and closure. However, ECHO motion, although qualitatively similar, is unpredictably delayed compared to cineroentgenography of clips on the MV free edge. Since the ECHO correlates well with hemodynamic indices of MV opening and closure, this noninvasive technique can be used as a reference in the timing of intracardiac events and in the determination of systolic and diastolic time intervals.

ISSN:0009-7322    

出版商:OVID    

年代:1975

数据来源: OVID