摘要:

AbstractThe role of coronary arteriography In the asymptomatic or mildly symptomatic post first myocardlal infarction patient is controversial. Thirty‐one class 0–1 patients (Canadian Heart Association Grading System) underwent coronary arteriography within six months (mean 67 days) of their first myocardlal Infarction. Coronary arteriography revealed three‐vessel disease in nine (29%), two‐vessel disease in ten (32%), single‐vessel disease in ten (32%), and normal coronary arteries in two (6%). No pattern had left main disease, and two (6%) had teft main equivalent disease. In 12 patients with single‐vessel disease or normal coronary arteries there were no morbid events over a mean follow‐up period of 26 months. In the 19 with multivessel disease, eight (40%) developed a cardiac event during a mean follow‐up period of 11.4 months. These Included one who elected to undergo immediate aortocoronary bypass surgery, two with unstable angina, three acute myocardial infarctions, and two deaths. Based on these date and a review of the literature, a scheme Is proposed for the subsequent evaluation and treatment of thi

ISSN:0098-6569    

DOI:10.1002/ccd.1810070102

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

年代:1981

数据来源: WILEY

摘要:

AbstractSixteen translumlnal coronary angioplasty procedures (TCA), eight right coronary artery (RCA) and eight left anterior descending coronary artery (LAD), by the brachial artery cut‐down approach, were attempted with 9/16 (56%) immediate successes and 2/16 (12%) early recurrences. The procedure success rate for RCA obstructive lesions, 6/8 (75%) was greater than for LCA obstructions, 3/8 (38%). In six unsuccessful procedures the balloon catheter could not be advanced into the lesion, and in one unsuccessful procedure dissection of the coronary artery proximal to the lesion occurred. The brachial (Sones) technique for transluminal coronary angioplasty permits the use of softer guiding catheters for selective probing and approach to the coronary lesion but may be more likely to induce coronary spasm. Complete and high‐resolution pre TCA anglograms with multiple views to disclose the exact anatomy of the coronary artery and Its lesion Is essential to ensure successful dilatat

ISSN:0098-6569    

DOI:10.1002/ccd.1810070103

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

年代:1981

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810070104

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

年代:1981

数据来源: WILEY

摘要:

AbstractThe hemodynamlc effects of disopyramide phosphate, 2.0 mg/kg body weight, given intravenously over a period of five minutes were studied at rest and during exercise in ten patients without clinical or anglographlc evidence of heart disease.Following disopyramide, the resting cardiac index was lower (4.0 ± 0.6 vs 4.3 ± 0.6 iners/min/m2, mean ± 1 SO, P<0.05), while left ventricular end‐dlastollc pressure (16 ± 4 vs 11 ± 4 mm Hg, P<0.001), pulmonary arterial (PA) mean pressure (20 ± 5 vs 17 ± 5 mm Hg, P<0.05), and brachlal arterial (BA) mean pressure (105 ± 8 vs 96 ± 7 mm Hg, P<0.05) were higher than the pre‐infuslon resting values. During exercise, there was no change in left ventricular end‐diastollc pressure while cardiac index rose from 4.0 ± 0.6 to 6.5 ± 0.6 itters/mln/m2(P<0.001) and left ventricular stroke work index increased from 62 ± 19 to 84 ± 22 gm/beat/m2(P<0.001). The normal hemodynamlc response during exercise after disopyramide despite the apparent depression of left ventricular function at rest probably reflects the positive inotroplc effect of enhanced sympathoad

ISSN:0098-6569    

DOI:10.1002/ccd.1810070105

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

年代:1981

数据来源: WILEY

摘要:

AbstractIn 11 of 34 patients with typical mitral valve prolapse on the M‐mode echocardlogram, cross‐sectional echocardiography in the apical four‐chamber view revealed a characteristic abnormality not previously described. In mid‐ to late‐systole the ventricular septum contracted vigorously, forming a bend or sharp convexity toward the left ventricle, while motion of the posterolateral basal left ventricle was diminished and delayed. This finding was not encountered In 35 other patients with innocent systolic murmurs, or in 15 patients with mitral regurgitation of etiologies other than mitral valve prolapse. This abnormal pattern of left ventricular contraction on cross‐sectional echocardiography occurred with equal frequency In patients with holoaystollc and late‐systolic prolapse; it was seen more frequently In patients with severe prolapse than In those with mild to mode

ISSN:0098-6569    

DOI:10.1002/ccd.1810070106

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

年代:1981

数据来源: WILEY

摘要:

