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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients in congestive heart failure are known to have altered autonomic responses to circulatory stress. In this study, two different age groups of male coronary heart disease (CHD) patients, not in failure, as well as normal male subjects, underwent standard 20-min 70 degrees head-up tilt and Valsalva tests. Responses were monitored by noninvasive methods and cardiac output was estamated with a transthoracic impedance method. During tilt, the CHD patients and control subjects had similar heart rate and diastolic pressure responses. However, the CHD patients had a greater decline in pulse pressure during tilt, mainly due to a decrease in systolic pressure. CHD patients had lesser declines in stroke volume and cardiac index and lesser increases in total vascular resistance than did control subjects. In the Valsalva, the heart rate phase increments (and decrements) from control and rate increments (and decrements) between successive phases were less in the coronary patients. The results indicate that coronary patients, not in failure, have diminished circulatory responses to the tilt and Valsalva maneuver and suggest that these tests may be useful functional indices of cardiovascular capability in coronary disease.
Am J Physiol 1977 Dec
PMID:Alterations of postural and Valsalva responses in coronary heart disease. 59 67

The circulatory effects of plateau plasma theophylline concentrations of 5, 10 and 20 mg/l were examined in normal male volunteers using forearm plethysmography, systolic time intervals and echocardiography. Systemic arterial and forearm venous pressures were not significantly altered during theophylline infusions. Forearm blood flow increased an average 9.4% at 5 mg/l, 15.3% at 10 mg/l and 41.2% at 20 mg/l. Forearm venous distensibility was maximally increased by 20.9% at 10 mg/l. Changes in heart rate and systolic time intervals were apparent only at concentrations between 10-20 mg/l. Heart rates increased from 3-16 beats/min. The left ventricular ejection time index and isovolumetric contraction time were significantly reduced with an increase in the PEP/LVET ratio consistent with a reduction in cardiac pre-load and an increase in inotropy. However, the interindividual variability in circulatory responses was great and consistent alterations in cardiac stroke volume and ejection fraction were not observed in either the supine or 60 degrees passive-tilt positions. The variable responses cannot be due to variations in drug disposition between subjects since the range of plasma theophylline values at each concentration plateau was narrow.
Eur J Clin Pharmacol 1977 Dec 28
PMID:Cardiovascular response to increasing theophylline concentrations. 59 15

The hemodynamic effects of dihydralazine and prazosin (0.1 and 1.0 mg/kg i.v.) on the circulatory system and left ventricular dynamics and contractility has been performed in 10 purebred beagle dogs (15.5 +- 1.4 kg) under pentobarbital sodium (35-40 mg/kg i.p.) anaesthesia by means of thermodilution and catheter technics. The changes of cardiovascular values were: 1. Either dihydralazine and prazosin decreased mean arterial blood pressure in the dose of 0.1 mg/kg i.v. Following application of 1.0 mg/kg intravenously, the arterial pressure abruptly decreased after prazosin. 2. Both pharmaca caused tachycardia. Being slowly introduced but continued by dihydralazine, the increase of pulse rate after prazosin was only initial. 3. The cardiac dynamics were differently influenced by dihydralazine and prazosin. In the estimated dose range prazosin led to an increase of cardiac output directly after application while dihydralazine induced a gradual enhancing of cardiac output. 4. The stroke volume was decreased by prazosin and slightly increased by dihydralazine. 5. While distinctly decreasing initially after prazosin, peripheral total resistance was slowly reduced by dihydralazine. 6. The contractility of the left ventricle, estimated as dp/dtmax and VCE, showed a distinct increase of the myocardial inotropy after both compounds. The maximal effect after prazosin, however, was to be seen immediately post applicationem. Dihydralazine led to a deferred enhancing of the measured contractility parameter.
Z Kardiol 1977 Dec
PMID:[Dihydralazin versus prazosin. The hemodynamic effect of the modul substances (author's transl)]. 60 53

Arterial hypoxia was produced in 10 conscious, chronically instrumented, tracheostomized dogs by allowing them to breathe 7.5% O2 in N2 for 10 min. Hypoxia (Pao2 = 28 +/- 0.7 (SE) Torr) caused significant increases in coronary blood flow (+196%), left ventricular dP/dt max (+60%), aortic blood flow (+48%), heart rate (+50%), and left ventricular systolic (+12%) and aortic (+10%) pressures. Left ventricular end-diastolic pressure and stroke volume were unchanged, while systemic (-30%) and coronary diastolic (-66%) vascular resistances declined significantly. When equivalent levels of arterial hypoxia were produced in four of these dogs after chronic sinoaortic denervation, the coronary, cardiac, and systemic hemodynamic responses were not significantly different, with the exception that the small arterial pressure response was abolished. Thus the peripheral chemoreflexes are not essential for the normal coronary vasodilator and cardiac adjustments to occur during hypoxia in the conscious dog. The data support the hypothesis that a large part of the cardiac adjustments to hypoxia is initiated outside the sinoaortic reflexogenic zones, probably within the central nervous system.
J Appl Physiol Respir Environ Exerc Physiol 1977 Dec
PMID:Influence of arterial hypoxia on cardiac and coronary dynamics in the conscious sinoaortic-denervated dog. 60 85

