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PubMed1971

Closed head trauma and aphasia.

A prospective study has been done on the relationship between closed head trauma and aphasia. The most frequent type of aphasia seen after closed head injury is an anomic aphasia. This aphasia is often associated with other defects of higher cortical function. The second most common type of aphasia is a Wernicke's aphasia. Other types of aphasia were not seen in this study. The areas of the head which when injured produce aphasia are the right orbitofrontal region and the left temporoparietal region. The prognosis for recovery appeared highly variable.

Adult↗

PubMed1995

Cardiovascular adjustments to acute hypoxemia superimposed on chronic hypoxemia in lambs.

Cardiovascular responses to acute hypoxemia are in part mediated through adrenergic and chemoreceptor stimulation. In chronic hypoxemia the response to these stimuli may be blunted. Therefore, we determined whether the cardiovascular responses to acute hypoxemia superimposed on 3-4 wk of chronic hypoxemia were blunted in lambs with an experimental cardiac right-to-left shunt (combination of atrial septal defect and variable pulmonary stenosis). Cardiovascular variables and regional blood flows were determined during chronic hypoxemia and after acutely reducing the arterial oxygen saturation by increasing the cardiac right-to-left shunt. Arterial oxygen saturation decreased (65 +/- 7 to 40 +/- 7%, P < 0.001) and systemic blood flow increased (164 +/- 63 to 233 +/- 100 ml.min-1.kg-1, P < 0.01), maintaining systemic oxygen supply and oxygen uptake. Blood flow to the myocardium (P < 0.01), the adrenals (P < 0.05), and the brain (0.05 < P < 0.10) increased, and oxygen supply to these organs was maintained. Conversely, blood flow to the kidneys and the gastrointestinal tract was unaltered, so that oxygen supply to these organs was decreased. The responses to acute hypoxemia in chronically hypoxemic lambs were similar to those previously reported in normoxemic lambs. We conclude that the cardiovascular responses to acute hypoxemia in chronically hypoxemic lambs are not blunted.

Acute Disease↗

PubMed2005

Anatomic relations between the esophagus and left atrium and relevance for ablation of atrial fibrillation.

BACKGROUND: Esophageal injury is a potential complication after intraoperative or percutaneous transcatheter ablation of the posterior aspect of the left atrium. Understanding the spatial relations between the esophagus and the left atrium is essential to reduce risks. METHODS AND RESULTS: We examined by gross dissection the course of the esophagus in 15 cadavers. We measured the minimal distance of the esophageal wall to the endocardium of the left atrium with histological studies in 12 specimens. To measure the transmural thickness of the atrial wall, we sectioned another 30 human heart specimens in the sagittal plane at 3 different regions of the left atrium. The esophagus follows a variable course along the posterior aspect of the left atrium; its wall was <5 mm from the endocardium in 40% of specimens. The posterior left atrial wall has a variable thickness, being thickest adjacent to the coronary sinus and thinnest more superiorly. Behind is a layer of fibrous pericardium and fibrofatty tissue of irregular thickness that contains esophageal arteries of 0.4+/-0.2-mm external diameters. CONCLUSIONS: The nonuniform thickness of the posterior left atrial wall and the variable fibrofatty layer between the wall and the esophagus are risk factors that must be considered during ablation procedure. Esophageal arteries and vagus nerve plexus on the anterior surface of the esophagus may be affected by ablative procedures.

Adult↗

PubMed1985

[Characteristics of phages-transposons of Pseudomonas aeruginosa belonging to 2 groups distinguished by DNA-DNA homology].

14 new transposable phages (TP) were isolated from approx. 200 clinical isolates of Pseudomonas aeruginosa. The frequent occurrence of TP of P. aeruginosa has been confirmed. There are at least two different groups of TP, namely, the group of D3112 and that of B3. The distinctive features of phages belonging to the groups are as follows: 1) low level of DNA-DNA homology (less than 10%), the whole region of homology in phage genomes of different groups being located on right genome end (29-38 kb); only one of phages of the B3 group shows an additional homology with D3112 DNA outside the above mentioned region; 2) a variable DNA is observed on the left end of the B3 group phage genomes and no such DNA is revealed on the left end of genomes of the D3112 group phages; 3) all phages of the B3 group have specific type of interaction with RPL11 plasmid, which distinguish them from phages of the D3112 group; 4) phages belonging to the two groups differ greatly in their growth in cells harbouring pMG7 plasmid which mediates production of PaeR7 endonuclease and in the number of DNA sites sensitive to SalGI, PstI, BglII endonucleases. Since some of the B3 group phage genomes possess BamH1 sites, resistance to this enzyme cannot be regarded as a general characteristics for all TP of P. aeruginosa, as it was earlier proposed. Some aspects of modular hypothesis of bacteriophage evolution concerning, in particular, the ways of module formation are discussed.

