Cigarette smoking is a major risk factor of coronary artery disease. Frequent repetition of an acute effect on the heart caused by cigarette smoking has been suggested as the etiology because of the increased incidence of myocardial infarction in cigarette smokers which drops to the incidence in non-smokers after cessation of smoking. This study of cardiac patients during cardiac catheterization evaluates the acute effect of the ordinary cigarette, smoked in the individuals own manner, on parameters of cardiac pump and muscle performance. The accuracy of measurements was enhanced by employing high-fidelity pressure signals, signal averaging, and computer analysis of the data. The results of the present study suggest that when cardiac patients smoke 1 cigarette of their own brand in their accustomed manner, no deleterious effects on pump performance, ventricular contraction or relaxation and blood pressure are evident.

Acute Disease↗

PubMedDate not supplied

[Hemodynamic changes caused by prazocin in patients with uncomplicated arterial hypertension].

Hemodynamic changes produced by prazosin were evaluated in 19 patients with mild non complicated essential hypertension using M mode echocardiography. Patients received an initial dose of the drug of 0.5 mg tid, which was augmented gradually. As a whole, arterial pressure was reduced significantly. Heart rate did not show changes. Telediastolic and stroke volumes augmented significantly (p less than 0.05) and consequently cardiac output was increased. Systemic vascular resistance decreased notably (p less than 0.01). Left ventricular function indexes (EF, % shortening, Vcf) were not modified at all. These findings suggest that prazosin is a good antihypertensive drug and its actions upon the different hemodynamic parameters in normal and non complicated hypertensive patients are complex. Generally, it decreases systemic vascular resistance, without modification of contractility. Decreases in afterload were evident and something interesting, in contrast with other papers, is the demonstration of an augmented telediastolic volume, which indicates that the venodilatator effect with the consecutive decrease in blood return to the heart is masked by other effects. Nevertheless, it is necessary to perform a more detailed study with more sensitive methods in order to elucidate the complex hemodynamic interactions produced by prazosin in patients with mild non complicated essential hypertension.

Adult↗

PubMedDate not supplied

[Abnormalities of left ventricular function in atherosclerotic heart disease].

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Coronary Disease↗

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[Simplified method of obtaining the correction factor for calculating ventricular volumes].

For the accurate measurement of ventricular volume it is required the obtainment of a correction factor for the magnification caused by the non-parallel X-rays and the "pincushion" distortion, which causes more magnification in the periphery than in the center of the fluoroscopic field. The Kasser and Kennedy method is based in the attainment of the relation between the actual and projected dimensions of a micrometrically calibrated grid filmed at the distance measured between the intensifier tube and the mid-thoracic line during the ventriculography. This technique is very accurate but expensive and troublesome. With the simpler catheter method it is obtained the relation between the projected and actual linear dimensions of the ventriculographic catheter inmediately before ventriculography. This study was aimed to compare the accuracy of the catheter method and two other proposed methods, in which the relation between the projected and actual dimensions were obtained by filming one central coin or five arranged through the fluoroscopic field at the distance measured between the tube and the patients during the ventriculography. These four correction factors were obtained in 15 patients undergoing a diagnostic cardiac catheterization. The catheter method showed a poor correlation with the grid method (r = 0.34), while both coin methods showed a high correlation with the grid method (r = 0.93 and 0.92, respectively). It is concluded that the catheter method is inaccurate and therefore is unwise to use it for the estimation of ventricular volumes. Because the peripheric distortion is clinically unimportant, the central coin methods is proposed as a simplified method for obtaining the magnification correction factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗

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[The diastolic function of the left ventricle. I. The ventricular suction].

The paper describes the normal and pathological characteristics of left ventricular filling. There are described some of the most sophisticated methods of assessing left ventricular function: The volume-time curve, the rate of change of left ventricular volume (dV/dt) and the pressure-volume loop. It is discussed the phenomenon of ventricular diastolic suction as an accessory mechanism of filling in some restrictive disorders.

Blood Pressure↗

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[Ventricular rigidity in mitral stenosis measured by an echocardiographic and hemodynamic method].

Ten patients with mitral stenosis underwent right and left heart catheterization. In order to assess the diastolic properties of these ventricles an hemodynamic-echocardiografic techniques was employed. Left ventricular pressure and an echocardiogram of the body of the left ventricle were simultaneously registered. Ventricular volume was determined using the minor axis (T) of the left ventricle measured form the echogram and assuming the long axis (L) from the L to T relationship observed in the left cineventriculography. Using a microcromputer, a smoothed volume-time curve was obtained, together with its first derivative and a pressure-volume loop. The exponential portion of the diastolic loop was used to obtain a felt ventricular stiffness index at zero volume. End diastolic volume and ejection fraction were normals. Left ventricular filling was impaired but ventricular stiffness was found in the normal range. It is concluded that the proposed method permits the simultaneous obtention of pressure volume data. The processing of complex data can be achieved with a pocket microcomputer. There is no evidence of a left ventricular compliance defect in mitral stenosis.