Five prepubertal females and five college women, matched for aerobic power, walked on a treadmill at approximately 30% VO2 max for two 50-min periods in three environments: 1) 28 degrees C, 45% rh, 2) 35 degrees C, 65% rh, and 3) 48 degrees C, 10% rh. In the mild heat (28 degrees C) both groups were able to work 100 min with no discomfort. At 35 and 48 degrees C tolerance time for the prepubertal subjects averaged 84.4 and 37.0 min, respectively; for adults, 100 and 75.0 min. At all temperatures the girls had higher heart rates and a lower stroke index, and finished the walks with a higher rectal temperature. There were no differences between groups in cardiac index, mean skin temperature, forearm blood flow, or percent loss in body weight. The proportion of the thermal load dissipated by the two groups was similar but the route for heat transfer was related to the BSA/wt ratio and environmental conditions. Marked circulatory instability was a primary factor in the lower tolerance of the prepubertal girls to work in the heat probably due to a shift in blood volume from the central to the peripheral circulation.
J Appl Physiol Respir Environ Exerc Physiol 1977 Dec
PMID:Response of prepubertal girls and college women to work in the heat. 60 89

Twenty-seven patients undergoing open-heart surgery were divided into three groups, i.e., control, intermittent aortic crossclamping and coronary perfusion groups. Myocardial oxygen extraction, lactate extraction, arterial-coronary sinus hydrogen ion difference, potassium difference and glucose difference were determined during the operation, as well as, postoperative stroke and cardiac indices and comparisons were made. When the ascending aorta was not crossclamped, myocardial metabolism was well preserved during and after the perfusion at a flow rate of 2.0 L./min/m2. Intermittent aortic crossclamping for 15 minutes alternating with a period of perfusion for five minutes at 30 degrees C was sufficient to protect the myocardium from ischemia. Perfusion of the left coronary artery alone at a flow rate of six per cent of total body perfusion (150 to 200 ml per minute) at 30 degrees C was sufficient to protect the myocardium when the aorta was opened. Since intermittent perfusion of the left coronary artery may produce myocardial derangement, coronary perfusion should be continuous. Otherwise topical cardiac cooling or other means of myocardial protection should be used.
Jpn J Surg 1977 Dec
PMID:Myocardial protection during open-heart surgery: intermittent aortic crossclamping versus coronary perfusion. 60 90

Using the life table method, 962 cases of infarction, 279 cases of hemorrhage, and 243 cases of undetermined type of stroke, occurring in Manitoba between Jan 1, 1970, and June 30, 1971, were analyzed for factors affecting survival. Survival until Dec 31, 1973, was found to be adversely affected by the presence of coma or unconsciousness and the absence of localizing signs and symptoms. Also, the prognosis was poor if the heart was enlarged on the x-ray film or the ECG was abnormal. On the other hand, the presence of individual clinical entities such as hypertension, hypertensive heart disease, myocardial infarction, atrial fibrillation, or diabetes did not affect the survival significantly. These findings will help in predicting the prognosis and in planning for management of stroke cases.
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PMID:Prognostic factors in the survival of 1,484 stroke cases observed for 30 to 48 months. II. Clinical variables and laboratory measurements. 63 54

Ten patients in severe cardiac failure were treated with dopamine (4 microgram/kg . min) and dobutamine (7.5 microgram/kg.min). Both drugs brought about a similar increase in stroke volume and cardiac output of about 50% and 60%, respectively, accompanied by a fall in peripheral vascular resistance of about 33%. On dopamine the heart rate increased by 12%, but remained unaltered on dobutamine. There was a significant fall in the preload of both ventricles with dobutamine, while ventricular filling pressure during dopamine infusion was only slightly decreased, unchanged or even increased. The pulmonary (wedge) pressure during dopamine infusion averaged 9 mm Hg higher than during dobutamine (P less than 0.001). There is thus the potential danger with dopamine of aggravating pulmonary congestion. Furthermore, the improvement in cardiac function due to dopamine is at the expense of a higher oxygen demand than with dobutamine. Dobutamine is, therfore, preferable to dopamine in the treatment of advanced myocardial failure.
Dtsch Med Wochenschr 1978 Dec 01
PMID:[Dopamine and dobutamine in the treatment of severe cardiac failure (author's transl)]. 71 Mar 19

In a prevalence epidemiologic study conducted in a characteristic submontane area in North Bohemia, the genealogic incidence of myocardial infarction, sudden brain vascular episodes, and malignant tumors was studied in a representative sample of persons aged 70 to 105 years. The incidence was then compared with that in two other samples: 1) men under age 40 with a history of transmural myocardial infarction, and 2) both men and women aged 40--60 who had a stroke. The statistical evaluation was performed according to accepted international criteria (WHO). A significantly lower genealogic incidence of myocardial infarction and sudden brain vascular episodes was found in the geriatric subjects (70--105 years old) who had symptoms of so-called physiologic aging, as compared with the incidence in the younger subjects who had symptoms of so-called pathologic aging. The difference was less clear-cut with respect to the genealogic incidence of malignant tumors.
J Am Geriatr Soc 1978 Dec
PMID:Relative genealogic incidence of certain "civilization diseases" in a geriatric population versus pregeriatric groups. 71 22

We studied 83 women younger than 46 years with acute myocardial infarction (MI) and 154 controls. There was a strong positive association between MI and the following: (1) age, (2) both oral contraceptive and noncontraceptive estrogen use, (3) cigarette smoking, and (4) the presence of predisposing medical conditions, eg, past MI, hypertension, and diabetes. ABO blood type and family history of arterial disease were also positively associated with MI. Whereas the risks for idiopathic stroke and venous thromboembolism have also been shown to be increased among oral contraceptive users, there is comparatively little correlation between these two illnesses and age or smoking in young women. The present study, taken together with previously published work, provides reasonable estimates of the vascular risks associated with oral contraceptive use.
JAMA 1978 Dec 01
PMID:Myocardial infarction and other vascular diseases in young women. Role of estrogens and other factors. 71 57


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