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 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Left ventricular volumes were determined by means of ECG-gated RI angiocardiography, which were compared with volumes derived from contrast cineangiocardiography in 25 patients with various heart disease. There was a close correlation of end-diastolic and end-systolic volumes and ejection fraction between RI and contrast angiocardiography, although stroke volume yielded rather scattered values. In 46 of 52 patients with myocardial infarction left ventricular asynergy was demonstrated with our method. Mean velocity of circumferential shortening (mVcf) was exaggerated in patients with apical asynergy. mVcf derived from direct axis measurement yielded a higher value than that from area-length method. Left ventricular volume curve was constructed to obtain normalized systolic ejection rate during initial 100--200 msec after the start of ventricular depolarization. The index was in parallel to ejection fraction in every patient except in moderately severe hypertensive patients. End-diastolic compliance was calculated from Gaasch formula by obtaining pulmonary artery wedge pressure and end-diastolic volume, which was determined by injecting 99mTc pertechnetate into pulmonary artery through Swan-Ganz catheter. This way of access to patient with acute myocard infarction was most useful to evaluate the mechanism of elevated left ventricular end-diastolic pressure.
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PMID:Radioisotope angiocardiographic evaluation of left ventricular function in cardiac patients. 87 30

Acute myocardial infarction with shock (AMI/S) was produced in 46 anesthetized "closed-chest" dogs by catheter injection of metallic mercury into the circumflex coronary artery. Twenty-four dogs were kept normothermic and 22 were maintained at 32 degrees C. Nine of the latter were rewarmed to 37 degrees C. and the experiments then were terminated, so that true survival time was arbitrarily shortened. Including these dogs, the survival time was three times longer than in the normothermic series (p less than 0.001). Hypothermia reduced heart rate (HR) by 34 percent, oxygen consumption by 38 percent, and myocardial oxygen consumption by an estimated 30 to 40 percent, while cardiac output (CO), stroke volume, and stroke work were unchanged. Left ventricular end-diastolic pressure (LVEDP) was reduced by 40 percent during hypothermia (p less than 0.05) and increased by 60 percent on rewarming. HR during rewarming increased substantially more than CO and thereby significantly reduced stroke volume.
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PMID:Induced hypothermia in dogs with acute myocardial infarction and shock. 88 82

In 100 consecutive patients with acute cerebrovascular accident, due to cerebral thrombosis in 72, cerebral hemorrhage in 12, embolus in 6, and subarachnoid hemorrhage in 10, there were 90 who had electrocardiographic abnormalities during the first three days after admission, compared to 50% in a control group. The patients with cerebrovascular accident had a 7- to 10-fold higher incidence of ST segment depression, prolonged Q-Tc interval and atrial fibrillation, and a 2- to 4-fold higher incidence of T wave inversion, conduction defects, premature ventricular beats and left ventricular hypetrophy. Patients who died had a 2-, 3- and 5-fold higher incidence of electrocardiographic evidence of recent myocardial infarction, atrial fibrillation and conduction defects than those who survived, but these changes occurred in only 5, 21 and 14% of all patients, and other electrocardiographic changes could not be correlated with mortality. During the first three days after admission 29 patients had elevation of serum enzymes which may be derived from cardiac muscle, particularly CPK, which was increased 6-fold, compared to 2-fold increases in HBDH, GOT, and LDH. Only 5 of these patients had electrocardiographic evidence of recent myocardial infarction. Patients with elevated serum CPK had a 2-fold higher incidence of ST segment depression, T wave inversion, conduction defects and atrial fibrillation than those with normal CPK, and a mortality of 66%, compared to 30%. Of 41 patients who died, 49% had elevated serum CPK, compared to 15% of 59 patients who survived. These differences were significant (P less than 0.01). Serum CPK was more frequently helpful than the electrocardiogram in evaluating the extent of cardiac damage and in predicting mortality. Patients with acute cerebrovascular accident should have repeated evaluation of serum CPK and the ECG, and be monitored for arrhythmias.
Stroke
PMID:Electrocardiographic changes and myocardial damage in patients with acute cerebrovascular accidents. 89 40