Bacteriophages↗

PubMed2005

Neural localization of semantic context effects in electromagnetic and hemodynamic studies.

Measures of electrical brain activity (event-related potentials, ERPs) have been useful in understanding language processing for several decades. Extant data suggest that the amplitude of the N400 component of the ERP is a general index of the ease or difficulty of retrieving stored conceptual knowledge associated with a word, which is dependent on both the stored representation itself, and the retrieval cues provided by the preceding context. Recordings from patients with brain damage, intracranial recordings, and magnetoencephalographic data implicate a (probably large portion of) the left temporal lobe as the largest source of the N400 semantic context effect, with a substantial but lesser contribution from the right temporal lobe. Event-related functional magnetic resonance (fMRI) studies using semantic context manipulations are dominated by observations of greater hemodynamic activity for incongruent sentence completions or semantically unrelated words than congruent or related words, consistent with the direction of the ERP effect. The locations of the hemodynamic effects show some variability across studies, but one commonly identified region is the left superior temporal gyrus, which is compatible with the electrophysiological results. A second commonly identified region in the fMRI studies is the left inferior frontal gyrus, which does not appear to make a substantial contribution to the N400 effect.

Brain↗

PubMed2006

Occurrence of regional left ventricular dysfunction in patients undergoing standard and biofeedback dialysis.

BACKGROUND: Cardiac failure and cardiovascular death are extremely prevalent in dialysis patients. Recurrent subclinical myocardial ischemia is important in the genesis of heart failure in nondialysis patients. We examined whether this phenomenon occurs in response to the stress of hemodialysis (HD). METHODS: Eight patients prone to intradialytic hypotension were recruited for a randomized crossover study to compare the development of left ventricular regional wall motion abnormalities during standard (HD) and biofeedback dialysis. Patients underwent serial echocardiography with quantitative analysis to assess ejection fraction and regional left ventricular systolic function during both types of dialysis. Blood pressure and hemodynamic variables also were measured by using continuous pulse wave analysis. RESULTS: Forty-two new regional wall motion abnormalities developed in all 8 patients during HD compared with 23 regional wall motion abnormalities that developed in 7 patients during biofeedback dialysis (odds ratio, 1.8; 95% confidence interval, 1.1 to 3.0). The majority of regional wall motion abnormalities showed improvement in function by 30 minutes postdialysis. Overall mean regional function was significantly more impaired during HD (P = 0.022). At peak stress, ejection fraction (measured by percentage of change from baseline) was significantly lower during HD (P = 0.043). Blood pressure was higher during biofeedback dialysis, with significantly fewer episodes of hypotension (odds ratio, 2.0; 95% confidence interval, 1.01 to 4.4). Significantly smaller decreases in stroke volume and cardiac output and a greater increment in pulse rate were observed during biofeedback dialysis. CONCLUSION: This study shows that reversible left ventricular wall motion abnormalities develop during dialysis with ultrafiltration. We also show that this phenomenon can be ameliorated by the improved hemodynamic stability of biofeedback dialysis and therefore is a potential target for intervention.

Aged↗

PubMed2000

In vivo investigation of white matter pathology in schizophrenia with magnetisation transfer imaging.

OBJECTIVES: This study is the first to use magnetisation transfer imaging (MTI), a technique sensitive to myelin and axonal abnormalities, to investigate the white matter in vivo in patients with schizophrenia. METHODS: MTI was performed in 25 schizophrenic patients and 30 healthy controls. A region of interest (ROI) approach was used to obtain magnetisation transfer ratios (MTRs) in several regions of cerebral white matter. RESULTS: MTR values were significantly reduced in the right and left temporal regions in schizophrenic patients compared with controls (p<0.001). Clinical variables such as age, duration of symptoms, schizophrenic symptomatology, and soft neurological signs did not predict this reduction in MTR. There were no MTR abnormalities in the other regions sampled. However, the correlation between the left and right frontal MTR values was marginally significantly different in schizophrenic patients compared with controls suggesting that subtle differences in interhemispheric connections may be present. CONCLUSIONS: Subtle white matter pathology, most likely related to myelin and axonal abnormalities, can be detected in the temporal lobes in schizophrenic patients. MTI may be a useful tool in investigating the white matter in schizophrenia.

Adult↗

PubMed1987

Conservation and variation in orf virus genomes.

