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At least 37 records · Page 2Linked to original sources
PubMed1978

[Usefulness of x-ray parameters in the functional evaluation of patients with nonvalvular cardiopathies].

In 49 patients suffering of heart diseases we have studied the changes of radiologic cardiac measurements and systolic time intervals (STI) in the four functional classes of the New York Heart Association (NYHA) classification, investigating also the existence of any relationship between these different parameters. Only the patients in functional classes 3rd and 4th showed significant changes in STI and radiologic measurements as compared to the control group. Moreover, a significant negative correlation has been observed between relative heart volume and left ventricular ejection time (LVET) (r = 0.69, P less than 0.001) and LVETc (r = 0.82, P less than 0.001) and a positive correlation between relative heart volume and pre-ejection period (PEP) (r = 0.59, P less than 0.01) and PEP/LVET ratio (r = 0.75, P less than 0.001). These results seem to demonstrate that relative heart volumetry is a fairly accurate index of the cardiac conditions in non valvular heart diseases.

Adult↗
PubMed1978

Correlation between systolic time intervals and roentgen findings in normal subjects and cardiopathic patients.

This study was designed to evaluate the usefulness of non-invasive parameters in the follow-up of cardiopathic patients without valvular cardiac diseases. In 49 patients suffering from heart disease we have studied the changes of radiologic cardiac measurements and systolic time intervals (STI) in the 4 functional classes of the NYHA classification, investigating also the existence of any relationship between these different parameters. Only the patients in the 3rd and the 4th functional classes showed significant changes in STI and radiologic measurements, as compared with the control group. Moreover, significant negative correlations have been observed between relative heart volume and LVET (r = 0.69, P less than 0.001) and LVETc (r = 0.82, P less than 0.001) and positive correlations between relative heart volume and PEP (r = 0.59, P less than 0.01) and PEP/LVET ratio (r = 0.75, P less than 0.001). These results, while confirming the close correlation between STI and cardiac performance, seem to demonstrate that relative heart volumetry is a fairly accurate index of the cardiac conditions in non-valvular heart diseases.

Adult↗
PubMed1978

Locus of control and cardiac response to reaction time, mental arithmetic, and time-estimation tasks.

In Exp. 1 subjects, classified on the basis of locus of control scores, performed both reaction time and mental arithmetic tasks. In Exp. 2, similarly classified subjects were required to estimate the duration of a signal with feedback following each trial. Between-groups comparisons in Exp. 1 showed no differences on heart rate or performance measures. This does not support an explanation of differential heart rates during cardiac conditioning based upon cognitive styles of "rejecting" or "accepting" stimuli. Similar comparisons in Exp. 2 indicated significant differences for heart rate and proficiency in time estimation. These differences suggest greater task involvement for internally controlled subjects on feedback tasks, with cardiac acceleration a function of that involvement.

Attention↗
PubMed1978

Physiological effects of lowered blood oxygen affinity in dogs.

Ten adult Labrador retrievers were studied under control conditions and while blood oxygen affinity was lowered by intravenous infusions of glycolytic intermediates. Blood P50 was increased from 32.4 +/- 1.3 mm Hg (mean +/- SD) to 34.3 +/- 1.2 mm Hg, a highly significant increase (P less than 0.001). Blood oxygen capacity, mixed venous oxygen tension and arterial PCO2 were not significantly different in the two conditions. Cardiac output (Q) was lower with the higher P50 (89 +/- 16 ml/kg/min) than in the control state (111 +/- 31 ml/kg/min) but the difference was not statistically significant. The arteriovenous oxygen concentration difference (CaO2 - C-V(O2)) was significantly increased (P less than 0.05) from 4.4 +/- 0.6 vol % to 4.9 +/- 0.8 vol %. Oxygen consumption, the product of Q and (CaO2 - C-V(O2)), was the same in the two conditions: 4.9 +/- 1.3 ml/kg/min (control) versus 4.4 +/- 0.9 ml/kg/min. The animals responded to lowered blood oxygen affinity with increased oxygen extraction by peripheral tissues and a concomitant, although not statistically significant, fall in cardiac output.

Animals↗
PubMed1976

[Significance of Alfatesine in anesthesia for multiple dental extractions before major cardiac surgery].

This technique of anaesthesia used for oral surgical operations such as, multiple dental extractions, apical resection, carried out in cardiac patients before major cardiac surgery under extra-corporeal circulation, for insertion of valvular prostheses or aorto-coronary by-pass operations, has passed by various stages. The present technique associating phenoperidine-alfatesine-suxame-thonium-N2o-o2, was used in the last 58 cases. It presents a certain number of advantages compared with previous techniques: -very stable level of anaesthesia whatever the duration of the operation, -satisfactory cardio-vascular stability, -almost constant absence of hypo-excitability of the myocardium even in patients in poor cardiac condition before the operation with uninterrupted treatment with digitalis and diuretics, -good quality of awakening.

