Cardiology Commons^™

Thrombolytic Therapy For Acute Myocardial Infarction In The Elderly, Bernard Bun-Lap Wong, Wai-Hong Chen

Journal of the Hong Kong College of Cardiology

Acute myocardial infarction (MI) is a leading cause of morbidity and mortality in developed countries. Patients ≥75 years constitute up to 30% of the acute MI population and are associated with a 50% in-hospital mortality. Thrombolytic therapy was shown in a metaanalysis of 9 largest randomized controlled trials to reduce 35-day mortality. However, the benefit was observed mainly among patients < 75 years old. For patients ≥ 75 years, the 35-day mortality was 24.3% in those treated with thrombolytic therapy and 25.3% in the placebo group, a difference not reaching statistical significance.

Cardiac Hypertrophy, Heart Failure, And Regulation Of Microtubule Stability, Kristie Lynn Beaton-Blade

MUSC Theses and Dissertations

This work focused on the regulation of the different isotypes of beta-tubulin during cardiac hypertrophy, with the specific hypothesis that increased levels of the beta I isotype leads to the increase in microtubule density seen during hypertrophy. Partial cDNAs for the three beta-tubulin isotypes expressed in the heart (I, II, and IV) have been cloned and used to show that there is a differential upregulation of the beta I and beta II isotypes during cardiac hypertrophy. Messenger RNA half-life studies of cells isolated from hypertrophied myocardium have shown that this upregulation is due to increased transcription of the genes encoding …

Gender Differences In Presenting Symptoms, Treatment, And Outcome In Myocardial Infarction, Alona Dalusung-Angosta

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purposes of this study were to compare the presenting symptoms, treatment, and outcome between men and women with MI. The study sample consisted of 300 patients (N = 300) who were diagnosed with MI in a county hospital in the Southwest area of the United States.

Chest pain, shortness of breath, sweating, and left arm pain were the most common symptoms reported by both genders. Men had more chest pain than their women counterparts (p = .022). No significant difference was found in the cardiac enzyme levels between both genders. Men had more Q wave changes during MI than …

Recognition Of Left Atrial Aneurysm By Fetal Echocardiography., R R. Fountain-Dommer, H B. Wiles, C O. Shuler, S M. Bradley, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Brachytherapy In The New Millennium Abstracts, Jilin Chen, Runlin Gao, Qiangjun Cai, Yuejin Yang

Journal of the Hong Kong College of Cardiology

In order to examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy, 790 patients who underwent successful PTCA and PTCS+Stent in this Hospital were followed by direct interview or letter.

Differences Between Blacks And Whites With Coronary Heart Disease In Initial Symptoms And In Delay In Seeking Care, Sally B. Richards, Marjorie Funk, Kerry A. Milner

Nursing Faculty Publications

BACKGROUND: Mortality rates for coronary heart disease are higher in blacks than in whites. OBJECTIVES: To examine differences between blacks and whites in the manifestation of symptoms of coronary heart disease and in delay in seeking treatment. METHODS: Patients were directly observed as they came to an emergency department with symptoms suggestive of coronary heart disease. The sample included 40 blacks and 191 whites with a final diagnosis of angina or acute myocardial infarction. RESULTS: After controlling for pertinent demographic and clinical characteristics, logistic regression analysis revealed that blacks were more likely than whites to have shortness of breath (odds …

Angiotensin Ii Promotes Atherosclerotic Lesions And Aneurysms In Apolipoprotein E-Deficient Mice, Alan Daugherty, Michael W. Manning, Lisa A. Cassis

Gill Heart & Vascular Institute Faculty Publications

Increased plasma concentrations of angiotension II (Ang II) have been implicated in atherogenesis. To examine this relationship directly, we infused Ang II or vehicle for 1 month via osmotic minipumps into mature apoE^–/– mice. These doses of Ang II did not alter arterial blood pressure, body weight, serum cholesterol concentrations, or distribution of lipoprotein cholesterol. However, Ang II infusions promoted an increased severity of aortic atherosclerotic lesions. These Ang II–induced lesions were predominantly lipid-laden macrophages and lymphocytes; moreover, Ang II promoted a marked increase in the number of macrophages present in the adventitial tissue underlying lesions. Unexpectedly, pronounced abdominal …

