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Response time and heart rate in coronary patients under mild mental stress. 轻度精神压力下冠心病患者的反应时间和心率。
Pub Date : 1980-01-01
D A Sideris, J N Nanas, S Thomakos, S D Moulopoulos

A mild mental stress was applied on 39 normal people and on 33 patients with coronary artery disease. The test consisted in their selecting the proper switch out of 2, in order to switch off a lamp out of 3 as soon as possible after its ignition. The 3 lamps were lit by the examiner in a stereotyped random sequence. No consequences were implied against the subjects in case of failure and this was clearly explained to them. The response time of the people was recorded together with their electrocardiogram in a one-channel recorder using a suitable circuitry. The study showed that the response time became progressively shorter during the test only in the coronary group, although the mean value did not differ significantly from that in the normal group. The R-R interval was shortened in both groups but in the coronary group significantly more so than in the normal group. Pretreatment with diazepam reversed both responses of the coronary group. Pretreatment with propranolol mitigated the tachycardiac effect of the test in the coronary group, reversed its effect in the normal group and shortened the response time significantly in the normal group. The objective time measurements by the device used might suggest that in patients with coronary artery disease both the specific (response time) and the nonspecific (R-R interval) behaviour in response to a mental stress differ from that in normal people. This behaviour may be modified by medicaments like diazepam and propranolol.

对39名正常人和33名冠状动脉疾病患者施加轻度精神压力。测试包括从2个开关中选择合适的开关,以便在3个灯点燃后尽快关闭灯。这三盏灯由考官按固定的随机顺序点燃。如果失败,不会对受试者造成任何后果,并向他们清楚地解释了这一点。人们的反应时间和他们的心电图一起记录在一个单通道记录仪上,使用合适的电路。研究表明,只有冠状动脉组在测试过程中反应时间逐渐缩短,但平均值与正常组无显著差异。两组R-R间期均缩短,冠状动脉组明显大于正常组。地西泮预处理可逆转冠状动脉组的两种反应。心得安预处理可减轻冠状动脉组的心动过速效应,逆转正常组的心动过速效应,显著缩短正常组的反应时间。所使用设备的客观时间测量可能表明,冠状动脉疾病患者对精神压力的特定(反应时间)和非特定(R-R间隔)行为与正常人不同。这种行为可以通过地西泮和心得安等药物得到改善。
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引用次数: 0
Amiodarone-induced ventricular fibrillation. 胺碘酮引起的心室颤动。
Pub Date : 1980-01-01
J M McComb, K R Logan, M M Khan, J S Geddes, A A Adgey

Amiodarone, 600 mg orally daily, was used in an attempt to control supraventricular tachyarrhythmias in a patient with the sick sinus syndrome. Twenty days from the onset of therapy the Q-T interval lengthened. Episodes of ventricular flutter, ventricular fibrillation and self-terminating ventricular tachyarrhythmia (torsade de pointes) developed on the 28th day of amiodarone therapy. Temporary cardiac pacing prevented further episodes of ventricular fibrillation. Despite the suggestion that this drug may be given in large doses for long periods of time since it has a wide safety margin, we feel that the risk of lethal arrhythmias is such that caution is required in its use.

胺碘酮,600毫克,每日口服,用于控制病人的室上性心动过速与病态窦综合征。治疗开始后20天,Q-T间期延长。在胺碘酮治疗第28天出现心室扑动、心室颤动和自终止性室性心动过速(扭转点)发作。临时心脏起搏可防止心室颤动的进一步发作。尽管这种药物有很大的安全范围,因此建议可以长期大剂量服用,但我们认为,致命心律失常的风险是如此之大,因此在使用时需要谨慎。
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引用次数: 0
Echocardiographic demonstration of porcine mitral valve vegetation and dehiscence. 猪二尖瓣生长和开裂的超声心动图显示。
Pub Date : 1980-01-01
B Strasberg, C Kanakis, F Eckner, K Rosen

The echocardiographic study of a patient with a malfunctioning porcine valve in the mitral position is presented. Echocardiography of the mitral valve revealed multiple, dense heterogeneous echoes behind and within the valve stent which were suggestive of vegetations. At the aortic valve level, a clear systolic echo in the left atrium was recorded. This echo probably represented the prolapsing anterior valve stent and was caused by a major dehiscence of the valve stent due to endocarditis.

