| 1. |
- Blomström, P, et al.
(författare)
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Precision of preoperative electrophysiological study in predicting the intraoperatively defined location of single left-sided accessory pathways
- 1987
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Ingår i: European Heart Journal. - 0195-668X .- 1522-9645. ; 8:5, s. 510-520
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Tidskriftsartikel (refereegranskat)abstract
- In 34 patients with a left-side anomalous pathway (AP) considered for arrhythmia surgery, the atrial insertion of the anomalous pathway in the preoperative investigation was determined by using three different techniques. The atrial activation sequence during orthodromic tachycardia or ventricular stimulation was recorded in the coronary sinus by using either (a) unipolar leads from an eight-polar electrode catheter with an interelectrode distance of 1 cm, (b) bipolar leads from consecutively positioned pairs of electrodes on the same electrode catheter or (c) bipolar leads recorded at one centimeter intervals by withdrawal of the electrode catheter. The corresponding location at surgery was obtained by atrial epicardial mapping during ventricular stimulation. Each way of recording the atrial activation sequence in the coronary sinus during orthodromic tachycardia or ventricular stimulation was compared with regard to their predictive value in assessing the corresponding location by intraoperative mapping. At surgery, a visual grid system was used to define the anatomical landmarks which were located 20 mm apart. When the unipolar technique was used to assess the anomalous pathway location, there was a difference corresponding to a distance of 2–2.5 anatomical landmarks (48 mm) between the preoperative and intraoperative assessments. With the bipolar technique the difference was up to 3 anatomical landmarks (60 mm) while it was up to 4.5 anatomical landmarks (90 mm) when the withdrawal technique was employed. The unipolar technique was superior in differentiating a left lateral from a left posterior or a septal location.
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| 2. |
- Herlitz, Johan, et al.
(författare)
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Mortality and morbidity in suspected acute myocardial infarction in relation to ambulance transport
- 1987
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 8:5, s. 503-509
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Tidskriftsartikel (refereegranskat)abstract
- In 681 patients admitted to the coronary care unit (CCU) at Sahlgrenska hospital between 1 May 1983 and 31 May 1984, due to suspected acute myocardial infarction (MI), the hospital mortality and morbidity were related to whether the patients were transferred to hospital by ambulance or not. In the ambulance group acute MI developed in 48% (during the first 3 days in hospital) compared with 41% in the non-ambulance group (P= 0.10). The overall mortality rate was 10.4% in the ambulance group versus 3.8% in the non-ambulance group (P= 0.001). Corresponding figures for MIpatients were 193% versus 9.1% (P=0.02) In all, patients referred by ambulance had larger infarcts according to maximum serum enzyme activity and a higher incidence of congestive heart failure. Similar findings were observed when MI patients were analysed separately. On the other hand, the incidence of ventricular fibrillation, requirement for lidocaine, and the course of pain was fairly similar in the two groups. In a multivariate analysis, infarct size was the major independent predictor for early mortality rate. We conclude that patients who call for an ambulance due to suspected acute MI appear to have a different early mortality and morbidity pattern compared to those who do not. The most obvious observation was a higher early mortality. These patients therefore might be the most suitable candidates for early intervention studies.
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| 3. |
- Wranne, Bengt, et al.
(författare)
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Problems related to the assessment of fluid velocity and volume flow in valve regurgitation using ultrasound Doppler technique.
- 1987
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Ingår i: European Heart Journal. - 0195-668X .- 1522-9645. ; 8 Suppl C, s. 29-33
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Tidskriftsartikel (refereegranskat)abstract
- Understanding of the factors affecting regurgitant flow through a heart valve and of the inherent limitations of the Doppler technique is needed to interpret correctly the information obtained during an ultrasound Doppler examination. This paper describes the flow conditions at the leaking valve and limitations of the Doppler technique which become important in the case of valve regurgitation. The flow conditions can be described in the following terms: contraction of the flow, core flow dimensions, friction, and intrusion and width of the jet flow. Contraction occurs at the entrance to the orifice and causes the width of the jet at the orifice to be smaller than the orifice itself. This contraction should be taken into account when calculating volume flow. The jet reaches a minimal area at the vena contracta where the flow velocity is close to that expected from the Bernoulli equation. The area of the vena contracta relative to the area of the hole can vary between 0.6 and 1.0; the lowest value is seen at a sharp-edged orifice and the highest value, at a hole with an ideally rounded inlet. Friction has a marginal role on flow velocity at the vena contracta. The velocity at the vena contracta persists in a region called the core flow region. This region has a length of 4-8 hole diameters. The total jet intrusion and the width of the jet are related to both the flow velocity at the hole and the diameter of the hole.(ABSTRACT TRUNCATED AT 250 WORDS)
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| 4. |
- Ljunghall, S, et al.
(författare)
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Clinical studies of calcium metabolism in essential hypertension
- 1987
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Ingår i: European Heart Journal. - 1522-9645. ; 8:Suppl. B, s. 37-44
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Tidskriftsartikel (refereegranskat)abstract
- Many factors can ultimately lead to an increased blood pressure and it is a generally accepted view that an increase in the active tension of arterioles reflects an increase of the free calcium concentration in the cytosol of the vascular smooth muscle cells. Only recently, however, has the possibility been considered that blood pressure regulation could be influenced by calcium homeostasis. A background for these studies has been provided by the epidemiological observations which link hypertension to a low dietary intake of calcium as well as experimental studies in animals, mostly rats, which have demonstrated that various disturbances of calcium metabolism are related to a raised blood pressure. This review is focused on clinical studies of a possible association between systemic calcium metabolism and the regulation of blood pressure.
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| 5. |
- Swedberg, Karl, 1944, et al.
(författare)
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Central haemodynamic and antiplatelet effects of iloprost--a new prostacyclin analogue--in acute myocardial infarction in man.
- 1987
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Ingår i: European heart journal. - 0195-668X. ; 8:4, s. 362-8
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Tidskriftsartikel (refereegranskat)abstract
- In 14 patients with acute myocardial infarction, a 24-hour Iloprost infusion was started with a mean delay of 309 +/- 22 minutes from onset of symptoms. Patients were haemodynamically monitored with a pulmonary artery catheter and an arterial cannula. The dose of Iloprost was 1-4 ng kg-1 min-1 and titrated according to blood pressure and systemic vascular resistance. When 2.0-4.0 ng kg-1 min-1 of Iloprost were infused, 5 out of 10 patients required dose reduction due to hypotension, nausea or both. However, in all patients the infusion period was completed as planned. Acute reductions of systolic blood pressure and vascular resistance were seen, whereas stroke volume increased and heart rate remained unchanged. The infusion of Iloprost caused profound inhibition of ADP-induced platelet aggregation but no significant changes in plasma values for platelet-specific proteins or thromboxane B2 were recorded. It is concluded that it was possible to safely administer Iloprost over 24 hours in the early phase of acute myocardial infarction and profound anti-aggregatory effects were observed. These findings should be evaluated in a controlled study.
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