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Biomedical subjects

G D Curfman

Publications and source records attributed to G D Curfman.

11 recordsLinked to original sources
PubMed1990

Exercise electrophysiology testing: the effect of exercise on the induction of ventricular arrhythmias by programmed ventricular stimulation.

In order to assess the effect of acute, reversible myocardial ischemia on the outcome of programmed ventricular stimulation (PVS), ventricular stimulation was performed at rest, during exercise, and during recovery in 10 patients with coronary artery disease. Of these ten patients, four were tested while off antiarrhythmic drugs and six were tested on antiarrhythmic drug therapy. Nine of the ten patients developed acute myocardial ischemia during exercise PVS. However, in only two of these ten patients ventricular arrhythmia could be induced by PVS, one during exercise and one during recovery.

Aged↗
PubMed1986

Aging and exercise performance.

Diverse physiologic changes occur in the oxygen transport system during the aging process. Physical performance and VO2max decline with age, but the changes may be attenuated by exercise training. Increased ventilation is required during exercise in order to compensate for reduced efficiency of gas exchange. Cardiovascular alterations include prolonged duration of myocardial contraction, a slightly reduced left ventricular ejection fraction during exercise, decreased heart rate during both submaximal and maximal exercise, and attenuation of myocardial response to beta-adrenergic stimulation. Cardiac output during exercise can be maintained in the elderly owing to a greater dependence on ventricular filling. Appropriate exercise training leads to enhanced efficiency of the lungs, heart, and skeletal muscles. These physiologic benefits contribute to an increase in functional capacity and an enhanced sense of well-being. Exercise testing is recommended for individuals who have cardiorespiratory symptoms and for those at risk for the development of coronary artery disease. Reasonable goals for an aerobic training program are continuous activity for 30 minutes at a moderate intensity of exertion at least 3 days per week. The intensity of exercise should be based on a prescribed training heart rate. The exercise prescription should be individualized and should incorporate one or more activities for optimal enjoyment and compliance. Opportunities and facilities for indoor exercise are important during inclement weather. Regular physical exercise is important at any age!

Aged↗
PubMed1979

Valve replacement for aortic regurgitation: long-term follow-up with factors influencing the results.

One hundred consecutive cases of valve replacement for aortic regurgitation performed between 1967--1971 were analyzed to identify and quantitate factors related to a favorable result. Of 83 perioperative survivors, 78% (n = 65) became asymptomatic and 58% (n = 48) were alive 5--9 years postoperatively. The cause of aortic regurgitation affected both the speed of progression of symptoms and the postoperative result. Death due to myocardial failure may be prevented by optimal timing of operation. Accordingly, we identified variables that discriminated between patients who had an excellent postoperative result and those who died of myocardial failure. The most important discriminators were the severity (p = 0.03) and duration (p = 0.04) of dyspnea, the extent of therapy for heart failure (p = 0.001), physical findings of left ventricular failure (p = 0.002), the cardiothoracic ratio (p = 0.007), the resting pulmonary capillary wedge pressure (p = 0.01), and a cardiac index less than 2.2 1/min/m2 (p = 0.03). The data suggest that evidence of left ventricular failure, even of mild degree, is an indication for operation in patients with severe aortic regurgitation.

Adolescent↗
PubMed1977

Thyroid-induced alterations in myocardial sodium-potassium-activated adenosine triphosphatase, monovalent cation active transport, and cardiac glycoside binding.

The effects of thyroid hormone on guinea pig myocardial NaK-ATPase activity, transmembrane monovalent cation active transport, and cardiac glycoside binding were were examined. NaK-ATPase activities of left atrial and left ventricular homogenates of control and triiodothyronine (T3)-treated animals were determined, and compared to activities of skeletal muscle and liver. T3 administration was associated with a significant increase of 18% in left atrial and left ventricular NaK-ATPase specific activities. This increment was less than that noted in skeletal muscle (+42%) and liver (+30%). To determine if enhanced NaK-ATPase activity was accompanied by increased monovalent cation active transport, in vitro 86Rb+ uptake by left atrial strips and hemidiaphragms was measured. Transition from the euthyroid to the hyperthyroid state resulted in a 68% increase in active 86Rb+ uptake by left atrium, and a 62% increase in active uptake by diaphragm. Passive 86Rb+ uptake was not affected in either tissue. Ouabain binding by atrial and ventricular homogenates of T3-treated animals was increased by 19 and 17%, respectively, compared to controls, in close agreement with thyroid-induced increments in NaK-ATPase activiey. Taken together, these results are consistent with enhanced myocardial NaK-ATPase activity and monovalent cation activt transport due to an increase in the number of functional enzyme complexes.

Adenosine Triphosphatases↗
PubMed1976

Correlation of echocardiographic and clinical findings in patients with pericardial effusion.

Clinical data and echocardiographic findings were correlated in 20 patients with pericardial effusion. Moderate to large effusions were associated with increased motion of the entire heart within the pericardial sac. A correlation was found between the estimated volume of fluid and the diastolic excursion and velocity of the right ventricular and left ventricular walls (P less than 0.01). For any given volume of fluid as estimated from the echocardiogram neoplastic effusions resulted in greater increments in wall motion (P less than 0.02). Patterns of "pseudo" mitral valve prolapse occurred and were correlated with the extent and timing of cardiac swinging and heart rate. A diminished E-F slope of the mitral valve echo and notch on the right ventricular epicardial echo during early systole were found in all four patients with pericardial tamponade. These preliminary observations suggest that echocardiographic examination of patients with pericardial effusion may provide clues to the presence or absence of tamponade in addition to providing an estimate of the quantity of fluid in the pericardial sac.

Adolescent↗