超声心动图研究的病人与故障猪瓣膜在二尖瓣的位置提出。二尖瓣超声心动图显示瓣膜支架后及支架内多发、密集、不均匀回声,提示有植被。在主动脉瓣水平,左心房有清晰的收缩期回声。该回声可能代表前瓣膜支架脱垂,由心内膜炎引起的瓣膜支架主要开裂引起。
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引用次数: 0
Diagnostic capacity of sinus node recovery time after inhibition of autonomous neural tone. 自主神经张力抑制后窦结恢复时间的诊断能力。
Pub Date : 1980-01-01
H Vallin, O Edhag, E Sowton

Symptomatic arrhythmias often occur intermittently in patients with sinus node dysfunction. A diagnostic test with ability to reveal latent sinus disease has therefore been much sought for. Determinations of sinus node recovery time (SNRT) and corrected sinus node recovery time (CSNRT) have been attempted but limitations in their diagnostic power are well recognized. To eliminate a possible masking effect of autonomous neural tone, propranolol 0.1 mg/kg and atropine 0.02 mg/kg was administered to 30 patients with established symptomatic sinus bradydysrhythmias (SSBD) and to a control group of 18 age-matched healthy volunteers. In addition the same procedure was applied to 9 patients with symptoms suggesting SSBD in whom, however, this cause was later excluded. The upper normal limit of CSNRT defined by the control group was 545 msec before and 505 msec after drugs. In the SSBD group, CSNRT was falsely negative in 8 of the 30 patients. Repeated testing after drug inhibition reduced this number to 2 patients. Thus, the sensitivity increased from 73% to 93%. CSNRT determinations were normal in the non-SSBD patients, specificity remaining at 100%. Thus, the discriminative power of electrophysiologic testing for sinus node disease was found to be high when CSNRT determinations were performed both before and after drug inhibition of autonomous neural tone.

窦房结功能障碍患者常间歇性出现症状性心律失常。因此,一种能够显示潜伏性鼻窦疾病的诊断试验一直被广泛寻求。已尝试测定窦结恢复时间(SNRT)和矫正窦结恢复时间(CSNRT),但其诊断能力的局限性是公认的。为了消除自主神经张力可能的掩盖效应,对30例已确定症状性窦性慢性心律失常(SSBD)患者和18名年龄匹配的健康志愿者给予0.1 mg/kg的心得安和0.02 mg/kg的阿托品。此外,同样的程序应用于9例有SSBD症状的患者,但后来排除了这一原因。对照组规定的CSNRT正常上限值为用药前545 msec,用药后505 msec。在SSBD组中,30例患者中有8例CSNRT假阴性。药物抑制后的重复测试将这一数字减少到2例。因此,灵敏度从73%提高到93%。CSNRT检测在非ssbd患者中正常,特异性保持在100%。因此,在药物抑制自主神经张力之前和之后进行CSNRT测定时,发现电生理测试对窦结疾病的判别能力很高。
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引用次数: 0
Directly measured tension-time index as a correlate of myocardial oxygen consumption. 直接测量张力时间指数与心肌耗氧量的相关性。
Pub Date : 1980-01-01
B Lewartowski, J Michałowski, G Sedek, E Kryńska, E Wasilewska-Dziubińska