Adolescent↗
PubMed1978

Supraventricular tachyarrhythmias in hospitalized adults after surgery. Clinical correlates in patients over 40 years of age after major noncardiac surgery.

To assess the clinical correlates and therapeutic outcome of new postoperative supraventricular tachyarrhythmias, 916 patients who were in sinus rhythm throughout the course of surgery were prospectively followed after major noncardiac surgery. The 35 patients (4 percent) who developed new postoperative supraventricular tachyarrhythmias frequently had concurrent medical problems, such as the following: other acute cardiac conditions, 16 patients (46 percent); major infections, 11 patients (31 percent); preexisting hypotension, ten patients (29 percent); anemia, nine patients (26 percent); metabolic derangements, eight patients (23 percent); parenteral therapy with new medications, eight patients (23 percent); and hypoxia, seven patients (20 percent). The arrhythmias of all treated patients reverted to sinus rhythm; 40 percent (14 patients) required no new therapy with cardiac medications, and only two patients required electrical cardioversion. No deaths were related to the supraventricular tachyarrhythmias, but 49 percent (17) of the patients died from their concurrent medical problems. The onset of a new postoperative supraventricular tachyarrhythmia should prompt a search for remediable medical problems. Direct antiarrhythmic therapy is often unnecessary and is usually secondary in importance to correction of the causes of the arrhythmia.

Adult↗
PubMed1978

Flow control in prolonged ventricular bypass and clinical application in 15 patients.

Long-term experiments employing left ventricular or biventricular bypass with local heparinization and blood filtration for up to 48 days was conducted in 51 calves at different flow rates. The principle of flow control obtained was applied to 15 patients in critical cardiac states. An avcothanized extracorporeal circuit consisted of heparin and protamine microperfusion lines, Pall filter, and nonpulsatile pump. Bypass with flow rates at 30--40% of cardiac output was conducted between 3 and 48 days. Survival was obtained in 34 of 36 calves. Bypass with flow rates at 60--80% of cardiac output was associated with 6 deaths in the 10 calves who underwent the procedure. Bypass with flow rates over 90% of cardiac output was often technically difficult and only 2 of 5 calves survived. Hemodynamic changes correlated well with the above results. In clinical cases flow rate was adjusted up to a maximum of 100% of left ventricular blood flow initially and thereafter to 30--40% of cardiac output for chronic support. A total of 15 patients with myocardial infarction, myocarditis and failing cardiac condition post-surgically were supported for 9--172 hrs. Six of the 15 survived. Adequate flow control in ventricular bypass support is important and the regimen developed in experimental studies proved effective clinically.

Adolescent↗
PubMed1978

Late hemodynamic and angiographic findings after ascending aorta--pulmonary artery anastomosis.

Ascending aorta-pulmonary artery (Waterston) anastomosis was performed in 75 children, 51 of whom were younger than 1 month of age and 36 younger than 1 week of age at the time of operation. There were 21 operative and eight late deaths. Operative deaths occurred more frequently in infants with complex cardiac conditions and severe hypoxemia and acidosis preoperatively. The postoperative status of the pulmonary arteries or arterioles could not be correlate with the degree of cardiomegaly, the pulmonary vascular markings, or characteristics of the shunt murmur. Sixty-four percent of the patients catheterized had one or more postoperative structural abnormalities of the pulmonary arteries following the operation, most frequently kinking or narrowing of a pulmonary artery. Occlusion of a pulmonary artery occurred in five of 33 patients studied by angiography. Pulmonary vascular disease may also develop. Therefore, patients should be catheterized 1 year postoperatively to evaluate the level of pulmonary vascular resistance and the pulmonary arteries.

Aorta↗
PubMed2025

Clinical and genetic variant re-analysis among pediatric probands undergoing genetic testing for arrhythmia syndromes.

