ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Data from a study of 97 consecutive patients who participated in a comprehensive inhospital rehabilitation program were compared with data on 100 patients treated conventionally at the same hospital. All patients were under age 65 and were suffering from their first myocardial infarction or had no sequelae from a previous infarction. The rehabilitation program consisted of education of the patient and family, vocational rehabilitation counseling, and supervised, graded exercise. Treatment effects were measured three months and one year after discharge. When compared with control group patients at the three‐month follow‐up, treated patients more frequently followed the recommended diet (P < .001), lost more weight (P = .02), were more active with leisure walking (P = .04), had lower serum cholesterol (P = .01), and had less severe angina pectoris (P = .007). However, at three‐month follow‐up the program was not associated with better exercise capacity or with lower rates of death, reinfarction, or smoking. At one‐year follow‐up, only the statistically significant difference in serum cholesterol persisted (P = .005). No new differences appeared. There was a nonsignificant trend for intervention group patients to return to work slightly later in the course of recovery than did the control group patients. Thus, this in‐hospital rehabilitation program influenced behavior in a favorable manner, but the influence tended to decay over the observation period and was not strong enough to affect outcomes. It was concluded that the immediate convalescent period is an appropriate time to effectively introduce the patient to behavioral changes, but for sustained behavioral change leading to improved survival, the intervention must be followed by continued support after hospital discharge.

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Noninvasive studies have shown the efficacy of combined digitalis and propranolol treatment of angina pectoris. To validate these data further, a hemodynamic study of 12 patients who were taking propranolol for angina pectoris was done to determine the effects of acute digitalization in cases without cardiomegaly or clinical congestive heart failure. Patients on an average of 300 mg oral propranolol daily were studied at cardiac catheterization before and 45 minutes after administration of 0.5 mg intravenous ouabain.Baseline left ventricular end‐diastolic pressure, cardiac index, and left ventriculogram were compared with these indices after ouabain. Surprisingly, all patients had elevated left ventricular end‐diastolic pressure, varying from 13 to 33 mm Hg (average 21.5 mm Hg), which fell 22.7% (P < .001) to 16.6 mm Hg after ouabain. Mean end‐systolic volume fell 12.2% (P < .02) and ejection fraction rose 6.7% (P < .025). The cardiac index, left ventricular end‐diastolic volume, heart rate, stroke volume, and mean aortic pressure did not change significantly.We conclude that ouabain shifts the patient's hemodynamics from its position on the Starling function curve directly leftward. The demonstration of a reduction in preload from a consistently elevated level suggests the value of using propranolol and digitalis in combination in patients with angina, even in the absence of congestive failure or cardiomegaly.

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;A 36‐year‐old marathon runner with a previously normal electrocardiogram developed a bifascicular block (right bundle branch block plus left anterior hemiblock) and has continued to run without incident. Exercise testing, radionuclide scanning, and echocardiography revealed no evidence of reversible ischemic heart disease or of ventricular dysfunction. These noninvasive techniques are useful in evaluating the cardiac status of a clinically normal, endurance‐trained athlete in whom electrocardiographic changes have been demonstrated.

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;This issue's In the Literature presents summaries of pertinent abstracts from the 54th Scientific Sessions of the American Heart Association held November 16‐19, 1981, in Dallas. The number in parentheses following the authors' names is the number for locating the complete abstract inCirculation1981;64 (part 2).

ISSN:0275-1429    

出版商:OVID    

年代:1982

数据来源: OVID