Left ventricular systolic pressure (LVSP) and stress in the outer layers of the left ventricular wall were directly recorded in 10 anaesthetised, open-chested dogs. Left ventricular oxygen consumption (VO2) was calculated from the difference in oxygen content in the arterial and in the coronary sinus blood and from the left ventricular coronary flow (LVCF). LVCF was measured in the shunt between the carotid artery and left coronary artery (2 experiments) or in the shunt between the coronary sinus and jugular vein. Tension-time index was calculated either as the product of the mean LVSP and time (TTI(P)), or as the product of mean systolic stress and time (TTI(sigma)). Both TTIs were changed within the broad range by means of exsanguination and blood infusion. Contractility was changed by means of Inderal or noradrenaline infusion. In all experimental conditions VO2/100 g/stroke correlated linearly (P less than 0.01) with TTI(sigma), with correlation coefficient r greater than 0.8. When TTI(P) was used, correlation coefficient r was less than 0.6 and no correlation was found in one series of experiments with noradrenaline infusion. It is concluded that TTI calculated from the directly measured wall stress is a very good correlate of the VO2, which is not the case when the 'classical' TTI is used.

直接记录10只麻醉开胸犬左室收缩压(LVSP)和左室壁外层应力。左室耗氧量(VO2)由动脉血和冠状窦血含氧量差及左室冠状动脉血流(LVCF)计算。在颈动脉与左冠状动脉之间的分流处(2个实验)或冠状窦与颈静脉之间的分流处测量LVCF。张力时间指数计算为平均LVSP与时间的乘积(TTI(P)),或平均收缩应力与时间的乘积(TTI(sigma))。通过放血和输注,两种tti均在较宽范围内改变。通过注射吲哚或去甲肾上腺素来改变收缩力。在所有实验条件下,VO2/100 g/stroke与TTI(sigma)呈线性相关(P < 0.01),相关系数r > 0.8。采用TTI(P)时,相关系数r < 0.6,输注去甲肾上腺素的一系列实验均无相关性。结论是,从直接测量的壁应力计算得到的TTI与VO2有很好的相关性,而当使用“经典”TTI时则不是这样。
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引用次数: 0
An easy and reliable estimation of acute myocardial infarct size from serum CK-MB measurements. 一个简单和可靠的估计急性心肌梗死大小从血清CK-MB测量。
Pub Date : 1980-01-01
P Grande, J Naestoft, C Christiansen

The purpose of this study was to determine a simple and reliable procedure of estimating acute myocardial infarct (AMI) size by measuring serum creatine kinase MB (CK-MB) in few daily blood samples. In 13 patients with AMI blood samples were drawn every second hour for 60 h for determination of serum CK-MB activity. Infarct size was calculated using the CK-MB values of all samples and compared to the size calculated according to various models based on enzyme levels in few samples. Two models, using 3 daily samples, showed very high correlations and satisfactory standard errors of estimate when compared to the infarct size calculated from all samples. One of the 2 models was based on a computerized log-normal curve fit programme and one on accumulation of serum activities of CK-MB. The coefficient of variation of infarct size estimated from thrice-daily sampling was 7.4 and 9.4 for the 2 models. Considering the twenty-fold variation in infarct size a satisfactory quantitation is achieved from 3 daily samples.

本研究的目的是确定一种简单可靠的方法,通过测量少量每日血液样本的血清肌酸激酶MB (CK-MB)来估计急性心肌梗死(AMI)的大小。13例急性心肌梗死患者每2 h抽血,连续60 h测定血清CK-MB活性。使用所有样本的CK-MB值计算梗死面积,并将其与基于少量样本酶水平的各种模型计算的梗死面积进行比较。与从所有样本计算的梗死面积相比,使用3个每日样本的两个模型显示出非常高的相关性和令人满意的估计标准误差。其中一个模型基于计算机化对数正态曲线拟合程序,另一个模型基于血清CK-MB活性积累。两种模型的梗死面积变异系数分别为7.4和9.4。考虑到梗死面积的20倍变化,从3个每日样本中获得令人满意的定量。
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引用次数: 0
Oxygen uptake and cardiac output at rest and during exercise after surgery for coarctation of the aorta. 主动脉缩窄手术后休息和运动时的摄氧量和心输出量。
Pub Date : 1980-01-01
E Hanson, B O Eriksson

Oxygen uptake and cardiac output at rest and during exercise were studied in 19 men operated on for coarctation of the aorta during childhood. Their aerobic capacity and their maximal values for cardiac output, stroke volume and arteriovenous oxygen difference were normal. No differences were found regarding these variables between hypertensive and normotensive subjects. Thus, there was no sign of failure of the left ventricle even in patients with high blood pressure during exercise. Whether the normal arteriovenous oxygen difference indicates a normal distribution of the cardiac output cannot be settled from the present data.

