PubMed Health⌕ Search

Biomedical subjects

S Coll

Publications and source records attributed to S Coll.

29 records · Page 2Linked to original sources
PubMed1984

Natural history of severe left ventricular dysfunction after myocardial infarction.

The prevalence and prognosis of severe left ventricular dysfunction after infarction was prospectively analyzed in a series of 259 male patients aged 60 years or less surviving an acute myocardial infarction. All patients underwent coronary angiography 30 days after the acute event and were followed up for a mean period of 34 months (range, 15 to 55 months). Forty-five patients (17 percent) were found to have severe left ventricular dysfunction (ejection fraction less than or equal to 30 percent). Comparison of patients with and without severe impairment of left ventricular function showed the former to have a lower cardiac index (p less than 0.001), higher left ventricular end-diastolic volume index (p less than 0.001), and a higher prevalence of three-vessel disease (p less than 0.025) and of total or subtotal occlusion of at least one coronary artery (p less than 0.025). While the occurrence of congestive heart failure was higher in patients with severe left ventricular dysfunction (p less than 0.001), the probability of developing angina was similar in both groups. Cox's regression analysis showed ejection fraction to be the only independent predictor of survival in patients with severe impairment of left ventricular function. An ejection fraction of 20 percent or less identified a subset of patients with the highest mortality (62 percent at four years), significantly different from that of patients whose ejection fraction was between 21 and 30 percent (28 percent) (p less than 0.001).

Adult↗
PubMed1983

Prevalence and prognosis after a first nontransmural myocardial infarction.

Prevalence, prognosis, and coronary anatomy associated with nontransmural myocardial infarction (MI) were prospectively assessed in 458 consecutive men admitted to our coronary care unit with a first MI. Cardiac catheterization was performed in 402 of the 436 survivors within 1 month of the acute event. Mean follow-up was 33 months (range 5 to 72). Nontransmural MI was diagnosed in 28 patients (6%). These patients were younger (46 +/- 10 versus 51 +/- 7 years, p less than 0.001) and had lower peak creatine kinase values (601 +/- 319 versus 1,141 +/- 923 U, p less than 0.01) and better ejection fraction (63 +/- 8 versus 46 +/- 14, p less than 0.001) than did their counterparts. Survivors of nontransmural MI also had fewer affected arteries (p less than 0.001) and a lower prevalence of total or subtotal occlusion (greater than 90%) in the involved artery (p less than 0.01). Mortality in the acute phase and long-term survival at 4 years (Kaplan-Meier) in patients with nontransmural MI (94%) were similar to those in patients with transmural MI (90%). The occurrence of new nonfatal coronary events was also similar in both groups of MI survivors. Thus, in the absence of symptoms, more aggressive management to improve survival does not seem warranted after nontransmural MI.

Adult↗
PubMed1982

Determinants of prognosis in survivors of myocardial infarction: a prospective clinical angiographic study.

To identify predictors of late mortality, 259 consecutive men (less than or equal to 60 years old) who survived acute myocardial infarctions were catheterized one month after admission and were then followed for a mean of 34 months. Nineteen patients (7 per cent) died during the observation period. Of 79 base-line descriptors, 17 proved to be univariate predictors of survival. Cox regression analysis demonstrated that the ejection fraction (P less than 0.001), the number of diseased vessels (P less than 0.005), and the occurrence of congestive heart failure in the coronary unit (P less than 0.01) were the only independent predictors of survival. Risk stratification showed that the probability of survival at four years was highest in patients with normal ejection fractions (96 to 100 per cent, depending on the number of diseased vessels) and lowest in those with ejection fractions below 20 per cent (3o to 75 per cent). The prognosis in patients with ejection fractions between 21 and 49 per cent was significantly worse (78 per cent) than in those with normal ejection fractions only in the group with three-vessel involvement (P less than 0.01). Since most survivors of myocardial infarction who are likely to have their lives prolonged by coronary-artery bypass surgery are in this group, it is reasonable to limit routine coronary angiography to the 56 per cent of survivors who have ejection fractions between 21 and 49 per cent.

Adult↗
PubMed1982

Angiographic findings 1 month after myocardial infarction: a prospective study of 259 survivors.

Coronary anatomy as it relates to left ventricular function was assessed prospectively in patients who survived acute myocardial infarction. The study population included 259 consecutive male patients age 60 years or younger who underwent catheterization 30 days after the acute event. Coronary artery obstructive lesions (greater than 50% reduction in luminal diameter) were found in 241 patients (93%), 118 (45%) of whom had total and 76 (29%) subtotal (greater than 90%) stenosis) occlusion of at least one coronary artery. Normal coronary vessels were seen in eight patients (3%) and nonobstructive lesions in 10 (4%). One-, two- and three-vessel disease were present in 89, 86 and 66 patients, respectively. Patients with normal coronary arteries or nonobstructive lesions had higher ejection fractions than those with obstructive lesions in one, two or three vessels (p less than 0.05). Ejection fraction was lower (p less than .001) and the percentage of akinetic segments higher (p less than 0.001) in patients with total or subtotal lesions and no collaterals. Adequate collaterals, seen in 29 patients (11%), significantly improved regional wall motion (p less than 0.05) and decreased the percentage of akinetic segments (p less than 0.001). Thus, in a substantial number of patients (32% in our series), the infarcted area is spontaneously reperfused by collaterals or through the involved artery. Both mechanisms ameliorate wall motion in corresponding areas.

Collateral Circulation↗
PubMedDate not supplied

Postpneumocystis aspergilloma in AIDS: CT features.

We describe a case of aspergilloma complicating a pulmonary cyst secondary to Pneumocystis carinii pneumonia in an AIDS patient. The utility of CT in the diagnosis is illustrated.

Acquired Immunodeficiency Syndrome↗