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Biomedical subjects

A Sadaniantz

Publications and source records attributed to A Sadaniantz.

36 records · Page 2Linked to original sources
PubMed1994

Echocardiographic assessment of the cardiac anatomy in patients with multifocal atrial tachycardia: a comparison with atrial fibrillation.

Although multifocal atrial tachycardia (MAT) has been recognized since 1968, few data exist on its associated anatomic correlates. Using echocardiography, the authors describe the cardiac anatomy observed in hospitalized patients with MAT. Because MAT closely resembles atrial fibrillation (AF), these echocardiographic data are compared with those from an age- and sex-matched population with AF. There were 25 patients in each of the MAT and AF groups. Biatrial enlargement was present in both groups. However, the atrial enlargement was mild and significantly less in the MAT group. The MAT group had normal ventricular and aortic dimensions. Right ventricular dysfunction was rare in both groups. Moderate to severe global left ventricular dysfunction was present in 7 of 25 in the MAT group and in 9 of 25 in the AF group. Systolic wall-motion abnormalities were significantly less in the MAT group. Severe Doppler and structural abnormalities were not common in the MAT group. Based on these parameters, physiologic and not anatomic factors are probably more important in the genesis of MAT as compared with AF.

Aged↗
PubMed1992

Left ventricular function is not impaired in weight-lifters who use anabolic steroids.

Recent reports suggest that anabolic steroid use might deleteriously affect left ventricular function. To examine this possibility, the present study measured left ventricular size and function with use of Doppler echocardiographic techniques in 23 weight lifters: 12 who were currently using anabolic steroids and 11 who reported that they had never used these drugs. Drug users had administered anabolic steroids to themselves for at least three cycles over the past year. All studies were interpreted by blind review and group assignment was confirmed by urine testing. Average age, years of exercise training and body weight, as well as heart rate and blood pressure at rest were similar in both groups. Cardiac dimensions (mean +/- SD) including left ventricular diastolic cavity diameter (57 +/- 3 vs. 56 +/- 5 mm), septal thickness (10 +/- 2 vs. 9 +/- 1 mm), posterior wall thickness (8 +/- 1 vs. 8 +/- 1 mm) and myocardial mass (149 +/- 27 vs. 135 +/- 21 g) did not differ between the anabolic steroid users and nonusers, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Exercise thallium-201 imaging in complete left bundle branch block and the prevalence of septal perfusion defects.

To determine the prevalence of septal defects in a generalized referral population, the records of 93 consecutive patients with complete left bundle branch block (BBB) who underwent symptom-limited treadmill exercise testing with thallium-201 myocardial imaging over a 3-year period were reviewed. Segmental analysis of the planar thallium-201 images was performed in a blinded fashion with agreement by consensus. Computerized quantitative analysis of the images also was independently performed, and was correlated with the visual interpretations. Forty-seven patients (51%) had normal images, and 46 (49%) had defects of greater than or equal to 2 segments. In the abnormal studies, only 13 patients (14% of the total population) had septal defects, while a much higher number of patients, 33 (39%), had inferior or apical defects, or both. Coronary angiography was performed in 6 patients with septal defects: Significant narrowing of the left anterior descending coronary artery was found in 4 patients, a narrowed right coronary artery was found in 1, and normal coronary arteries were seen in the other patient. In conclusion, whereas previous studies have suggested a high percentage of false-positive septal defects in patients with left BBB, this study demonstrates a low prevalence (14%) of septal defects in a large population of unselected patients presenting for exercise thallium-201 imaging. Therefore, exercise thallium-201 imaging remains a useful procedure for evaluating patients with complete left BBB.

Aged↗
PubMed1990

Acquired Lutembacher syndrome or mitral stenosis and acquired atrial septal defect after transseptal mitral valvuloplasty.

Critical mitral stenosis in selected patients may be treated successfully with percutaneous mitral valvuloplasty. Complications of this procedure, particularly an atrial septal defect following transseptal approach, are generally of minor clinical significance. We describe a woman who initially underwent a successful percutaneous double-balloon mitral valvuloplasty via the transseptal approach. Three months later she presented with right-sided heart failure. Color Doppler echocardiography and cardiac catheterization demonstrated an atrial septal defect (ASD) as well as restenosis of the mitral valve. We conclude that significant ASDs may occur following transseptal mitral valvuloplasty with appearance of right ventricular failure and that color Doppler imaging aids in the diagnosis of this new variant of the classical Lutembacher syndrome.