The genomes of several orf virus strains were analyzed with the restriction endonucleases EcoRI, HindIII, BamHI, and KpnI, and cleavage site maps were deduced. In general, the right half of the genome showed conservation of restriction sites compared with the left half. Variations in size of up to 0.5 kbp were found within an inverted terminal repetition, and a 1-kbp deletion was detected in some strains in a subterminal fragment at the left end. A region of approximately 20 kbp, some 12 kbp in from the left end, showed the greatest cleavage site variability although there was no evidence of large deletions in this region. A 1.55-kbp cloned DNA fragment from the internal variable region of NZ2 failed to hybridize to the DNA from three other strains. A fragment in the variable region of strain NZ7 was cloned and compared by hybridization and restriction endonuclease analysis with cloned NZ2 fragments from the same region. The region of nonhomology extended for at least 2.75 kbp. It is suggested that this internal variable region may provide sites for the insertion of foreign genes.

Animals↗

PubMed1997

RB1 deletion in gonadoblastoma in an XY female.

Cytogenetic studies of normal and tumor cells in a patient with gonadal dysgenesis and bilateral gonadoblastoma were performed. The karyotype was 46,XY in peripheral blood lymphocytes and skin fibroblasts. The conserved region of the SRY gene was detected by polymerase chain reaction amplification. Sequencing of this region did not reveal any alterations. A 46,XY chromosome constitution was observed in the right gonadoblastoma, but a partial deletion of chromosome 13 was present in the left tumor. This deletion included band 13q14, where the retinoblastoma gene is mapped. The study of the polymorphism of the variable number of tandem repeats region in intron 17 of the RB1 locus disclosed loss of heterozygosity in both the left tumor, which showed the deletion of chromosome 13, and in the right tumor, where no chromosome alterations of chromosome 13 were detected. In situ hybridization covering 130 kb of RB1 showed that a partial deletion of one of the RB1 alleles had occurred in the right tumor. Since the deletions affected different alleles in each tumor, independent events must have been involved in the development of the tumors. These findings point toward a significant role of RB1 in the development of gonadoblastoma.

Adolescent↗

PubMed1989

Studies of retrograde cardioplegia. II. Advantages of antegrade/retrograde cardioplegia to optimize distribution in jeopardized myocardium.

This study tests the hypothesis that retrograde/antegrade cardioplegic delivery can overcome the limitations of poor cardioplegic distribution resulting from either technique alone and, potentially, may expand the safety of using internal mammary artery grafts in cardiac muscle in jeopardy of inadequate cardioplegic protection. Jeopardized myocardium was produced in 20 dogs by ligating the left anterior descending coronary artery for 15 minutes before starting cardiopulmonary bypass and by 1 hour of aortic clamping with multidose 6 degrees C cold blood cardioplegia. Five dogs received antegrade cardioplegia via the aortic root. Ten dogs received retrograde cardioplegia via the coronary sinus. Five additional dogs received retrograde/antegrade cardioplegia via both routes. The ligature on the left anterior descending coronary artery was removed after aortic unclamping, and regional myocardial temperature (thermistor probe), segmental shortening (ultrasonic crystals), and global left ventricular and right ventricular myocardial function were evaluated. Antegrade cardioplegia produced excellent right ventricular cooling (14 degrees C) and allowed complete right ventricular functional recovery. However, it failed to cool muscle supplied by the left anterior descending coronary artery (only 31 degrees versus 12 degrees C, p less than 0.05), postischemic global left ventricular function recovered only 38% (p less than 0.05), and segmental shortening in the region supplied by the left anterior descending coronary artery recovered only 22% (p less than 0.05). Retrograde cardioplegia produced homogeneous cooling (17 degrees C) and allowed near normal recovery of global and regional left ventricular function (99% and 86%), but right ventricular cooling was variable (19 degrees to 30 degrees C) and right ventricular function recovered inconstantly (range 64% to 100%, average 82%). The best myocardial protection occurred after retrograde/antegrade cardioplegia; myocardial cooling was homogeneous, left ventricular and right ventricular global function recovered completely (95% and 90%), and regional contractility in muscle supplied by the left anterior descending coronary artery returned to 84% of control. We conclude that retrograde/antegrade cardioplegia provides better myocardial protection than either technique alone, ensures good cardioplegic distribution to the left and right ventricles, and allows regional delivery of cardioplegic flow to segments supplied by occluded arteries.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed2000

[Clinical significance of pressure measurement in the infarct-related coronary artery in acute myocardial infarction: evaluation of variables predicting recovery of left ventricular function in the convalescent stage].