研究了19例儿童时期主动脉缩窄手术患者静息及运动时的摄氧量和心输出量。他们的有氧能力、最大心输出量、每搏量和动静脉氧差均正常。在高血压和正常血压的受试者中,这些变量没有发现差异。因此,即使在运动期间患有高血压的患者中,也没有出现左心室衰竭的迹象。正常的动静脉氧差是否表明心输出量的正态分布还不能从目前的数据中得出结论。
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引用次数: 0
The role of reduced left ventricular enddiastolic volume in the apparently high prevalence of mitral valve prolapse in atrial septal defect. 房间隔缺损患者二尖瓣脱垂明显高发,左室舒张内容积降低的作用。
Pub Date : 1980-01-01
J Angel, J Soler-Soler, H Garcia del Castillo, I Anivarro, J Batlle-Diaz

Twenty-three patients with ostium-secundum atrial septal defect (ASD) were studied in order to investigate the etiology of angiographic mitral valve prolapse associated with ostium-secundum ASD. 12 patients (52%) had angiograhic MVP. Ventricular volumes, ejection fraction, segmentary contractility and oxygen step-up were analyzed in all patients. Patients with MVP had smaller enddiastolic and stroke volumes (73 +/- 21.8 ml/m2 and 46.6 +/- 18 ml/beat/m2) than patients without MVP (106.6 +/- 22 ml/m2 and 78 +/- 11.3 ml/beat/m2) (P less than 0.01). Oxygen step-up was greater in patients with MVP (P less than 0.05). No consistent differences in ejection fraction and segmentary contractility were found. Our findings suggest that angiographic MVP associated with ostium-secundum ASD is a functional disorder due to reduced left ventricular enddiastolic volume secondary to the atrial shunt.

本文对23例心房-第二段房间隔缺损(ASD)患者进行研究,探讨血管造影二尖瓣脱垂合并心房-第二段房间隔缺损的病因。血管造影MVP 12例(52%)。分析所有患者的心室容积、射血分数、节段性收缩力和氧加速。MVP患者的舒张末期容积和脑卒中容积(73 +/- 21.8 ml/m2和46.6 +/- 18 ml/beat/m2)小于无MVP患者(106.6 +/- 22 ml/m2和78 +/- 11.3 ml/beat/m2) (P < 0.01)。MVP患者的氧升压更大(P < 0.05)。射血分数和节段性收缩没有一致的差异。我们的研究结果表明,血管造影MVP与心房-第二腔ASD相关是由于心房分流继发的左心室舒张内容积减少而导致的功能性障碍。
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引用次数: 0
Myocardial lactic acid balance after left ventriculography. 左心室造影后心肌乳酸平衡。
Pub Date : 1980-01-01
O Visioli, S Bongrani, F Cucchini, M di Donato, R Ferrari

In order to study the effects of contrast media on myocardial metabolism the percentage of lactic acid extraction during left ventricular angiography has been determined in 16 normal patients (Group I), and in 29 patients with coronary artery disease (Group II). In addition, the lactic acid uptake was evaluated after atrial pacing (in 10 patients of Group I and in 13 patients of Group II) and after aortography (in 6 patients of Group I and in 9 patients of Group II). Normal patients usually did not show a myocardial lactic acid production after left ventriculography while the patients with coronary artery disease showed a net lactic acid production in the coronary sinus, which was similar to that obtained after atrial pacing stimulation and after aortography. These results indicate that ventriculography can be a useful technique to assess the kinetics of lactic acid uptake or release into the coronary sinus in patients with coronary artery disease and, in this respect could be useful for studying myocardial metabolism in aortic valve disease and to assess the toxicity of different contrast media.