Aged↗
PubMed1989

Time course of serum amyloid A response in myocardial infarction.

Plasma concentrations of serum amyloid A (SAA), high density lipoprotein (HDL) cholesterol, non-HDL cholesterol, and apolipoproteins (Apo) A-I and B were measured daily for 6 days in 10 patients following myocardial infarction (MI) and in 10 secular controls admitted to a coronary care unit. SAA concentrations peaked 3 days following MI (mean 47 mg/dl) and correlated with creatine kinase (CK) (r = 0.67, P less than 0.001). Non-HDL cholesterol and Apo B fell 15 and 18%, respectively, reached nadirs 3-4 days after MI and were inversely related to CK concentrations (P less than 0.01 for both). HDL cholesterol levels, in contrast, increased 15% and were significantly higher than baseline by day 3 when SAA concentrations were maximum. HDL cholesterol subsequently fell in parallel with SAA and had returned to baseline by day 6. Apo A-I declined throughout the 6 days of observation and was 13% lower than initial values on day 6 (P less than 0.05). The Apo A-I reduction was inversely related to both CK and SAA concentrations. There were no significant changes in any of the analytes in control subjects. We conclude that Apo A-I and possibly Apo B containing lipoproteins are negative acute phase reactants. HDL cholesterol is transiently elevated after MI despite decreasing Apo A-I levels and this may relate to incorporation of SAA into HDL particles.

Adult↗
PubMed1989

Transient acute severe aortic regurgitation complicating balloon aortic valvuloplasty.

Transient, acute severe aortic regurgitation documented by hemodynamic and Doppler-echocardiographic assessment was observed in an elderly woman immediately following balloon aortic valvuloplasty for critical aortic stenosis. Aortic regurgitation responded to medical therapy and resolved within 24 hr. Potential mechanisms are discussed. We suspect that an oversized balloon to aortic ring area stretched the annulus, separating the valve cusps and resulting in severe regurgitation, which rapidly normalized.

Acute Disease↗
PubMedDate not supplied

Cardiovascular changes in pregnancy evaluated by two-dimensional and Doppler echocardiography.

During pregnancy significant cardiovascular changes occur. To study these anatomic and physiologic changes we performed two-dimensional and Doppler echocardiography in 28 women during the third trimester (34.4 +/- 1.9 weeks) of pregnancy and then again after delivery (7.8 +/- 2.2 weeks). Fourteen nonpregnant age- and sex-matched subjects served as controls. Left ventricular diastolic and systolic dimensions were similar among pregnant, postpartum, and control subjects. Left atrial area as determined by two-dimensional echocardiography was significantly larger during pregnancy (16.7 +/- 4.0 cm2) compared with measurements postpartum (13.8 +/- 3.1 cm2) and with controls (15.5 +/- 3.5 cm2) (p less than 0.01). Doppler study showed that the ratio of early diastolic flow velocity to late diastolic flow velocity (E/A max) and E/A integral were lower among pregnant subjects (1.3 +/- 0.3, 2.0 +/- 0.5) compared with postpartum subjects (1.6 +/- 0.4, 2.5 +/- 1.5) and controls (1.9 +/- 0.5, 3.0 +/- 0.8) (p less than 0.05). Heart rate was higher among pregnant subjects (84 +/- 10 beats/min) compared with postpartum subjects (70 +/- 16) and controls (69 +/- 13) (p less than 0.05). In summary, in pregnant subjects during late third trimester left ventricular chamber dimensions were similar to these postpartum measurements in control subjects; however, the left atrium is dilated during pregnancy. Although there are significant alterations in Doppler-derived left ventricular diastolic parameters during the third trimester, increased heart rate and a dilated left atrium may explain these findings.

Adult↗
PubMedDate not supplied

Ineffective diastolic filling in tachycardia-induced cardiomyopathy with total pulsus alternans.