Eighteen men with myocardial infarction in their history and without signs of heart failure were investigated at rest and during standard supine exercise. In nine patients aneurysma or diskinesis of the left ventricular wall were found. The left ventricular end-diastolic volume was determined from the wash-out of 133Xe injected into the left ventricle by means of precordial scintillation counting. During exercise the cardiac index rose owing to acceleration of the heart rate, whereas the stroke index remained unchanged, and the left ventricular work and stroke indices increased. The left ventricular end-diastolic pressure, elevated at rest, reached high values during exercise. The left ventricular end-diastolic and residual volumes decreased during exercise in most patients, and simultaneously the systolic ejection fraction increased. In patients with aneurysma or diskinesis the end-diastolic volume both at rest and during exercise does not differ from EDV of other patients. Six patients developed angina pectoris during exercise, but their haemodynamics did not differ significantly. It is concluded that the left ventricle in patients with advanced coronary heart disease and previous myocardial infarction shows the signs rather of diminished compliance than of heart failure during adequate exercise and still possesses some functional reserves.
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PMID:Left ventricular end-diastolic volume during supine exercise in patients with healed myocardial infarction. 90 91

While differences in acceptability of steroidal contraceptives from nation to nation are generally recognized, variations in safety and effectiveness have been given little attention. Cardiovascular hazards such as thromboembolic disease, myocardial infarction, and stroke, which create such concern in developed countries, may be insignificant problems in other parts of the world where these diseases are rare in women of reproductive age. On the other hand, the influence of nutritional deficiencies, anemia, intestinal parasitism, malaria, and other widespread health problems on the effects and/or metabolism of steroids, which may be of major concern in developing countries, is just coming under study. Side effects also vary greatly among religiously and ethnically different populations, and significant differences in pregnancy protection and bleeding patterns among different populations have been reported-even with injectables. It is, therefore, important to examine and define intergroup differences and especially to recognize that safety concerns in one geographic setting cannot be automatically assumed to apply equally in other areas.
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PMID:Perspectives in evaluating the safety and effectiveness of steroidal contraceptives in different parts of the world. 92 97

The effect of physical training on hemodynamic performance was evaluated in a group of patients who had had a myocardial infarction and a group of healthy, age-matched controls. Before training, the patients' mean ventilatory equivalent was significantly less than that of the controls at the lowest workload (300 kpm/min), the mean stroke volume was significantly increased at the highest workload then achieved (600 kpm/min), and the mean arteriovenous oxygen content difference was significantly smaller at the highest workload. The patients had a relative bradycardia before training and there was no significant reduction in mean resting or submaximal heart rate after training. Their mean oxygen uptake was significantly reduced at the lowest exercise workload after training and this response was significantly different from that of the controls after 8 weeks of training. Mean cardiac output during exercise was significantly reduced in the patients after training, but only at the 600-kpm/min workload, the response being blunted at 900 kpm/min; mean stroke volume was also significantly reduced at this workload after training; both these responses were significantly different from those of the controls Mean arteriovenous oxygen content difference at 6oo kpm/min was significantly increased in the patients after training, though the response was not significantly different from that of the controls. Mean ventilatory equivalent was also significantly increased in patients after training, becoming similar to that of the controls.
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PMID:Effect of physical training on hemodynamic performance following myocardial infarction: a controlled study. 95 86

The present article describes the background and principles of a programme for community control of hypertension, which is part of the North Karelia project--a comprehensive community programme for the control of cardiovascular diseases. The hypertension programme also forms part of an international co-operative study by WHO. The programme consists of a community intervention integrated with the service structure. The methods used include health education of the public, education of health service personnel, organization of a service for the spreading of information and also for screening, treatment and follow-up. Every hypertensive person in the community is registered in the hypertension register and checked on annually. The evaluation is made mainly on baseline and terminal survey data from the intervention area and a reference area, the hypertension register, a myocardial infarction register and a stroke register in the intervention area.
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PMID:Hypertension programme of the North Karelia Project. 95 85

