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Biomedical subjects

E D Andersen

Publications and source records attributed to E D Andersen.

8 recordsLinked to original sources

Atrial fibrillation in the Wolff-Parkinson-White syndrome.

Atrial fibrillation in patients with Wolff-Parkinson-White (WPW) syndrome may lead to syncope, ventricular fibrillation, and sudden death. In a follow-up study of 241 patients with WPW syndrome in a relatively unselected population, 26 patients had documented atrial fibrillation (11%). These patients were followed up after 1-37 years (median 11 years; mean 15 years). During this period, 2 of 26 died suddenly. These 2 patients had the shortest RR interval during spontaneous atrial fibrillation (less than or equal to 220 msec), greater than or equal to 1 episodes of syncope, and a persistent delta wave in all available electrocardiograms. In comparison, sudden or tachycardia-related death was seen in 4 of the 241 patients. This difference is not statistically significant. Thus, atrial fibrillation of 26 patients with WPW syndrome was surprisingly well tolerated in our follow-up study with only 2 sudden deaths.

Adult

DC-conversion of atrial fibrillation after mitral valve operation. An analysis of the long-term results.

In a prospective study comprising 43 patients with atrial fibrillation after mitral valve surgery, an evaluation was made of the prognostic significance of clinical, radiological, haemodynamic and operative factors for the maintenance of sinus rhythm after DC-conversion. Atrial fibrillation with a duration of less than 12 months proved to be the only single factor of significance for sustained sinus rhythm after 12 months and it is suggested as a simple clinical criterion for selection of patients for DC-conversion after mitral valve operation.

Adult

Hepatic elimination of renin in man.

1. Hepatic elimination of renin was measured in 10 well-compensated cardiac patients with normal liver function during a control period and during a period of reduced hepatic plasma flow, induced by physical exercise (seven patients) or intravenous infusion of lysine vasopressin (three patients). 2. Hepatic renin elimination rate (hepatic plasma flow x arterial-hepatic vein difference of plasma renin activity) was found to be linearly correlated with arterial plasma renin activity (r = 0.986, P less than 0.001). 3. When hepatic plasma flow fell by 45% the hepatic extraction ratio of renin (arterial-hepatic vein plasma renin activity difference/arterial plasma renin activity) increased by 75%. Hepatic renin clearance (hepatic plasma flow x extraction ratio) remained constant. 4. The results indicate that changes in the hepatic elimination rate of renin do not contribute to changes in plasma renin activity during these events.

Adult

Renin release in relation to plasma noradrenaline during supine exercise in cardiac patients.

Plasma renin activity in the brachial artery and in the renal vein together with arterial noradrenaline concentration were determined repeatedly during and after 10 min of dynamic exercise in eight cardiac patients. Arterial renin increased slightly during exercise and gradually returned to control level after exercise. Renal vein renin increased markedly during exercise and returned to the resting value immediately after exercise, similarly to the changes in plasma noradrenaline and heart rate. A close temporal relationship between the changes in the renal veno-arterial renin difference, plasma noradrenaline and heart rate strongly suggests that the sympathetic nervous system is a major determinant of renin release in man during exercise.

Adult

Congenital apical aneurysm of the left ventricle: surgical removal in two infants.

The case histories are described of 2 infants, representing either type of congenital apical left ventricular aneurysm. Case 1 had a finger-like, pulsatile, actively contracting aneurysm which was associated with a split distal end of the sternum and a ventral hernia. In contrast to most of the 55--60 cases hitherto described, no other cardiovascular anomalies were detected at heart catheterization with angiocardiography. The aneurysm was resected at the age of 23 days. Postoperative angiocardiography demonstrated a normal-sized left ventricle with good contractions and no residual aneurysm. He was last seen at the age of 15 mth, doing well. Case 2 had a noncontractile aneurysm and congenital pyloric stenosis, which hitherto has not been found in association with this type of aneurysm in the about 20 reported cases. The aneurysm was resected at the age of 9 mth; the estimated reduction of the left ventricular cavity was 20%. 1 yr after operation the patient was doing well, but the chest roentgenogram was unchanged and at angiocardiography the left ventricular appearance was largely unchanged compared to the preoperative findings. He was last seen at the age of 2 yr, doing well. The long-term prognosis in the latter type of aneurysm has still to be elucidated.

Angiocardiography

Chronic supraventricular tachycardia in infancy and childhood.

The results of a one to 19 year follow-up study of 9 children with supraventricular tachycardia of more than one month's duration are reported. The ECG diagnosis of tachycardia was made before birth in one patient and between the ages of 8 months and 12 years in 8. Four had sustained and 4 had repetitive tachycardia, while one patient had both patterns at different times. Reciprocal rhythm was diagnosed in 3 patients and exit block in 2. Severe symptoms had occurred in 2 patients, but as a rule symptoms were mild or absent. No treatment abolished the arrhythmias but digitalis reduced the overall ventricular rate in 6 patients. After a duration of 1-7 years, 3 patients still had tachycardia at the follow-up. In the remaining 6 patients the tachycardia had subsided 7 months to 10 years after the onset.

Adolescent