AbstractTo assess the validity of thallium‐201 myocardial imaging in the diagnosis of non‐transmural ischemia and infarction, the proximal left anterior descending coronary artery was partially occluded for 60 minutes with a balloon‐tip catheter in intact anesthetized dogs in a basal state or during atrial pacing. In vivo sclntigrams of myocardium were compared with those obtained in the isolated heart and in the incised ventricle spread flat. None of the animals with partial occlusion wtth or without pacing demonstrated abnormal scintiscans in vivo. Removal of background by isolating the heart increased positive images to 30%; positive images were associated wtth an isotope count ratio between ischemlc and normal muscle of less than 0.67. Removal of superimposed nonischemic muscle in the heart enface increased image detection after pacing to 11 of 15. Since animals with subendocardlal scar failed to demonstrate a “cold area” in vivo, unfavorable geometry as well as extent and degree of ischemia appear to be important Thus, thallium radioactivity in superimposed and adjacent myocardium, as well as background, may limit the detection of nontransmural ischemia

ISSN:0098-6569    

DOI:10.1002/ccd.1810070107

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

年代:1981

数据来源: WILEY

摘要:

AbstractThe purpose of this study is to investigate the validity of performing biochemical analyses on human endomyocardlal biopsies. One problem of such analyses is the decay of metabolites between the time of biopsy and the analyses. This was addressed by varying the time delay from biopsy to submersion in liquid nitrogen (‐200°C). Neither cyclic AMP or cyclic GMP changed significantly up to 90 seconds after biopsy. The reproduclblllty of the assays in human heart biopsies was determined by submitting paired samples from each procedure. The ATP content was determined by a fluorescent technique and was related to the protein and creative content. The average ATP of 25 paired samples was 12.3 nm per mg protein; the average difference between the paired samples was ‐0.6, and the 95%confidence Interval was 5.6 nm/mg protein. The average ATP‐to‐creatJne ratio was 0.25; the 95% confidence interval was 0.12. The cyclic AMP and cyclic GMP were found to average 3.3 and 0.25 femtomoles/mcg protein, respectively. The 95% confidence intervals were 1.8 and 0.12 fmoles/mcg protein. The problems of sampling error and blood and connective tissue contamination decrease the reliability of the biochemical analyses. Reproduclblllty is adequate, however, to acquire meaningful biochemical information on the hum

ISSN:0098-6569    

DOI:10.1002/ccd.1810070108

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

年代:1981

数据来源: WILEY

摘要:

AbstractCimetidine has recently proved useful in the prophylaxis of certain allergic and other hlstamlne‐medlated reactions [1–6, 25]. We have encountered a patient who had a serious cutaneous and respiratory reaction to Renografln‐76 during cardiac catheterizatlon. For the four days preceding his second catheterizatlon, the patient was treated with prednlsone, 30 mg daily, dlphenhydramlne, 25 mg orally, three times a day, intravenous dlphenhydramlne, 25 mg, three times a day, and Solu‐Cortef, 500 mg, intravenously, every six hours. Despite this preparation, he developed an intense reaction to Renografln‐76, which did not respond to further doses of Solu‐Cortef and dlphenhydramlne in the catheterlzation laboratory. Cimetidine, 300 mg, in 100 ml of D5W over 15 minutes, rapidly reversed the entire cutaneous and respiratory phenomenon.In the future, strong consideration should be given to using Cimetidine, in its intravenous form, as a routine medication in angiographlc laboratories where radio‐graphic contrast materials (ROM) are used. It may be helpful as a pretreatment for recognized RCM reactive patients when catheterlzation

ISSN:0098-6569    

DOI:10.1002/ccd.1810070109

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

年代:1981

数据来源: WILEY

摘要:

AbstractIdlopathic hypertrophic subaortte stenosis (IHSS) is a disease manifested as a spectrum of various clinical and laboratory findings. We present the case of a patient with classical clinical and hemodynamlc findings of IHSS who lacked all of the typical echocardlographlc features of the disease. The case emphasizes the need for diligent use of bedside physical examination and vasoactlve manipulation of systolic murmurs whenever functional left ventricular outflow tract obstruction is suspected, since it can occasionally be missed by echocardlography.

ISSN:0098-6569    

DOI:10.1002/ccd.1810070110

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

年代:1981

数据来源: WILEY

摘要:

AbstractA case with relapsing polychondritis is described where primary involvement of the aortic valve cusps produced severe aortic regurgitation requiring valve replacement. An aneurysmal dilatation of the ascending aorta developing later led to disruption of the prosthesis requiring re‐operation. Superior vena caval obstruction, an abdominal aortic aneurysm which ruptured and required resection, and obstructive lesions in common iliac arteries, presumably the result of the same process that involved the aorta and the cartilaginous structures, were also see

ISSN:0098-6569    

DOI:10.1002/ccd.1810070111

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

年代:1981

数据来源: WILEY