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Biomedical subjects

C Crexells

Publications and source records attributed to C Crexells.

36 records · Page 2Linked to original sources
PubMed1978

Concealed atrial electrical activity.

In the following paragraphs we describe a case diagnosed clinically and haemodynamically as a cardiomyopathy. Atrial flutter which was not in evidence in the standard ECG was diagnosed by the use of a new technique of amplification and filtering of special surface leads (T.A.F.). The diagnosis was later confirmed by means of special internal techniques (intra-atrial ECG and His bundle recording). The existence of a subpraventricular rhythm, probably sinusal, and also unapparent in the standard ECG, was observed by using the same method after electrical defibrillation. We comment on the extreme rareness of discovering concealed atrial rhythms and their possible explanation, and we emphasize the usefulness of the T.A.F. technique in their diagnosis.

Adult↗
PubMed1975

Dissociation between indices of pump performance and contractility in patients with coronary artery disease and acute myocardial infarction.

An analysis of ventricular performance comparing pump function and muscle function indices was performed in 13 patients with acute myocardial infarction, ten patients with normal coronary arteries, and 15 patients with coronary artery disease. Pump function was described by plotting left ventricular stroke work index as a function of left ventricular end diastolic pressure. This description provided a clear separation between normal patients, and surviving and nonsurviving patients with acute myocardial infarction. Values of contractile element velocity (VCE5 as an estimate of Vmax) did not separate between normals and surviving or nonsurviving patients with acute myocardial infarction. In 15 patients with acute coronary artery disease there was no correlation between values of VCE5 and the ventricular function curve. Changes in performance following the stress of ventriculography, angiotensin infusion, or isometric hand grip exercise also did not show any correlation between pump function and muscle function indices. It is concluded that pump function indices are a better indicator of ventricular performance in patients with acute myocardial infarction and coronary artery disease.

Acute Disease↗
PubMedDate not supplied

Endomyocardial diagnosis of cardiac lipomatosis.

A patient with severe isolated right-sided cardiac failure of unknown origin is presented in whom three right ventricular endomyocardial biopsies obtained in different bioptome positions disclosed a yellowish material which was confirmed at histological examination as fat. At operation, a complete replacement of atrial and ventricular myocardium by fat was noted. this previously unreported use of endomyocardial biopsy is emphasized, especially when the differential diagnosis of isolated right-sided heart failure is considered.

Biopsy↗
PubMedDate not supplied

Antiplatelet agents and their effect on complications during or soon after percutaneous transluminal coronary angioplasty.

In a retrospective study, during which 179 patients had undergone percutaneous transluminal coronary angioplasty (PTCA), the overall initial success rate fell suddenly and unexpectedly from more than 90% to 70.4%: 54.9% in patients not receiving antiplatelet therapy and 86.4% in patients treated orally with 300 mg triflusal three times daily or 300 mg acetylsalicylic acid plus 75 mg dipyridamole three times daily. The initial success rate was similar in patients with unstable (66.0%) and stable (77.6%) angina. The overall incidence of severe complications (mainly occlusion) was 16.2% and was significantly (P less than 0.01) greater in the patients not receiving antiplatelet therapy (23.1% versus 9.1%). There was no significant difference between incidence according to antiplatelet therapy used. It is concluded that antiplatelet therapy during the peri-angioplasty period (from 2 days before to 2 days after) may prevent periprocedural events in patients undergoing PTCA.

Administration, Oral↗
PubMedDate not supplied

Development of myocardial beta-adrenergic receptor density and adenylate cyclase activity after human heart transplantation.

An increase in basal heart rate caused by a lack of vagal control and chronotropic supersensitivity to epinephrine has been shown in transplanted human hearts. Prejunctional and/or postjunctional origins for this supersensitivity have been suggested, the latter involving changes in the number of myocardial beta-adrenergic receptors or in the receptor adenylate cyclase system. To directly determine the time course of change, serial determinations were performed during the first 3 months after heart transplantation. The beta-adrenergic receptor density measured by iodine 125-labelled iodocyanopindolol binding in 61 endomyocardial biopsy specimens (a mean of 6.1 +/- 0.58 biopsies from each of 10 patients) showed great intraindividual and interindividual variability (56.6 +/- 6.8 fmol/mg protein) with no mean trend toward gradually changing receptor densities. Isoproterenol-stimulated adenylate cyclase activity measured in 33 biopsy specimens (a mean of 5.5 +/- 0.67 biopsy specimens from each of six patients) varied considerably (112.5 +/- 13.8 pmol cyclic adenosine monophosphate/mg protein/min), again with no definite tendency with regard to the development over time. The beta-adrenergic receptor densities showed no statistical correlation with the degree of rejection as assessed by histologic criteria and antimyosin ration. These results suggest that in the first 3 months after heart transplantation beta-adrenergic receptor density and adenylate cyclase responses to 10 mumol/L isoproterenol do not change and that beta-adrenergic receptor density in the transplanted myocardium does not seem to be affected by the degree of rejection.

Adenylyl Cyclases↗
PubMedDate not supplied

Reversal of rejection-induced coronary vasculitis detected early after heart transplantation with increased immunosuppression.

Four patients who underwent heart transplantation, in whom coronary obstruction was seen early after transplantation, are described. Repeated acute rejection episodes were detected within the first 2 months in each patient. Coronary obstruction or ischemia was shown through a combination of T1-201 isotopic study findings, evidence of vasculitis of a small coronary arteriole seen at endomyocardial biopsy, or coronary angiographic results. Vigorous treatment for rejection (antithymocyte globulin and bolus methylprednisolone) was given, and coronary artery lesions or myocardial ischemia resolved after treatment. Rejection-induced coronary obstruction should be considered in patients with repeated acute rejection episodes who are predisposed to the development of vascular rejection. Early after transplantation such obstruction is caused by diffuse vasculitis of small and medium-sized vessels and may be reversed with increased immunosuppression.

Adult↗