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Biomedical subjects

V M Cats

Publications and source records attributed to V M Cats.

29 records · Page 2Linked to original sources
PubMed1989

The effects of diltiazem on cardiac function in silent ischemia after myocardial infarction.

In a total group of 56 patients with an acute myocardial infarction who were maximally exercised at predischarge, 20 patients (36%) showed greater than or equal to 1 mm asymptomatic ST-T segment depression during exercise. The site of the infarction was anterior in 12 patients and inferior in eight patients. All 20 patients underwent repeated exercise radionuclide angiography 2 days later, 2 hours following oral intake of 120 mg of diltiazem. Double product was not significantly different before and after diltiazem, both at rest and during exercise. Maximal ST-T depression after diltiazem was reduced from 2.3 +/- 0.8 to 0.7 +/- 0.6 mm (p less than 0.01). Left ventricular (LV) ejection fraction at rest before diltiazem was 54.4 +/- 8.7% and after diltiazem was 56.2 +/- 11.3% (p = NS). During exercise, LV ejection fraction improved after diltiazem from 43.2 +/- 12.2% to 49.8 +/- 10.5% (p less than 0.05). Regional wall motion score (1 = normal, 2 = hypokinetic, 3 = akinetic, 4 = dyskinetic) at rest before diltiazem was 9.6 +/- 2.0 and after diltiazem was 9.1 +/- 1.8 (p = NS). During exercise, regional wall motion score improved after diltiazem from 5.8 +/- 1.3 to 4.3 +/- 1.1 (p less than 0.02). We conclude that silent ischemia occurs in a substantial number of patients after myocardial infarction and that diltiazem has acute beneficial effects on asymptomatic ST-T depression and on global and regional LV function in post-infarction patients with silent ischemia.

Aged↗
PubMed1989

Long-term benefit of early thrombolytic therapy in patients with acute myocardial infarction: 5 year follow-up of a trial conducted by the Interuniversity Cardiology Institute of The Netherlands.

Patients (n = 533) who participated in the Interuniversity Cardiology Institute of the Netherlands Trial were followed up for 3 to 7 years. The 5 year survival rate after thrombolytic therapy with intracoronary streptokinase was 81% (269 patients) compared with 71% after conventional therapy (264 patients). The greatest improvement in survival was observed in patients with anterior infarction (81% versus 64% with thrombolytic therapy or conventional therapy, respectively), in those with heart failure on admission or a previous infarction and in those with extensive myocardial ischemia on admission. Left ventricular ejection fraction at the time of hospital discharge was better after thrombolytic therapy. In the hospital survivors, long-term outcome was related to left ventricular function at the time of discharge and, to a lesser extent, to the underlying coronary artery disease. The initial therapy (thrombolysis or conventional) was not an independent additional determinant of long-term survival when left ventricular function and coronary status at the time of hospital discharge were taken into account. Thus, the salutary effects of thrombolytic therapy appear to be the result of myocardial salvage. Reinfarction within 3 years was observed more frequently after thrombolytic therapy, particularly in patients with inferior wall infarction and those with greater than or equal to 90% stenosis of the infarct-related vessel at discharge. Coronary bypass surgery and coronary angioplasty were performed more frequently after thrombolytic therapy than in conventionally treated patients. At 5 years, approximately 40% of patients in both groups had an uneventful course without reinfarction or additional revascularization procedures. These observations demonstrate that the benefits of thrombolytic therapy are maintained throughout 5 years of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1988

The acute effects of intravenous nisoldipine on left ventricular function 24 to 72 hours after uncomplicated acute myocardial infarction.

The acute effects on left ventricular function of nisoldipine were studied in six patients 56 +/- 12 hours (range 44 to 72 hours) after the onset of uncomplicated acute myocardial infarction. Nisoldipine was administered as a 4.5 micrograms/kg intravenous bolus over 3 minutes followed by an infusion of 0.2 microgram/kg during 60 minutes. Radionuclide angiography and two-dimensional echocardiography were performed before and during infusion with nisoldipine. The left ventricular ejection fraction increased significantly from 38% +/- 10% to 49% +/- 10% (P = 0.028) during nisoldipine infusion. Regional wall motion index was determined both by radionuclide and by two-dimensional echocardiography and showed a significant change during nisoldipine infusion from 1.9 +/- 0.3 to 1.5 +/- 0.3 (p = 0.028, radionuclide angiography) and from 0.7 +/- 0.2 to 0.3 +/- 0.2 (p = 0.043, two dimensional echocardiography). Heart rate increased significantly from 78 +/- 12 min-1 to 92 +/- 13 min-1 (p = 0.028), but mean double product did not change significantly during nisoldipine infusion. It is concluded that nisoldipine significantly improves global and regional left ventricular function in patients shortly after acute myocardial infarction. This beneficial effect may, however, be partially offset by an increase in heart rate. Since mean double product did not change, it is suggested that nisoldipine may improve coronary blood flow in patients with acute myocardial infarction.