The importance of diabetic angiopathy for prognosis and course of diabetes mellitus, possibilities and basis of angiological therapy Complications originating from the vascular system determine life expectancy of the diabetic patient. He is particularly endangered by apoplexy, heart attack, arteriosclerosis of the lower extremities, retino- and nephropathy. Microangiopathy is a specific diabetic problem, the development of which shows a clear dependency on the quality of metabolism. Conventional therapy of circulatory problems today is less concerned with the vascular system than with the qualities of blood viscosity. In this context, viscosity is of main concern. Particularly in microcirculation viscosity is dependent on blood factors such as: haematocrit, plasmaviscosity, erythrocytes and thrombocytes. Their changed behaviour results, in the case of diabetes mellitus, in an increase in viscosity partly dependent on metabolism. A promising concept of treatment is available by pharmaceutically influencing the alteration of erythrocytes.
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PMID:[Diabetes mellitus and microcirculation. Significance of diabetic angiopathy for the prognosis and course of diabetes mellitus, possibilities and bases of angiologic therapy]. 96 91

In 203 patients with large focal and transmural myocardial infarctions the cardiac output was studied by means of the dye dilution method, as well as the content of the lactic (Barker and Summerson's technique) and pyruvic acids (Travina's technique). Along with the growth of cardiac insufficiency a fall was observed in the cardiac and stroke indices, and a growing content of the lactic and pyruvic acids and of the L/P factor. The stroke index and the blood lactate level proved to be the most informative values. With a stroke index below 24 ml/m2 all patients with myocardial infarction displayed signs of cardiac insufficiency, while with a stroke index above 54.2 ml/m2 cardiac insufficiency was lacking. A stroke index falling between 24 and 54.2 ml/m2 was observed in both the patients with cardiac insufficiency, and in those without it. A lactic acid content above 31.8 mg% was always concomitant with cardiac insufficiency. With the lactic acid level ranging from 16 to 31.8 mg% the probability of cardiac insufficiency was doubtful.
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PMID:[Discriminative analysis in detecting cardiac insufficiency in myocardial infarct on the basis of the values of stroke volume and blood lactic acid level]. 96 30

When a candidate for aortocoronary bypass has an associated lesion of the aorta orone of its major branches, a single operation may be indicated for correction of both problems. Three typical cases illustrate the concept of the combined approach to surgical management of coronary arterial lesions and associated carotid arterial disease, abdominal aortic aneurysm, and superficial-femoral arterial disease. An aortocoronary bypass candidate with carotid stenosis may be in imminent danger of both myocardial infarction and stroke. The selection of the proper sequence of operations under these circumstances is extremely important because any form of hypotension might produce a stroke. Cardiopulmonary bypass usually results in at least a transient reduction of the systemic pressure which would further compromise the blood flow across the tight stenosis of the carotid artery. Therefore, we recommended repair of the carotid lesion before aortocoronary bypass is attempted in order to avoid the possibility of postoperative stroke. The combined presence of coronary arterial disease and abdominal aortic aneurysm is indication for operation, but resection of the aneurysm involves cross-clamping of the aorta, and subsequent changes in arterial pressure might impair the coronary circulation and lead to myocardial infarction. On the other hand, the systemic heparinization required for the establishment of cardiopulmonary bypass and arterial pressure changes could affect the integrity of aneurysm. Unless the abdominal aneurysm is expanding, however, we elect to perform coronay revascularization first, with resection and graft replacement of the aneurysm immediately after heparin reversal. Occlusive disease of the superficial femoral artery can be corrected immediately following aortocoronary bypass. Since the femoral and upper leg incisions have been performed, in certain cases it is convenient to complete the femoral popliteal bypass while the chest is being closed, thus saving a separate operation to correct the femoral occlusive disease.
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PMID:Surgical correction of coronary arterial disease associated with lesions of the aorta ad its major branches. 103 86


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