We report a case of total pulse alternans in a patient with paroxysmal ectopic atrial tachycardia and echocardiographic findings obtained before and after radiofrequency catheter ablation (RFCA) that terminated the arrhythmia. The patient was a 27-year-old man with history of paroxysmal palpitations with worsening episodic dizziness, chest tightness, and dyspnea. Electrocardiography (ECG) showed atrial tachycardia at 160 to 170 beats/min while the simultaneous pulse was in the 80s beats/min. Echocardiogram showed that aortic and mitral valves opened with alternating excursions and outflow velocities. Furthermore, despite similar ventricular wall thickening during systole of consecutive cardiac cycles, there was alternating mitral valve opening during diastole of the same cycles, providing direct evidence that ineffective diastolic filling and mitral valve opening may play a role in the pathogenesis of pulse alternans. Repeat ECG and echocardiography after the successful RFCA showed normal sinus rhythm and normal opening excursion and the velocity across the aortic and mitral valves.

Adult↗
PubMedDate not supplied

Managing acute myocardial infarction in a renal transplant recipient.

We describe the management of a patient, with a 13-year-old cadaveric renal transplant, who presented with acute myocardial infarction. Successful primary angioplasty was performed to the left anterior descending artery. It was complicated by transient renal failure and pseudoaneurysm of the femoral artery which was managed conservatively.

Acute Kidney Injury↗
PubMedDate not supplied

Coronary care unit requirements of patients with acute myocardial infarction treated with or without thrombolytic therapy: a pilot study.

OBJECTIVE: To determine if patients with acute myocardial infarction who receive thrombolytic therapy require more nursing care hours and a longer length of stay in the coronary care unit than those patients with acute myocardial infarction who do not receive thrombolytic therapy. DESIGN: Retrospective cohort study using the coronary care unit data base and patient classification records. SETTING: Northeastern university-affiliated, community-based, cardiovascular tertiary care center. PATIENTS: All patients admitted to the coronary care unit with a diagnosis of acute myocardial infarction were screened. Of these, 20 patients who also had a patient classification form completed were included in the study. Ten of these patients had received thrombolytic therapy and 10 had not. The patients were grouped according to treatment with a thrombolytic agent or conventional treatment. There was no significant difference in age between the groups (64 +/- 19 years and 67 +/- 15 years). OUTCOME MEASURES: Nursing care hours per patient per day and length of stay per patient in the coronary care unit. RESULTS: On days 1 and 2 of hospitalization, there were no significant differences in total nursing care hours provided per patient per day. On days 3 and 4, those patients who received thrombolytic therapy received fewer nursing care hours compared with those who did not (11.1 and 9.2 vs 13.8 and 12.7 hours per patient day, respectively; p < or = 0.05). Patients who were treated with thrombolytic therapy also had a significantly shorter coronary care unit stay (3.1 vs 4.0 days; p < or = 0.05). CONCLUSION: In this retrospective, observational pilot study, patients who received thrombolytic therapy for treatment of acute myocardial infarction had a significantly shorter coronary care unit stay and required significantly less nursing care on days 3 and 4.

Aged↗
PubMedDate not supplied

Inhibitors of 11 beta-hydroxysteroid dehydrogenase and 5 beta-steroid reductase in urine from patients with congestive heart failure.

Recently, the current authors reported the presence in normotensive male and female urines of reproducibly measurable levels of naturally occurring substances in partially purified extracts of urine with inhibitory activity like glycyrrhetic acid (GA) towards both 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) and steroid 5 beta-reductase (5 beta-SR) in vitro. Since these substances mimic two known inhibitory activities of GA, they have been named 'Glycyrrhetic Acid-Like Factors', abbreviated as 'GALFs' or, more specifically 11 beta-GALF for substance(s) active against 11 beta-OHSD, and 5 beta-GALF for those inhibitory to 5 beta-SR. Administration of glycyrrhetic acid in man leads to cortisol-dependent mineralocorticoid hypertension, owing to impaired inactivation of cortisol by 11 beta-OHSD, and may be associated with increased sensitivity to mineralocorticoids owing to impaired 5 beta-SR. In this preliminary report, the results are described of a study on the presence of GALF factors in urines collected from patients with congestive heart failure (CHF) and mild essential hypertension. The results show that in such patients there are increased amounts of both 11 beta- and 5 beta- GALFs compared to normotensive. The possible physiological significance of these results is discussed.

11-beta-Hydroxysteroid Dehydrogenases↗