The authors experienced 4 cases of calcified postinfarction aneurysm of the left ventricle. They were all male, aged 55 to 71 (mean 64). Risk factor for coronary artery disease was only smoking in 2 patients, but there was none in the others. They had had acute anteroseptal or extensive anterior infarction at age 41-57 years (mean 49.3), and associated major cardiac events 10-22 years (mean 14.5) after acute myocardial infarction. Ventricular tachycardia, congestive heart failure and systemic thromboembolism were seen in 4, 2 and 1 patients respectively. However, none developed angina pectoris. In the 2 patients in whom signal-averaged electrocardiogram was performed, late potential was detected, so it was suspected that ventricular tachycardia could be due to reentry. Left ventricular end-diastolic pressure was elevated in all patients except one and ranged from 11 to 22 mmHg. Left ventricle was dilated in all cases and the end-diastolic volume index ranged from 143 to 503 ml/m2. The left ventricular ejection fraction ranged from 11 to 24%. However, in 2 of the 4 patients, the cardiac index was within normal limits, and evidence of congestive heart failure was absent. In 2 other patients with associated congestive heart failure, cardiac indices were 2.32, 1.56 l/min/m2 respectively. Coronary arteriogram showed a total occlusion in the left anterior descending (LAD) artery in all cases, and only the LAD artery was affected in 2 patients. In the remaining 2 patients, the right coronary arteries also were significantly stenotic or totally occluded, i.e., they had 2-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

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Maternal or umblical venous levels of nitrite/nitrate during pregnancy and at delivery.

OBJECTIVE: This study was intended to measure serum concentrations of nitrite plus nitrate as an index of nitric oxide synthesis, in the maternal vein during pregnancy, just after a spontaneous delivery and at the puerperium, and at an elective cesarean section, and in the umblical vein and artery. METHODS: Maternal venous sera, and umblical venous and arterial sera were collected, and serum concentrations of nitrite/nitrate were measured by an automated procedure based on the Greiss reaction after reduction of nitrate to nitrite. RESULTS: Compared to a serum concentration of nitrite/nitrate at the first trimester (12-13 weeks of pregnancy), a serum concentration of nitrite/nitrate slightly increased at the second trimester (27-28 weeks), and became maximal at the third trimester (35-36 weeks), followed by a significant decrease near the term (38-40 weeks). A serum concentration of nitrite/nitrate slightly increased just after a spontaneous delivery with labor pains, and at the puerperium to levels slightly more than that at the first trimester. Serum concentrations of nitrite/nitrate in the umblical vein and artery did not differ. They were significantly higher than a serum concentration of nitrite/nitrate in the maternal vein just after a spontaneous delivery with labor pains but not at an elective cesarean section without labor pains. CONCLUSION: A decrease in maternal serum levels of nitrite/nitrate near term may support a hypothesis that NO is one of factors responsible for the maintenance of uterine quiescence during pregnancy. Moreover, the present results suggest that NO plays some role in the feto-placental circulation during a spontaneous delivery.

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