Early reperfusion and good antegrade flow are essential in restoring better regional left ventricular function in acute myocardial infarction, but they do not always correlate with the extent of recovery. This study evaluated coronary circulation using the new "pressure wire" technique to measure the direct pressure of the coronary circulation including antegrade and collateral flow before and after reperfusion in patients with acute myocardial infarction, and to clarify the influence of these variables on recovery of left ventricular function in the convalescent stage. Fifty six consecutive patients with first acute myocardial infarction underwent percutaneous transluminal coronary angioplasty(PTCA) for totally occluded or severely narrowed infarct-related lesion and evaluation of coronary circulation using pressure wire. Left ventriculography was analyzed at 1 month after the onset in 41 patients. Treatment variables including reperfusion time, reperfusion modality, Thrombolysis in Myocardial Infarction(TIMI) grade after PTCA, and pressure wire variables were compared with parameters of left ventricular function. Reperfusion time was not related to regional wall motion evaluated by the SD chord of left ventriculography in the infarcted zone. Pressure wire measurements showed a correlation between fractional flow reserve measured after PTCA and infarcted regional wall motion(r = 0.558, p < 0.01). Patients with infarct-related lesion in the right coronary artery showed the magnitude of left ventricular regional wall motion was related to fractional collateral flow reserve(maxQc/Qn) during PTCA(r = 0.768, p < 0.05), but no such relationship was observed in patients with infarct-related lesion in the left anterior descending artery. Fractional flow reserve measured after PTCA varied widely in patients with the same TIMI flow grade, so did not vary with it. The pressure wire technique enables assessment of the collateral circulation distal to infarct-related lesion quantitatively before reperfusion in patients with acute myocardial infarction. The fractional flow reserve derived by coronary pressure after reperfusion was significantly related to the recovery of regional wall motion in the infarcted area in the convalescent stage. The fractional flow reserve after reperfusion with PTCA is a better parameter than TIMI flow grade for predicting recovery of regional left ventricular function after myocardial infarction.

Angioplasty, Balloon, Coronary↗

PubMedDate not supplied

Variabilities in the distribution of neurofibrillary tangles in the anterior parahippocampal gyrus at initial stages of Alzheimer's disease.

The entorhinal region is located in the ventromedial surface of the temporal lobe on the parahippocampal gyrus. Occurrence of early argyrophilic neurofibrillary tangles was investigated in brain sections of the left and right entorhinal region of 9 individuals of both sexes between the age of 26 to 54 years. Parasagittal serial sections at 100 microns were performed to include the very anterior part of the entorhinal region. An advanced silver method was used for staining neurofibrillary changes. The neurofibrillary tangles were counted via light microscopy, marked on the sections and staged as proposed by Braak and Braak. In 1 case we found a left-right difference by 1 stage (right: stage I, left: stage II). The tangle distribution in another case exhibited several neurofibrillary tangles only in the very anterior part of the entorhinal cortex on both sides (stage 0). In 3 cases some neurofibrillary tangles occurred in the very anterior part of the right entorhinal region, while a few are present in more posterior parts (stage I). The corresponding left hemisphere showed the same anterior-posterior distribution pattern as on the right in only 1 of these cases. In the remaining 4 cases, no neurofibrillary changes were visible. In conclusion, the very anterior part of the entorhinal region is among the earliest sites for development of neurofibrillary tangles. Distribution of early Alzheimer-related neurofibrillary changes in the entorhinal region displays variabilities in the anterior-posterior direction as well as in a left-right comparison.

Adult↗

PubMed1999

[The effects cervicothoracic sympathetic blockade on left ventricular function].

OBJECTIVE: Cervicothoracic sympathetic blocks (stellate ganglion blocks) not only influence pain, but also lead to regional sympathetic denervation of part of the left ventricular wall, while other ventricular regions stay under the control of the unblocked side. What is the influence of these imbalances of sympathetic innervation on ventricular function? METHODS: Thirteen anaesthetised dogs were instrumented for measurement of left ventricular pressure (tip-manometer), cardiac output (ultrasonic flow probe) and regional myocardial function (sonomicrometry) in two left ventricular regions, innervated by the left or right sympathetic system, respectively. Electrical stimulations of the left and right stellate ganglia, and left and right sided stellate ganglion blocks were performed. In eight patients with no cardiac disease, the effects of left stellate ganglion blocks on echocardiographic variables of ventricular function were investigated. RESULTS: In dogs, the unilateral ganglion stimulations led to an increase in regional and global contractility. However, left ventricular wall motion became asynchronous and, despite an increase in contractility, relaxation was impaired. After the ganglion blocks, there was a decrease in regional contractility within the denervated area, also leading to an asynchronous wall motion. As a consequence, relaxation was impaired, but cardiac output was maintained. In the patients, there was an increase in isovolumic relaxation time. This change was also within the compensatory range and cardiac output increased slightly as a consequence of a simultaneous afterload reduction by the ganglion block. CONCLUSION: The studies show a disturbance of diastolic function after stellate ganglion blocks, resulting from an asynchronous wall motion pattern after the regional denervation. However, the changes were within the compensatory range of a healthy ventricle and cardiac output was not reduced.