Regulation Of Acetylated Low Density Lipoprotein Uptake In Macrophages By Pertussis Toxin-Sensitive G Proteins, Stewart C. Whitman, Alan Daugherty, Steven R. Post

Gill Heart & Vascular Institute Faculty Publications

Class A scavenger receptors (SR-A) mediate the uptake of modified low density lipoprotein (LDL) by macrophages. Although not typically associated with the activation of intracellular signaling cascades, results with peritoneal macrophages indicate that the SR-A ligand acetylated LDL (AcLDL) promotes activation of cytosolic kinases and phospholipases. These signaling responses were blocked by the treatment of cells with pertussis toxin (PTX) indicating that SR-A activates G_i/o-linked signaling pathways. The functional significance of SR-A-mediated G_i/o activation is not clear. In this study, we investigated the potential role of G_i/o activation in regulating SR-A-mediated lipoprotein uptake. Treatment of mouse …

Chapter 4: Normal And Anomalous Coronary Arteries In Humans. Part 2: Angiographic Atlas Of Coronary Anomalies, Paolo Angelini, Salvado Vilason, Albert V. Chan, Jr., Jose' G. Diez

Coronary Artery Anomalies

No abstract provided.

Contributors

Coronary Artery Anomalies

No abstract provided.

Foreward, William C. Roberts

Coronary Artery Anomalies

No abstract provided.

Preface

Coronary Artery Anomalies

No abstract provided.

Title Pages

Coronary Artery Anomalies

No abstract provided.

Chapter 4: Normal And Anomalous Coronary Arteries In Humans. Part 1: Historical Background, Paolo Angelini, Salvado Villason, Albert V. Chan, Jr., Jose' G. Diez

Coronary Artery Anomalies

No abstract provided.

Contents

Coronary Artery Anomalies

No abstract provided.

Cardiac Rehabilitation: Gender Differences In Factors Influencing Participation, Lani Lieberman, Marta Meana, Donna E. Stewart

Psychology Faculty Research

This study investigates gender differences in the barriers and incentives that are most influential in the coronary patient's decision to participate in cardiac rehabilitation (CRPs) and suggests strategies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Toronto, Canada. A survey questionnaire, constructed from a literature review and advice from key informants, examined potential factors affecting decisions to engage in CRPs. One129 attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physician recommendation was reported to be the most important factor …

Posttransplant Recoarctation Of The Aorta: A Twelve Year Experience., Girish S. Shirali, C E. Cephus, M A. Kuhn, K K. Ogata, L K. Vander Dussen, R E. Chinnock, N F. Mulla, J K. Johnston, L L. Bailey, S R. Gundry, A J. Razzouk, R L. Larsen

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation.

BACKGROUND: Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta.

METHODS: This was a retrospective review of all children (ageyears) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the …

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

The Relationship Between Health Locus Of Control And Health Behaviors Of Women Who Have Undergone Coronary Artery Bypass Grafting, Heather Ferrillo

Nursing Master’s Theses and Projects

Due to the increasing number of women who are diagnosed with heart disease and who are undergoing coronary artery bypass grafting, it is important to explore the psychosocial aspects involved in the recovery process of these women. This study examined the relationship between locus of control and health behaviors of women who underwent coronary artery bypass grafting.

