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Biomedical subjects

C Kanakis

Publications and source records attributed to C Kanakis.

At least 19 recordsLinked to original sources

Reduced training duration effects on aerobic power, endurance, and cardiac growth.

Thirteen subjects participated in an exercise program of bicycling and running 40 min/day, 6 days/wk. After 10 wk they continued to train either 26 of 13 min/day for an additional 15 wk. Intensity and frequency for the additional 15 wk remained the same as the last 3 wk of training. This study was undertaken to gain further insights into whether the increases in maximum uptake (VO2 max), endurance, and cardiac size can be maintained with reduced training durations. The average increases in VO2 max in response to 10 wk training were between 10 and 20% during the bicycle and treadmill testing. After reduced training, VO2 max continued to remain at the training levels in both groups. Short-term endurance (approx 5 min) was also maintained by both groups. Long-term endurance (2 h or more) remained the same in the 26-min group but decreased significantly (10%, 139-123 min) in the 13-min group. Calculated left ventricular mass increased 15-20% after training and remained elevated after reduced training in both groups. We conclude that it is possible to maintain almost all of the performance increases with up to a two-thirds reduction of training duration. Nevertheless, the data provide initial evidence that all aspects of the endurance-trained state may not be regulated uniformly in reduced training, particularly since VO2 max and short-term endurance were maintained, but long-term endurance decreased in the 13-min group.

Adult↗

Twenty-four hour continuous ECG recordings in long-distance runners.

Twenty-four hour ambulatory ECG recordings were performed on 20 male long-distance runners, aged 19 to 28 years, during normal activities other than running. Average, maximum, and minimum waking heart rates, respectively, ranged from 58 to 108 (mean +/- SD, 73 +/- 15), 90 to 164 (120 +/- 19), and 34 to 53 (43 +/- 5) beats/min. Longest waking sinus pauses ranged from 1.35 to 2.55 (1.7 +/- 0.3) seconds. Average, maximum, and minimum sleeping heart rates, respectively, ranged from 38 to 58 (47 +/- 6), 69 to 114 (83 +/- 14), and 31 to 43 (36 +/- 3) beats/min. Longest sleeping sinus pauses ranged from 1.60 to 2.81 (2.0 +/- 0.3) seconds. All 20 runners had atrial premature beats, but only one (5 percent) had more than 100/24 hours. Fourteen runners (70 percent) had ventricular premature beats, but only two (10 percent) had more than 50/24 hours, and none had ventricular couplets or ventricular tachycardia. Eight runners (40 percent) had one or more episodes of type 1 second-degree atrioventricular (A-V) block. Compared with untrained males of similar age, the runners had slower heart rates (by approximately 10 beats/min), longer sinus pauses, and a higher prevalence of A-V block. Runners and untrained males did not differ with respect to prevalence of ventricular premature beats, R on T phenomenon, ventricular couplets, or ventricular tachycardia.

Adult↗

Arrhythmias documented by 24-hour continuous ambulatory electrocardiographic monitoring in young women without apparent heart disease.

Results are reported of 24-hour ambulatory ECG recordings in 50 young women without apparent heart disease. During waking periods, maximum (sinus) rates ranged from 122 to 189 beats/min (bpm) (153 +/- 14 mean +/- SD) and minimum rates from 40 to 73 bpm (56 +/- 7). During sleeping periods, maximum and minimum rates ranged from 71 to 128 bpm (105 +/- 13) and from 37 to 59 bpm (48 +/- 6), respectively. Thirty-two subjects (64%) had atrial premature beats, with only one subject (2%) having greater than 100 beats/24 hrs. Twenty-seven subjects (54%) had ventricular premature beats, with only three subjects (6%) having greater than 50 beats/24 hrs. One subject (2%) had one three-beat episode of ventricular tachycardia. Two subjects (4%) had transient type I second-degree atrioventricular block.

Adult↗

Constrictive pericardial disease following mitral valve replacement.

Constrictive pericardial disease developing after open heart surgery is not a well-recognized complication of this procedure. It has been reported only a few times and usually not with good hemodynamic data before and after the subsequent pericardiectomy. We presently report a patient who developed constrictive pericardial disease five years after mitral valve replacement. This was documented with left- and right-sided heart catheterization. The patient underwent pericardiectomy with remarkable clinical improvement. Repeat right- and left-sided heart catheterization done three months postoperatively documented the resolution of the constrictive hemodynamic pattern present before pericardiectomy.

Bioprosthesis↗

Left ventricular responses to a program of lower-limb strength training.

