Search PubMed⌕ Search

Biomedical subjects

J F Goodwin

Publications and source records attributed to J F Goodwin.

At least 73 records · Page 4Linked to original sources
PubMed1981

Is there autonomic impairment in congestive (dilated) cardiomyopathy?

Autonomic function was investigated in patients with congestive (dilated) cardiomyopathy and compared with that in controls. Heart-rate and blood-pressure were recorded during physiological and pharmacological interventions and plasma noradrenaline concentration was measured at rest and when the physiological interventions produced a peak response. The results indicate that even at an early (pre-failure) stage of the disease parasympathetic function is impaired but no significant increase in sympathetic activity occurs at this stage.

Autonomic Nervous System↗
PubMed1981

Arrhythmia in hypertrophic cardiomyopathy. I: Influence on prognosis.

In order to examine the association between arrhythmia and subsequent prognosis, 72-hour ambulatory electrocardiographic monitoring was performed in 86 unselected patients with hypertrophic cardiomyopathy. During monitoring 23 patients experienced at least one episode of supraventricular tachycardia and 24 had ventricular tachycardia (of whom 10 had more than three episodes). The patients were then followed for a mean of 2.6 years (range one to four). Seven patients died suddenly. Of these, five had exhibited multiform and paired ventricular extrasystoles and ventricular tachycardia. These arrhythmias were significantly associated with sudden death whereas supraventricular arrhythmias were not. The patients who died suddenly were older and had experienced more symptoms than the survivors, and three had a family history of hypertrophic cardiomyopathy and sudden death. This experience provides the basis for the assessment of treatment in patients with hypertrophic cardiomyopathy and serious ventricular arrhythmia.

Adolescent↗
PubMed1981

Successful surgical treatment of two patients with eosinophilic endomyocardial disease.

Cardiac surgery to treat severe heart failure was of benefit to two patients with endomyocardial disease and hypereosinophilia-eosinophilic endomyocardial disease. Both patients had severe biventricular fibrosis with mitral and tricuspid regurgitation. One had predominant right ventricular disease and was treated by right ventricular endocardectomy with tricuspid and mitral xenograft valve replacement. The second patient's main haemodynamic problem was considered to be mitral regurgitation. His mitral valve was replaced by a Starr-Edwards prosthesis; endocardectomy was not performed. Though both patients had toxic confusional states for several weeks postoperatively there was distinct symptomatic and objective evidence of improvement which has been maintained for over 16 months. Previous reports of surgical treatment of 22 patients without eosinophilia (all of whom had endomyocardial resection) and three other patients with eosinophilia have shown equally encouraging results. There has been no evidence of recurrence or progression of heart damage in follow-up periods of up to seven years. It is concluded that cardiac surgery is an important advance in the treatment of endomyocardial disease in patients with or without an eosinophilia.

Adult↗
PubMed1980

Arrhythmia in hypertrophic cardiomyopathy: exercise and 48 hour ambulatory electrocardiographic assessment with and without beta adrenergic blocking therapy.

Submaximal treadmill exercise electrocardiography and 48 hour ambulatory electrocardiographic monitoring were performed in 30 patients with hypertrophic cardiomyopathy both with and without beta adrenergic blocking therapy. During ambulatory electrocardiographic monitoring 1 patient (3 percent) had no arrhythmia, 14 patients (46 percent) had supraventricular tachycardia or paroxysmal atrial fibrillation, 13 (43 percent) had multiform or paired ventricular extrasystoles and 8 (26 percent) had ventricular tachycardia. The frequency of these ventricular arrhythmias was almost identical with and without beta adrenergic blocking drugs (mean dose in "propranolol equivalents" 280 mg daily). With beta blocking therapy fewer patients had supraventricular tachycardia; however, the difference was not significant. During exercise testing 18 patients (60 percent) had ventricular extrasystoles and 3 patients (10 percent) had paired ventricular extrasystoles and the frequency was almost identical with and without beta adrenergic blocking therapy. No routine echocardiographic or hemodynamic measurement predicted the serious ventricular arrhythmias. It is concluded that asymptomatic ventricular arrhythmia is a common occurrence in patients with hypertrophic cardiomyopathy and its frequency is not reduced with beta adrenergic blocking therapy. Because occult arrhythmia may be the cause of sudden death it is important to detect it in these patients so that an effort can be made to improve prognosis with specific antiarrhythmic treatment.

