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Biomedical subjects

L A Papa

Publications and source records attributed to L A Papa.

17 recordsLinked to original sources

Effect of age on postmyocardial infarction ventricular arrhythmias (Holter Registry data from CAST I and CAST II). Cardiovascular Arrhythmia Suppression Trials.

Holter data from the 17,609 postmyocardial infarction patients in the CAST Registry were analyzed to study the effect of age on VPC and VT incidence and frequency. Multivariable analysis demonstrated that age is an important independent predictor of increased ventricular ectopy, with the median rate of VPCs/hour increasing from 0.4 (patients aged < 50 years) to 4.0 (patients aged 75 to 80 years), and the prevalence of VT increasing from 7.3% (patients aged < 50 years) to 15.3% (patients aged 75 to 80 years).

Age Factors

Peptide leukotriene receptor antagonism in myocardial ischaemia and reperfusion.

OBJECTIVE: The aim was to investigate the role of peptide leukotrienes in the pathophysiology of myocardial injury during reperfusion of previously ischaemic myocardium. METHODS: Adult male cats (2.9-5.4 kg) were subjected to left anterior descending coronary artery occlusion for 3 h followed by 3 h of reperfusion. The peptide leukotriene receptor antagonist, LY-171883, was given intravenously only during the reperfusion period (3 mg.kg-1 bolus; 3 mg.kg-1 x h-1 infusion). Ischaemic injury was assessed by nitroblue tetrazolium staining and tissue creatine kinase activity; neutrophil infiltration was determined by myeloperoxidase activity of myocardial homogenates. RESULTS: There was no significant difference at any time point in the experimental protocol between mean arterial blood pressure or pressure-rate index in cats given LY-171883 (3 mg.kg-1) and cats given vehicle. The area at risk of infarction (AAR) was 24(SEM 2)% for vehicle treated cats and 22(2)% for the drug treated cats. The necrotic area was 48(5)% of the AAR for the vehicle group but only 29(5)% of the AAR for the group given LY-171883 (p < 0.02). Left ventricular maximum +dP/dt tended to be higher with drug treatment compared to vehicle at the end of the reperfusion period. Tissue from the area at risk was assayed for creatine kinase activity and neutrophil specific myeloperoxidase activity as an index of the accumulation of neutrophils in this region. Creatine kinase activity was significantly higher (p < 0.05) in the AAR for drug nu vehicle treated cats following reperfusion, confirming the histochemical analysis. Myeloperoxidase activity increased approximately 12-fold in the AAR of cats receiving vehicle. LY-171883 did not reduce the myeloperoxidase activity significantly in the area at risk. CONCLUSIONS: LY-171883 has a protective effect in ischaemia-reperfusion injury to the myocardium. These findings suggest a role for peptide leukotrienes both in the extension of ischaemic damage and in post-ischaemic ventricular dysfunction during reperfusion.

Acetophenones

Coronary angiographic assessment of left posterior hemiblock.

The ECGs of 1,095 patients with coronary angiographic evidence of significant coronary artery disease (greater than or equal to 50% obstructive lesion in at least one major coronary artery) were reviewed. Five patients had left posterior hemiblock (LPHB), an incidence of 0.5%. Three of five patients also had a right bundle branch block (RBBB). Of the five patients with LPHB, all had significant right coronary artery (RCA) disease (four complete occlusions, one 90% obstructive lesion). All five patients having LPHB also had evidence of critical disease (greater than or equal to 75% obstruction) of at least one of the major branches of the left coronary artery; four of the five had complete occlusion of the left anterior descending coronary artery (LAD). The left circumflex coronary artery (CFx) was critically diseased in three patients. The ECGs of four patients showed evidence of only one myocardial infarction while one patient had evidence of an anterior and an inferior infarction. It is concluded that the presence of LPHB in patients with coronary artery disease is an ominous electrocardiographic finding, and is associated with extensive coronary artery disease.

Adult

The relationship of low voltage on the electrocardiogram and chronic obstructive pulmonary disease.

A retrospective analysis was performed to analyze the relationship between low voltage on the electrocardiogram and chronic obstructive pulmonary disease. Subjects were 250 patients who had both pulmonary function tests and an electrocardiogram at UMDNJ-John F. Kennedy Memorial Hospital from the years 1975-1980. Low voltage was detected in only 13 of 250 patients. An attempt to define the relationship between the incidence of low voltage on the electrocardiogram and the severity of airway obstruction, as judged by the reduction in the FEV1, was unsuccessful. Concomitantly, a relationship could not be established between the incidence of low voltage and the degree of hyperinflation, as judged by the residual volume. In conclusion, the electrocardiographic evidence of low voltage does not represent either a sensitive or a specific finding for patients with chronic obstructive lung disease. It cannot be construed as either a useful or predictive parameter in the diagnostic evaluation of these patients.

Adult

Mitral annular calcification: a cause of systolic murmur in the elderly.

Mitral annular calcification is predominantly a disease of females, typically above 65 years of age. The diagnosis should be considered in patients with a systolic murmur which is mitral in origin. This murmur is caused by mitral regurgitation due to loss of the sphincter action of the mitral annulus. Diagnosis is made by one- or two-dimensional echocardiography. Calcification in the mitral ring may be seen on chest x-ray films or fluoroscopy. Management includes antibiotic prophylaxis to avoid infective endocarditis and observation for the development of congestive heart failure. Conventional management with digitalis and diuretics is supplemented with use of vasodilators in severe cases.

Aged

Coexisting ventricular and blocked atrial parasystole.

A rare instance showing non-conducted atrial parasystole coexisting with ventricular parasystole is presented and a related subject is briefly discussed. The importance of recognizing parasystole is again emphasized because the ordinary extrasystoles, particularly ventricular in origin, are frequently digitalis-induced, while parasystole, which superficially resembles the ordinary extrasystoles, does not seem to be related to digitalis.

Cardiac Complexes, Premature

Ventricular fibrillation in Wolff-Parkinson-White syndrome, type A.

A young individual who developed ventricular fibrillation following atrial fibrillation in the WPW syndrome is presented. The precise cardiac rhythm diagnosis is extremely important for proper management. When the QRS morphology is bizarre and the ventricular rate is very fast (200 to 300 b.p.m.) in atrial fibrillation, the WPW syndrome should be considered as the underlying disorder. Digitalis should be avoided in this circumstance because anomalous conduction may be accelerated by the drug, leading to deterioration of the clinical picture and even death. When an antiarrhythmic drug is to be used, intravenous lidocaine is the drug of choice. For the prophylactic measure, oral quinidine or procainamide is equally effective for atrial fibrillation with anomalous conduction in the WPW syndrome.

Adult

Pacemaker hysteresis.

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Blood Pressure