Nine healthy male subjects ages 18-27 exercised five days per week. Three days per week they performed five repetitions of squats, leg extensions and leg flexions with maximal resistance for a total of 11 sets. On the other two days each week subjects performed five leg presses and 20 calf raises with maximal resistance. Resting echocardiograms and physiologic evaluations were made prior to starting the strength training and again after ten weeks of training. Resting heart rate +/- SEM before and after training was 65 +/- 2 and 58 +/- 1.7 beats/min (P < .001). Maximal O2 uptake did not change significantly. Left ventricular wall thickness +/- SEM before and after training increased from 0.76 +/- .02 to 0.85 +/- 0.04 cm (P < .05). Left ventricular mass +/- SEM increased from 81.9 +/- 5 to 92.3 +/- 3.7 g (P < .05). The percentage of left ventricular fractional shortening +/- SEM increased from 32 percent +/- 1.2 to 36 percent +/- .9 (P < .001). Lower limb strength training in normal subjects did not increase maximal O2 uptake, but did induce increases in left ventricular wall thickness similar to that seen in champion strength-trained athletes. In addition, improvement in left ventricular performance without significant changes in left ventricular volumes was also observed.

Adolescent↗

Myotonia dystrophica and mitral valve prolapse.

Two siblings are described, both afflicted with myotonia dystrophica and mitral valve prolapse. This family supports the recent association of these two familial diseases. One of the siblings had severe conduction disease and recurrent ventricular tachycardia, possibly reflecting potentiation of arrhythmia, because of the association of these two familial diseases.

Adult↗

Echocardiographic practice in a large metropolitan area.

A survey performed concerning echocardiography in a metropolitan area. Of 110 hospitals in the area, 62 reported having echocardiographic facilities. Echocardiographic physicians and/or technicians from 41 of these hospitals responded to questionnaires designed to determine the following: (1) educational background and credentials of technicians, (2) average salaries of technicians, (3) role of the physician and technician in the performance and reporting of echocardiograms, (4) volume, cost, and method of storage of echocardiograms, and (5) number and type of echocardiographic units in use. Our data suggest various trends, including a lack of formal training among technicians, the prevalence of cardiologists-internists as directors of echocardiographic facilities, the performance of echocardiograms by cardiology fellows in only 46% of institutions with cardiology training programs, and the widespread projected availability of cross-sectional echocardiographic capability within the next two years.

Allied Health Personnel↗

Echocardiographic demonstration of porcine mitral valve vegetation and dehiscence.

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.

Adult↗

Lack of cardiovascular effects of delta-9-tetrahydrocannabinol in chemically denervated men.

We have previously reported that 25 micrograms/kg of intravenous (i.v.) delta-9-tetrahydrocannabinol (delta-9-THC) produces marked increases in heart rate, prolongation of left ventricular ejection time corrected for heart rate (LVETc), and a shortening of the pre-ejection period in normal volunteers. Beta-adrenergic blockade partially attenuates these responses. To elucidate further the mechanism of action of delta-9-THC, we gave 10 normal volunteers 0.1 mg/kg of i.v. propranolol and 2 mg of i.v. atropine before they received 25 micrograms/kg of i.v. delta-9-THC. Systolic time intervals were compared in the denervated subjects before and after delta-9-THC. Post delta-9-THC responses were measured at a time approximating peak psychologic high. Mean +/- SEM heart rate before and after delta-9-THC was 89 +/- 4 and 87 +/- 3 beats/min (NS); mean +/- SEM pre-ejection period before and after delta-9-TCH was 107 +/- 5 and 109 +/- 4 ms (NS); and mean +/- SEM LVETc before and after delta-9-THC was 433 +/- 6 and 429 +/- 6 ms (NS). Since previous denervation of our subjects with atropine and propranolol totally abolished changes in heart rate and systolic time intervals, the cardiac effects of delta-9-THC appear to be mediated totally via the autonomic nervous system, probably reflecting direct central nervous system stimulation.

Adult↗

Arrhythmias documented by 24 hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease.

Results are reported of portable 24 hour dynamic electrocardiographic monitoring in 50 male medical students without cardiovascular disease, as defined by normal clinical and noninvasive cardiovascular examination. During waking periods, maximal sinus rates ranged from 107 to 180 beats/min (mean +/- 5). Twenty-five subjects (50 percent) had episodes of marked sinus arrhythmia as defined by spontaneous changes in adjacent cycle lengths of 100 percent or more. Fourteen subjects (28 percent) had sinus pauses of more than 1.75 seconds, usually during sinus arrhythmia. Transient nocturnal type I second degree atrioventricular (A-V) block was noted in three subjects (6 percent). Of 28 patients (56 percent) having atrial premature beats, only 1 (2 percent) had more than 100 such beats (141) in 24 hours. Of 25 patients (50 percent) having premature ventricular contractions, only 1 (2 percent) had more than 50 such contractions (86) in 24 hours. In conclusion, frequent atrial and ventricular premature beats are unusual in a young adult male population. In contrast, bradyarrhythmias (including marked sinus arrhythmia with sinus pauses, sinus bradycardia and nocturnal A-V block) are common. These findings are useful in evaluating the clinical significance of arrhythmias detected with portable monitoring.

Adult↗