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

Stent Placement Compared With Balloon Angioplasty For Obstructed Coronary Bypass Grafts. Saphenous Vein De Novo Trial Investigators., M P Savage, J S Douglas, D L Fischman, C J Pepine, S B King, J A Werner, S R Bailey, P A Overlie, S H Fenton, J A Brinker, M B Leon, S Goldberg

Department of Medicine Faculty Papers

BACKGROUND: Treatment of stenosis in saphenous-vein grafts after coronary-artery bypass surgery is a difficult challenge. The purpose of this study was to compare the effects of stent placement with those of balloon angioplasty on clinical and angiographic outcomes in patients with obstructive disease of saphenous-vein grafts.

METHODS: A total of 220 patients with new lesions in aortocoronary-venous bypass grafts were randomly assigned to placement of Palmaz-Schatz stents or standard balloon angioplasty. Coronary angiography was performed during the index procedure and six months later.

RESULTS: As compared with the patients assigned to angioplasty, those assigned to stenting had a higher rate …

Ventricular Remodeling Following Infant-Pediatric Cardiac Transplantation. Does Age At Transplantation Or Size Disparity Matter?, Girish S. Shirali, F Lombano, W L. Beeson, D A. Dyar, N F. Mulla, A Khan, J K. Johnston, R E. Chinnock, S R. Gundry, A J. Razzouk

Manuscripts, Articles, Book Chapters and Other Papers

Early left ventricular (LV) remodeling following pediatric cardiac transplantation has not been described. To identify patterns and determinants of change in left ventricular mass and volume posttransplant, we studied 125 consecutive children who underwent cardiac transplantation between January 1, 1989 and July 31, 1993. Two-dimensional imaging-directed M-mode echocardiograms were studied weekly until 26 weeks post-transplant. LV mass and volume (indexed to BSA1.5) were measured. LV mass index increased until 3 weeks post-transplant, and then decreased. The mean decrement in LV mass index after 8 weeks post-transplant (relative to baseline) was significantly larger in patients with donor-recipient weight ratio > 1.5 compared …

A Model Of Cytomegalovirus Association With The Development Of Heart Graft Atherosclerosis, Evan Skowronski

Loma Linda University Electronic Theses, Dissertations & Projects

The development of graft atherosclerosis in heart transplant recipients has been associated with the development of post-transplant cytomegalovirus infection. The mechanism of this involvement, however, remains unclear. I undertook a study to determine the role of cytomegalovirus in the development of graft atherosclerosis. First, a rapid method of detecting cytomegalovirus based on capillary polymerase chain reaction and gel electrophoresis was employed to determine the presence of cytomegalovirus in a wide variety of clinical samples. Detection of cytomegalovirus is a lengthy procedure under normal conditions, and timely detection of cytomegalovirus in transplant recipients may allow intervention early enough to block the …

A Randomized Comparison Of Coronary-Stent Placement And Balloon Angioplasty In The Treatment Of Coronary Artery Disease. Stent Restenosis Study Investigators., David L. Fischman, Martin B. Leon, Donald S. Baim, Richard A. Schatz, Michael P. Savage, Ian Penn, Katherine Detre, Lisa Veltri, Donald Ricci, Masakiyo Nobuyoshi, Michael Cleman, Richard Heuser, David Almond, Paul S. Teirstein, R. David Fish, Antonio Colombo, Jeffrey Brinker, Jeffrey Moses, Alex Shaknovich, John Hirshfeld, Stephen Bailey, Stephen Ellis, Randal Rake, Sheldon Goldberg

Department of Medicine Faculty Papers

BACKGROUND: Coronary-stent placement is a new technique in which a balloon-expandable, stainless-steel, slotted tube is implanted at the site of a coronary stenosis. The purpose of this study was to compare the effects of stent placement and standard balloon angioplasty on angiographically detected restenosis and clinical outcomes.

METHODS: We randomly assigned 410 patients with symptomatic coronary disease to elective placement of a Palmaz-Schatz stent or to standard balloon angioplasty. Coronary angiography was performed at base line, immediately after the procedure, and six months later.

RESULTS: The patients who underwent stenting had a higher rate of procedural success than those who …

Instrumentation And Control For A Microprocessor-Based Coronary Perfusion System, Daniel L. Priester

Master's Theses (1922-2009) Access restricted to Marquette Campus

No abstract provided.