Acute Disease↗
PubMed1988

Coronary arterial aneurysm: possible relation with malaria?

We report a case of an aneurysm of a coronary artery in a 29-year-old male with an acute myocardial infarction. The patient had no risk factors for atherosclerosis and his medical history revealed only repeated episodes of quartian malaria three years before. Coronary arteriography showed aneurysmal dilatation of the proximal part of the left anterior descending coronary artery with thrombus formation at the site of the dilatation. The right coronary artery and the left circumflex artery were free from disease. To the best of our knowledge, this is the first presentation of coronary arterial aneurysm probably related to quartian malaria.

Adult↗
PubMed1988

Balloon angioplasty in the treatment of pulmonary hypertension caused by pulmonary embolism.

We present a 30-year-old man with pulmonary hypertension after pulmonary embolism. Pulmonary angiography showed multiple stenoses in the pulmonary vascular tree. We treated four of these stenoses by balloon angioplasty in three sessions. Pulmonary artery pressure was reduced from 90/25 mm Hg (mean 46) to 78/13 mm Hg (mean 35) with concomitant increase of aortic pressure from 105/60 mm Hg (mean 75) to 134/68 mm Hg (mean 90). Pulmonary perfusion scintigraphy showed increase of perfusion in the treated segments. Two procedures were followed by transient segmental pulmonary edema, but no other complications were noted. We conclude that balloon angioplasty is a promising method of lowering pulmonary artery pressure and improving pulmonary perfusion in suitable cases of pulmonary hypertension secondary to pulmonary embolism.

Adult↗
PubMed1987

Mediastinal rupture of a thoracoabdominal mycotic aneurysm caused by Salmonella typhimurium in an immunocompromised patient.

A case is presented of rupture of a mycotic thoracoabdominal aneurysm caused by Salmonella typhimurium in a patient on immunosuppressive therapy following kidney transplantation. After initial medical treatment, surgery consisted of local debridement and implantation of an aortic prosthesis. Lifelong antibiotic treatment was prescribed because of the combination of immunosuppressive therapy, the history of recurrent S. typhimurium bacteremia and the presence of an aortic prosthesis.

Aneurysm, Infected↗
PubMed1986

Ambulatory ECG recording during competitive parachute jumping in apparently healthy young men: more evidence for intermittent vagal dominance during enhanced sympathetic activity.

Using two-channel 24-hour ambulatory ECG recording we studied seven healthy young men during one day of parachute jumping competition (day 1), as compared to one control day (day 2). A symptom limited exercise test was also performed on day 2. Maximal heart rates attained during exercise testing were of the same order as during parachute jumping. In the phases just prior to 'exit', short periods of striking sinus arrhythmia with slow atrial rhythm were present in 3 subjects. Only one of these had slow atrial rhythm during the control day. Atrial and ventricular premature complexes, when present, disappeared with higher heart rates under all circumstances. No AV conduction disturbances were found.

Adult↗
PubMedDate not supplied

Value of magnetic resonance imaging in patients with a recent myocardial infarction: comparison with planar thallium-201 scintigraphy.

The diagnostic accuracy of spin-echo Magnetic Resonance (MR) imaging in the detection and localization of a recent myocardial infarction (mean 4 days old) was compared to planar thallium-201 scintigraphy in 20 patients with a documented myocardial infarction. A control group of 10 subjects underwent a similar MR imaging procedure without thallium-201 scintigraphy. T1-weighted MR images (TE 30 msec) showed abnormal thinning of the infarcted left ventricular wall during systole (less than 50% of the opposite wall) in 11 patients (55%). On T2-weighted multi-echo MR images, (TE 30-60-90-120 msec) abnormally increased signal intensity was found in 17 patients and coincided with the location of the infarction. Thallium-201 scintigraphy detected the infarction in 18 patients. Comparison of T2-MR imaging and thallium-201 scintigraphy showed concordant findings in 82% of the left ventricular segments. In 9% of segments, thallium uptake was reduced with normal T2-MR and in 9% we found a normal thallium uptake with abnormal T2-MR findings. In all subjects of the control group, T1-MR images were normal, and only one subject showed increased signal intensity on T2-MR images. We conclude that the diagnostic accuracy of MR imaging in detecting a myocardial infarction is similar to that of T1-201 scintigraphy.

Female↗