BACKGROUND: Despite increases in genetic testing, longitudinal data regarding changes in diagnostic yield and variant reclassification for inherited arrhythmia syndromes are limited. OBJECTIVE: Determine longitudinal changes in diagnostic yield and variant classification. METHODS: Single-center retrospective study of probands <18 years undergoing genetic testing for suspected inherited cardiac conditions associated with arrhythmias, 2007 to 2018. Variants were classified as diagnostic (pathogenic/likely pathogenic), non-diagnostic (benign/likely benign [B/LB]), or variants of uncertain significance (VUS). Variant reclassification was performed in October 2023 using VarSome and American College of Medical Genetics criteria. We evaluated results by era (early 2007-2013 vs. later 2014-2018, coinciding with Sanger and next-generation sequencing, respectively) and by likelihood of disease based on clinical evaluation. RESULTS: Of 306 probands, initial testing was 23.2% diagnostic, 55.6% non-diagnostic (33.7% no variant, 21.9% B/LB), and 21.2% VUS. When comparing eras, diagnostic yield decreased (34.1%-15.3%), VUS increased (9.3%-29.9%), and non-diagnostic remained similar (55% to 57%). Variants for 22.7% (46/203) of probands with &#x2265;1 variant changed: 9.9% of diagnostic variants (7/71) downgraded to VUS or non-diagnostic, and 60.0% of VUS changed (23.1% upgraded, 36.9% downgraded). B/LB variants did not change. Probands with higher disease likelihood had 6-times the odds of diagnostic results compared to lower disease likelihood, regardless of era (odds ratio 6.3, 95% confidence interval 3.2-12.4, P < .0001). CONCLUSION: Variant reclassification led to changes in 23% of probands, both downgrading and upgrading status, even among probands initially thought to be pathogenic. When comparing later to earlier eras, VUS variants increased while diagnostic yield decreased. Findings support the need for variant re-interpretation and periodic reclassification over time.

Humans↗
PubMed1979

Chest wall syndrome. A common cause of unexplained cardiac pain.

Twelve patients with severe, often incapacitating chest pain initially believed to be cardiac in origin were shown on subsequent evaluation to have chest wall syndrome. Diagnosis was suspected by the atypical nature of pain in 11 of 12 patients and confirmed by chest wall tenderness simulating the spontaneously occurring pain in all. Seven patients had chest wall syndrome in conjunction with other associated cardiac conditions. Five patients had isolated chest wall syndrome. All five had normal ejection fractions and no regional wall abnormalities on radionuclide cineangiographic studies performed during symptom-limited supine exercise, findings observed in few patients with coronary artery disease. Chest wall syndrome should be considered in all patients with chest pain, as its recognition can greatly aid in patient care.

Adult↗
PubMed1979

Echocardiographic study on diastolic posterior wall movement and left ventricular filling by disease category.

The diastolic characteristics of the left ventricle with special reference to the patterns of left ventricular filling and diastolic posterior wall movement were studied echocardiographically in 95 patients with various cardiac conditions including constrictive pericarditis, idiopathic cardiomyopathy (CCM, HCM), valvular aortic stenosis (AS), mitral stenosis (MS), hypertension (HT), aortic insufficiency (AI), mitral insufficiency (MI), and in 20 normal subjects. 1. Various types and severities of LV diastolic abnormalities were revealed by analyzing the patterns of posterior wall movement and LV filling in three diastolic phases--rapid filling period, slow filling period, and atrial filling period, respectively. 2. Disturbances of posterior wall distension and LV filling during the rapid filling period with a compensatory augmentation of atrial contribution to LV filling were observed in most patients. These patients also showed a markedly decreased posterior wall velocity and LV filling rate during rapid filling period. 3. E-F slope was significantly decrease in patients with MS, AS, and HCM. E-F slope correlated well with DPWV and RFR in most patients. In MS, however, DDR decreased to a disproportionate degree with a decrease in DPWV and RFR, probably due to the structural changes and decreased mobility of the mitral valve. From this study, we conclude that the patterns of the left ventricular filling and posterior wall movement during three phases of diastole obtained by echocardiography is useful in detecting left ventricular diastolic abnormalities.

Adult↗
PubMed1979

Obstruction of the duodenal bulb caused by gallstone perforation.

Because of acute symptoms in the upper abdomen, upper gastrointestinal endoscopy was performed in a 75-year-old female patient. A large (5 cm x 10 cm) perforated gallstone was embedded in the duodenum, causing complete obstruction of the duodenal bulb. The stone was removed via pylorotomy. A fistula remained between the gallbladder and the duodenum. Cholecystectomy was not carried out because of the unfavourable cardiac condition of the patients. There was no complications.

Aged↗
PubMed1977

Temporal bone pathology in an active case of glue ear.

A child aged 3 1/2 died from a cardiac condition after many and prolonged antibiotic courses: bilateral glue ear had been treated for the previous 18 months. Histopathology showed cholesterol granulomata in the mastoid air cells, with evidence of old hemorrhage, and of former inflammation of bone. The exudate was histiocytic with some giant cells. An 'orange spot' on the tympanic membrane was hyperaemic middle-ear mucosa, heavily infiltrated by plasma cells, lymphocytes and histiocytes. There was no evidence of hypersecretion. Some of the most abnormal areas were around the stapedial niche and the round window.

Child, Preschool↗
PubMed1979

Let us not lose echocardiography.