Clinical Features And Management Of Malignant Ascites, I Malik, S Abubakar, I Rizwana, F Alam, J Rizvi, A Khan

Section of Cardiology

Retrospective analysis of 45 patients (33 females, 12 males) with cytologically-proven malignant ascites is presented. Abdominal pain was the most frequent symptom (69%). Fiftythree percent cases had low serum albumin. Ascitic fluid was haemorrhagic or serosanguinous in 48% cases, in the rest it was clear or straw-coloured. Peritoneal effusion was exudative in 84% cases. Mean glucose content of ascitic fluid was 95 mg/dl and the mean white cell count of 919 cells/cmm. Vast majority (82%) of the cases had metastatic adenocarcinomas. Primary malignancy was mostly ovarian (47%) followed by non-Hodgkin's lymphoma (11%) and gall bladder carcinoma (9%). Primary site could …

The Report Of The American Heart Association Task Force On Strategies To Increase Federal Research Funding, Michael R. Rosen, Harold C. Strauss, Holly G. Atkinson, Alfred P. Fishman, Charles K. Francis, Arnold M. Katz, August M. Watanabe, Francois M. Abboud, Myron L. Weisfeldt, William F. Friedman, Bernadine P. Healy, Scott D. Ballin, Claudia Louis, Rodman D. Starke, Wallace G. Frasher

Publications and Research

No abstract provided.

In Vivo Demonstration Of Maturational Changes Of The Chronotropic Response To Α-Adrenergic Stimulation, Jorge Mccormack, Henry Gelband, Juan Villafañe, Hui Xu, Adrienne Stolfi, Arthur S. Pickoff

Medical Education Faculty Publications

In vitro studies suggest that neonates and adults may have different cardiac chronotropic responses to a-adrenergic stimulation. To investigate these differences in vivo, three groups of dogs were studied. Group I = 12 puppies, ages 3-7 days; group II = 12 puppies ages 8-15 days, and group III = seven adult dogs. Heart rate and blood pressure determinations were made in the control setting and then after combined β-adrenergic and parasympathetic blockade (propranolol 0.6 mg/kg and bilateral vagotomies). Alpha-stimulation was then achieved with phenylephrine given in doses of 0.5, 1.0, and 10.0 μg/kg/ min. A second, high dose of propranolol …

Atrioventricular Nodal Function In The Immature Canine Heart, Jorge Mccormack, Henry Gelband, Hui Xu, Juan Villafane, Adrienne Stolfi, Arthur S. Pickoff

Medical Education Faculty Publications

Previous studies have suggested that the atrioventricular nodal functional refractory period in the neonate is equal to or shorter than that of the ventricle, providing little or no protection to the ventricle against rapid atrial rates and allowing closely coupled atrial beats to fall within the ventricular vulnerable period. We evalu­ated atrioventricular node function in 21 mongrel neonatal puppies, 3-15 days old, and 15 adult dogs utilizing intracardiac His bundle recording and stimulation techniques. The mean atrioventricular nodal functional refractory period (173.1 ± 20.0 ms) exceeded both the ventricular effective refractory period (139.5 ± 14.3) and ventricular functional refractory period …

Ectopic Origin Of A Coronary Artery From The Aorta. Sudden Death In 3 Of 23 Patients., John Mahowald, L C. Blieden, J I. Coe, J E. Edwards

Articles

Ectopic origin of a coronary artery from the aorta is uncommon. In the last decade, its importance as a possible cause of sudden death has been documented. Initially, only the left coronary artery was implicated. Lately, the ectopically arising right coronary artery has also been shown to be involved in cases of sudden death. We reviewed the pathologic anatomy in 23 cases of ectopic origin of a coronary artery from the aorta. In three of these cases, death could be attributed to ectopic origin of a coronary artery. In one case the left coronary artery arose from the right aortic …