为了研究造影剂对心肌代谢的影响,我们测定了16例正常患者(I组)和29例冠心病患者(II组)左心室血管造影时乳酸提取的百分比。乳酸的吸收后评估心房踱步(10位病人组我和13个病人组II)和之后造影术(6例组我和9组患者II)。正常的患者通常没有显示左侧脑室造影术后心肌乳酸生产而冠状动脉疾病患者冠状窦显示净乳酸生产,后获得的类似造影术后心房刺激和踱来踱去。这些结果表明,心室造影可以作为一种有用的技术来评估冠状动脉疾病患者乳酸摄取或释放到冠状动脉窦的动力学,并且在这方面可以用于研究主动脉瓣疾病的心肌代谢和评估不同造影剂的毒性。
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引用次数: 0
Familial cardiomyopathy--a 15-year follow-up. 家族性心肌病,15年随访。
Pub Date : 1980-01-01
M Rosenqvist, G Biörck, U de Faire, U Freyschuss, K Lindvall, B Magnusson

In 1961--1962 five families including 53 members with a familial form of cardiomyopathy (CMP) were examined. Fifteen years later a reinvestigation of the previously examined families was carried out using community registers; mortality as well as new family members were registered. Another 50 family members were thereby added. Three out of 6 young subjects who were diagnosed as having definite (2) or suspected (1) CMP at the initial examination died during the follow-up period. Four of the five families, totalling 39/41 members, were given a thorough noninvasive clinical examination including ECG, phonocardiogram exercise test, measurement of systolic time intervals and carotid arterial pulse curves, and echocardiography (Echo). A high number (17/39) of suspected or definite pathologic echocardiographic changes consistent with CMP was observed on reinvestigation. Eleven of these 17 were asymptomatic. Except for Echo, the non-invasive methods used in this study did not contribute to the diagnosis of CMP, but the non-Echo methods confirmed the Echo findings in those patients with symptoms of cardiac disease. The four reexamined families revealed a very heterogenous pattern of CMP, with both symmetric and asymmetric hypertrophy (ratio symmetric/asymmetric = 15 : 2). It may be questioned whether asymptomatic subjects with borderline changes, indicative of symmetric hypertrophy, will develop definite symmetric CMP or whether their symptoms constitute an early stage of asymmetric CMP. Echocardiographic findings may well fit with the theory of a dominant mode of inheritance.

1961- 1962年,研究了5个家族,包括53名家族性心肌病(CMP)患者。15年后,利用社区登记册对先前调查的家庭进行了重新调查;对死亡率和新家庭成员进行了登记。因此又增加了50名家庭成员。在最初的检查中被诊断为明确(2)或疑似(1)CMP的6名年轻受试者中有3人在随访期间死亡。对5个家庭中的4个,共39/41名成员进行了全面的无创临床检查,包括心电图、心音图运动试验、收缩时间间隔和颈动脉脉搏曲线测量以及超声心动图(Echo)。再次调查时发现大量(17/39)疑似或明确的病理超声心动图改变与CMP一致。这17人中有11人无症状。除Echo外,本研究中使用的非侵入性方法对CMP的诊断没有帮助,但非Echo方法证实了有心脏病症状的患者的Echo结果。四个重新检查的家庭显示CMP的模式非常异质性,对称和不对称肥大(对称/不对称的比例= 15:2)。可能值得怀疑的是,无症状的边缘性改变,表明对称肥大,是否会发展为明确的对称CMP,或者他们的症状是否构成不对称CMP的早期阶段。超声心动图的发现可能很好地符合显性遗传模式的理论。
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引用次数: 0
期刊
European journal of cardiology
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