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Biomedical subjects

W R Pitts

Publications and source records attributed to W R Pitts.

At least 19 recordsLinked to original sources
PubMed1999

Platelet glycoprotein IIb/IIIa receptor blockade: lessening the risk of coronary interventions.

For the patient undergoing percutaneous coronary intervention, the administration of a platelet glycoprotein IIb/IIIa receptor blocker reduces the incidence of a periprocedural nonfatal myocardial infarction and the need for unplanned emergency stenting. In the diabetic patient undergoing intracoronary stenting, the use of a platelet glycoprotein IIb/IIIa receptor blocker appears to decrease the need for subsequent target vessel revascularization. There is considerable evidence in support of the use of glycoprotein IIb/IIIa receptor inhibitors in all categories of patients--"high-risk" patients, "low-risk" patients, and those undergoing primary angioplasty for acute myocardial infarction--and for the full armamentarium of percutaneous procedures (angioplasty, directional atherectomy, rotational atherectomy, and intracoronary stenting).

Angioplasty, Balloon, Coronary↗
PubMed1998

Coronary arterial anatomy in patients with left ventricular systolic dysfunction without chest pain or previous myocardial infarction.

Patients with left ventricular systolic dysfunction without chest pain or previous myocardial infarction are unlikely to have 3-vessel coronary artery disease and are very unlikely to have coronary anatomy suitable for bypass grafting. Of our 108 subjects, only 3 (3%) had 3-vessel coronary artery disease thought to be suitable for revascularization.

Aged↗
PubMed1998

Effects of the intracoronary infusion of cocaine on left ventricular systolic and diastolic function in humans.

BACKGROUND: In dogs, a large amount of intravenous cocaine causes a profound deterioration of left ventricular (LV) systolic function and an increase in LV end-diastolic pressure. This study was done to assess the influence of a high intracoronary cocaine concentration on LV systolic and diastolic function in humans. METHODS AND RESULTS: In 20 patients (14 men and 6 women aged 39 to 72 years) referred for cardiac catheterization for the evaluation of chest pain, we measured heart rate, systemic arterial pressure, LV pressure and its first derivative (dP/dt), and LV volumes and ejection fraction before and during the final 2 to 3 minutes of a 15-minute intracoronary infusion of saline (n=10, control subjects) or cocaine hydrochloride 1 mg/min (n=10). No variable changed with saline. With cocaine, the drug concentration in blood obtained from the coronary sinus was 3.0+/-0.4 (mean+/-SD) mg/L, similar in magnitude to the blood cocaine concentration reported in abusers dying of cocaine intoxication. Cocaine induced no significant change in heart rate, LV dP/dt (positive or negative), or LV end-diastolic volume, but it caused an increase in systolic and mean arterial pressures, LV end-diastolic pressure, and LV end-systolic volume, as well as a decrease in LV ejection fraction. CONCLUSIONS: In humans, the intracoronary infusion of cocaine sufficient in amount to achieve a high drug concentration in coronary sinus blood causes a deterioration of LV systolic and diastolic performance.

Adult↗
PubMed1997

Repeat coronary angiography in patients with chest pain and previously normal coronary angiogram.

Patients with chest pain and normal coronary angiograms have excellent long-term survival and are unlikely over the ensuing years to develop clinically significant atherosclerotic coronary artery disease. Specifically, of the 17 subjects with a previously normal coronary angiogram who had repeat angiography an average of almost 9 years later, 15 showed no appearance of coronary artery disease and 2 developed single-vessel coronary artery disease, 1 of whom had a myocardial infarction.

Adult↗
PubMed1997

Preoperative left ventricular peak systolic pressure/end-systolic volume ratio and functional status following valve surgery in patients with mitral regurgitation and enlarged end-systolic volumes.

This study was done to determine if the left ventricular (LV) peak systolic pressure/end-systolic volume (PSP/ ESV) ratio predicts symptomatic improvement with valve replacement or repair in patients with mitral regurgitation (MR) and an enlarged LV ESV. Patients with MR and LV ESV <30 ml/m2 consistently improve symptomatically with valve surgery, whereas the response of those with an ESV >30 ml/m2 is heterogeneous. The LV PSP/ESV ratio, an easily acquired measure of LV performance, may discriminate those who improve with valve surgery from those who do not. Accordingly, in 40 patients (15 men and 25 women, aged 14 to 74 years) with moderate or severe MR, no other cardiovascular abnormalities, and a LV ESV >30 ml/m2, we assessed the utility of clinical, hemodynamic, and angiographic variables routinely measured preoperatively to predict symptomatic improvement with valve replacement or repair. Of the 40 subjects, 3 died during or within 6 months of surgery. Six months after valve surgery, symptoms had improved in 34 patients, were unchanged in 1, and had worsened in 2. By univariate analysis, only the preoperative pulmonary capillary wedge pressure was predictive of a change in functional class (p = 0.05). The PSP/ESV ratio was not predictive of a change in functional class after valve surgery. Thus, the PSP/ESV ratio does not identify which patients with MR and an enlarged LV ESV will manifest symptomatic improvement with valve surgery.

Adolescent↗