Adrenergic beta-Antagonists↗
PubMed1980

Sudden death in hypertrophic cardiomyopathy: associated accessory atrioventricular pathways.

Sudden death is a known but unpredictable complication of hypertrophic cardiomyopathy. We describe two patients who both had a strong family history of the disorder complicated by sudden death. Necropsy disclosed accessory bypass tracts, concealed in one and previously suspected in the other. One died from ventricular fibrillation and the other, who died outside hospital, had previously complained of palpitation. Arrhythmia complicating pre-excitation appears to be one of the factors responsible for sudden death in hypertrophic cardiomyopathy.

Adolescent↗
PubMed1980

Electrophysiological manifestations of non-penetrating cardiac trauma.

Electrophysiological disturbances were observed in four cases of non-penetrating cardiac trauma. Ventricular tachycardia occurred both as an early and late complication in three, responding to medical treatment in two; it was cured by cryoablation in the other case. The fourth patient developed an isolated conduction defect associated with anteroseptal myocardial infarction, the coronary arteries and left ventricular function being normal.

Adult↗
PubMed1980

Echocardiographic differentiation of hypertensive heart disease and hypertrophic cardiomyopathy.

The clinical differentiation of hypertensive heart disease from hypertrophic cardiomyopathy usually presents no problem but it is less clear whether an echocardiographic distinction can always be made and, if so, what those echocardiographic criteria of difference are. It can be inferred from recent publications that when echocardiographic criteria for hypertrophic cardiomyopathy are met in hypertensive subjects, both diagnoses may be made. This may be unjustified, and in order to clarify this problem that M-mode echocardiographic features of 37 patients with severe systemic hypertension were compared with those of 70 patients with hypertrophoic cardiomyopathy and normal blood pressure. Systolic anterior movement of the mitral valve and/or mid-systolic closure of the aortic valve were found in 82 per cent of patients with obstructive and 35 per cent of patients with non-obstructive hypertrophic cardiomyopathy. These features were not seen in patients with hypertension. The conventional echocardiographic features of left ventricular hypertrophy and function did not permit distinction between hypertensive heart disease and hypertrophic cardiomyopathy. The echocardiographic diagnosis of hypertensive heart disease from hypertrophic cardiomyopathy is, therefore, difficult unless systolic anterior movement of the mitral valve and/or mid-systolic closure of the aortic valve can be shown.

Adult↗
PubMed1980

Arrhythmias in patients with hypereosinophilia: a comparison of patients with and without Löffler's endomyocardial disease.

About one third of patients with Löffler's endomyocardial disease have abnormal electrocardiograms and some develop arrhythmias and die suddenly. To assess the significance of these findings, continuous ambulatory ECG monitoring was performed for 48 hr on 6 patients with acute or chronic forms of Löffler's endomyocardial disease, and the types and frequencies of arrhythmias were compared with recordings from 6 other patients with equally high blood eosinophil counts who did not have clinically evident cardiac disease. It was hoped that this would show whether arrhythmias were related to high blood eosinophil counts, cardiac injury or other factors. Three of the patients with endomyocardial disease had multiple ventricular extrasystoles with episodes of ventricular arrhythmias and occasional supraventricular arrhythmias which had not been detected with conventional ECGs. These abnormalities did not occur in 2 of the patients with acute endomyocardial lesions who died, nor were they found in patients who did not have congestive cardiac failure or in the control patients. Rhythm disturbances appeared to be most closely related to the development of cardiac failure and they resolved after successful cardiac surgery. Multiple ventricular extrasystoles and arrhythmias occurring in these patients with Löffler's endomyocardial disease are probably due to metabolic changes in the heart associated with cardiac failure and mechanical changes related to valvular dysfunction rather than a direct effect of the eosinophils themselves on the heart.

Adult↗