Despite the unquestioned value of echocardiography in the diagnosis of valvular disease, pericardial effusion, cardiomyopathy and many other cardiac conditions, few residency programs in radiology are offering training in echocardiography. Echocardiograms of the last 100 consecutive patients in a small community hospital demonstrated a surprising breadth of clinical material. Echocardiography should be included in every residency program lest our role in this technique is lost altogether.

Echocardiography↗
PubMed1976

Body position, electrode level, and respiration effects on the Frank lead electrocardiogram.

Frank lead ECG/VCG changes with deep inspiration, expiration, and body position were investigated in 194 patients, 100 with an old myocardial infarction and the remaining 94 chosen as a representative sample of catheterization laboratory patients with a variety of cardiac conditions. In a subgroup of 144 of the patients, Frank lead records were made both at the fifth and the fourth intercostal space. Diagnostic interpretation was performed using the VA-Pipberger ECG Program. The results indicate that, in general, body position and electrode level influence on mean intervals and orientation angles is negligible. There was a highly significant decrease in the R and Q wave amplitudes in leads X and Z and in the maximum spatial magnitude of QRS when electrodes were shifted from the fifth to the fourth interspace. The most pronounced decrease in ECG/VCG amplitudes took place in deep inspiration while mean orientation angles changed little, with the exception of QRS elevation. However, while mean changes with body position and electrode level were rather small, substantial orientation and magnitude changes took place in many patients. Diagnostic interpretation of the records changed in 12.5% with electrode level change, in 11.9% with the transition of body position, and in 16.8% with deep inspiration. Strict standardization of electrode positions and recording procedure is suggested, particularly when serial comparison of Frank lead records is planned.

Adolescent↗
PubMed2025

What Should a Clinical Cardiologist Know About Cardiogenetics?

Inherited cardiovascular diseases are becoming increasingly prominent in clinical practice, significantly impacting diagnosis, risk assessment, and family screening strategies. Progress in genetic testing has broadened access to cardiogenetic evaluations, while also presenting new challenges in interpreting variants and incorporating findings into clinical care. This narrative review explores 20 essential questions that clinical cardiologists may face when dealing with suspected or confirmed inherited cardiac conditions. Organized as a practical, question-driven guide, it outlines when to consider a genetic cause, how to choose and interpret genetic tests, and how to manage patients regardless of their genetic test results. The review emphasizes variant classification based on American College of Medical Genetics and Genomics criteria, the importance of clinical context in interpreting uncertain results, and the principles behind family cascade screening. Particular attention is given to the management of relatives who carry a genetic variant but show no symptoms, and to the current limitations of genetic testing technologies (eg, performance). Ethical considerations, including the appropriate timing of testing in children minors, are also discussed. By connecting genetic insights with clinical cardiology, this review aims to support practical, informed decision making and promote effective collaboration with cardiogenetic specialists.

Humans↗
PubMed1975

An unusual case of urticaria -- cause and therapy.

A case is reported of a female patient who took 140 tablets of the antihistamine, mebhydrolin ('Fabahistin'), in one day for urticaria and experienced virtually no side effects. The urticaria cleared completely when her husband, who had a cardiac condition, died suddenly.

Adult↗
PubMed1975

The spectrum of degenerative changes in hypertrophied human cardiac muscle cells: an ultrastructural study.

Light and electron microscopic observations were made on cardiac tissues removed at operation from 91 patients with ventricular hypertrophy, including left ventricular myocardium from 16 patients with aortic valvular disease and from 16 patients with asymmetric septal hypertrophy, and crista supraventricularis muscle from 59 patients with congenital heart diseases associated with right ventricular outflow tract obstruction. In all patients the majority of cardiac muscle cells were hypertrophied, had intact myofibrils, and were surrounded by small amounts of fibrous tissue. In 18 (20%) of the 91 patients cardiac muscle cells with a wide spectrum of degenerative changes were present in addition to hyperthrophied, nondegenerated cells. Early degenerative changes consisted of focal myofibrillar lysis, with preferential loss of thick myofilaments, and focal proliferation of tubules of sarcoplasmic reticulum. Cardiac muscle cells with advanced degeneration had extensive myofibrillar damage and a marked decrease in numbers of myofibrils and T-tubules. The most severely degenerated cells showed selective proliferation of organelles, including sarcoplasmic reticulum, mitochondria, and glycogen, which replaced the contractile elements in the cytoplasm. These findings suggest that degenerated cardiac muscle cells have poor contractile function and may be responsible for impaired cardiac performance in some patients with ventricular hypertrophy. These morphological features appear to represent a final common pathway for degeneration of cardiac muscle cells in a variety of cardiac conditions.

Aortic Valve Insufficiency↗