Adult↗

PubMedDate not supplied

[Comparison between echocardiographic and hemodynamic indices in the evaluation of mitral stenosis].

The echocardiographic data (the amplitude of the mitral echogram, the velocity of the E to F slope and the dimension of the left atrium) of 12 patients with mitral stenosis were compared with hemodynamic data obtained during a cardiac catheterization (the mitral valve area and the peak left ventricular filling rate, expressed in millimeters/second [dv/dtD] and normalized by the end-diastolic volume [dv/dtD/VTD seg-1]). None of the echocardiographic variables showed a good correlation with the hemodynamic indices. It is concluded that echocardiography is a useful total in the diagnosis of mitral stenosis, but at the same time there is not a single echocardiographic sign which by itself evaluate correctly the severity of mitral stenosis.

Adult↗

PubMedDate not supplied

[The use of microcomputers in the processing of complex hemodynamic data].

The use of a low-cost microcomputer in the clinical study of left ventricular diastolic function is described. Both left ventricular filling and compliance were studied by means of the simultaneous recording of left ventricular pressure and an echocardiogram displaying ventricular dimensions. A program was written to calculate ventricular volume every 40 msec and a volume-time diagram was obtained. The raw curve was smoothed with a second degree polinomial. The rate of change of ventricular volume (dV/dt) was obtained. Simultaneous left ventricular volume and pressure were plotted. The diastolic, exponential portion of the pressure-volume loop was used to calculate an index of ventricular stiffness at zero volume. It is concluded that a simple microcomputer, when conveniently programed, is able to perform the time-consuming mathematical operations involved in the clinical assessment of left ventricular diastolic function.

Cardiac Volume↗

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[Thrombolysis and beta-block in acute myocardial infarct. Their effects on left ventricular function].

The effects of metoprolol or streptokinase or the combination of both drugs on left ventricular function and the rescue of the jeopardized myocardium in patients with acute myocardial infarction (AMI) were compared. Thirty-seven patients with AMI were allocated in 3 different groups: 19 received 15 mg of metoprolol i.v. in 15 minutes, 7 were treated with 1.5 million IU i.v. of streptokinase and 11 more received both drugs. The following variables were studied at control and one and twenty-four hours after treatment; blood pressure, heart rate, "double product", systolic time intervals, diastolic time and the sum of ST-segment elevation and the sum of the R wave in the EKG. Blood pressure, heart rate and "double product" decreased in the groups treated with metoprolol. The pre-ejection time/ejection time index did not change in any group. The diastolic time increased with metoprolol and the sum of ST-segment elevation was more reduced with the combined treatment. Also in this group, the sum of R wave did not decrease as it happened in the other 2 groups. It is concluded that the combination of streptokinase and metoprolol was more effective in the rescue of jeopardized myocardium than metoprolol or streptokinase administered alone.

Adult↗

PubMedDate not supplied

[The hostility complex and myocardial infarct].

Several studies have associated the hostility complex (part of type A personality) to the development of coronary atherosclerosis. The complex is composed by aggressive behavior, frequent rage outbursts, intolerance to waiting lines and sense of urgency. To investigate the occurrence of this behavioral trait, 50 post-myocardial infarction men were compared against 50 normal male subjects of the same age. In all of them sphygmomanometric blood pressure was obtained, total blood cholesterol was measured and hostility was quantified by means of the Cook and Medley's questionnaire and an arbitrary ad hoc scale. Diastolic blood pressure was significatively higher in post-infarction patients (82 +/- 10 vs 77 +/- 9, p < 0.001), as well as the cholesterol level (231 +/- 55 vs 197 +/- 43, p < 0.001). Also, hostility score was higher in the post-infarcted men (16 +/- 4 vs 13 +/- 5, p < 0.001). The hostility score showed correlation with the occurrence of myocardial infarction (p < 0.02). These results establish that post-myocardial infarction patients express more hostility than control subjects. It was not possible to establish the true nature of the relationship among hostility and diastolic blood pressure, total cholesterol and the occurrence of coronary events. Nevertheless, this study confirms that the hostility complex is frequently present in atherosclerotic patients.

Adult↗