Anesthesia, Spinal↗

PubMed1998

Dynamic competition between alternative structures in viroid RNAs simulated by an RNA folding algorithm.

The folding pathways of viroid RNAs were studied using computer simulations by the genetic algorithm for RNA folding. The folding simulations were performed for PSTVd RNAs of both polarities, using the wild-type sequence and some previously known mutants with suggested changes in the stable or metastable structures. It is shown that metastable multihairpin foldings in the minus strand replicative intermediates are established due to the specific folding pathway that ensures the absence of the most stable rod-like structure. Simulations of the PSTVd minus strand folding during transcription reveal a metastable hairpin, formed in the left terminal domain region of the PSTVd. Despite high sequence variability, this hairpin is conserved in all known large viroids of both subgroups of PSTVd type, and is presumably necessary to guide the folding of the HPII hairpin which is functional in the minus strand. The folding simulations are able to demonstrate the changes in the balance between metastable and stable structures in mutant PSTVd RNAs. The stable rod-like structure of the circular viroid (+) RNA is also folded via a dynamic folding pathway. Furthermore, the simulations show that intermediate steps in the forced evolution of a shortened PSTVd replicon may be reconstructed by a mechanistic model of different folding pathway requirements in plus- and minus-strand RNAs. Thus the formation of viroid RNA structure strongly depends on dynamics of competition between alternative RNA structures. This also suggests that the replication efficiency of viroid sequences may be estimated by a simulation of the folding process.

Algorithms↗

PubMedDate not supplied

Organization and variation of the mitochondrial control region in two vulture species, Gypaetus barbatus and Neophron percnopterus.

We report the first entire mitochondrial DNA (mtDNA) control region sequences in two endangered vulture species, the bearded vulture (Gypaetus barbatus) and the Egyptian vulture (Neophron percnopterus). Results showed that the general organization of vulture control regions was very similar to other birds, with three distinct domains: a left variable domain (DI), a central conserved one (DII) including the F, E, D, and C boxes, and a right domain (DIII) containing the CSB1 sequence. However, due to the presence of long tandem repeats, vulture control regions differed from other avian control regions both in size and nucleotide composition. The Egyptian vulture control region was found to be the largest sequenced so far (2031 bp), due to the simultaneous presence of repeats in both DI (80 bp) and DIII (77 bp). Low variation was found in vulture control regions, particularly in G. barbatus, as the probable result of populations declines in the last few centuries.

Animals↗

PubMed2006

Obligatory role of cardiac nerves and alpha1-adrenergic receptors for the second window of ischemic preconditioning in conscious pigs.

We tested the hypothesis that cardiac nerves may mediate ischemic preconditioning. Pigs were chronically instrumented to measure aortic, left atrial and left ventricular pressures, and regional myocardial function (wall thickening). Hemodynamic variables, area at risk, and tissue blood flows (radioactive microspheres) were similar among groups. Myocardial infarct size following 60 minutes coronary artery occlusion and 4 days reperfusion, expressed as a fraction of the area at risk, was 42+/-4.0%, in innervated pigs and similar in pigs with regional cardiac denervation (CD, 41+/-2.5%). Infarct size in innervated pigs during the first window of preconditioning (first window) was markedly reduced (6+/-1.8%, P<0.01), as it was in the second window of preconditioning (second window) (16+/-3.3%, P<0.01). Although infarct size was still reduced in pigs with CD and first window preconditioning (9+/-1.8%, P<0.01), the protective effects of second window were abrogated in pigs with CD resulting in an infarct size of 38+/-5.6%. In another group of innervated pigs during pharmacological alpha(1)-adrenergic receptor (AR) blockade, infarct size was also not reduced during the second window (48+/-3.2%). Additionally, Western blot analysis of inducible nitric oxide synthase and cyclooxygenase-2 proteins demonstrated significant (P<0.05) upregulation following the second window in innervated pigs, but not in pigs with CD or alpha(1)-AR blockade. Thus, the mechanism of protection during the second window, but not the first window, appears to be dependent on cardiac nerves and alpha(1)-AR stimulation.

Adrenergic alpha-1 Receptor Antagonists↗

PubMed1993

Early administration of amrinone does not impair regional metabolism of O2 or lactate and, by improving myocardial performance, preserves myocardial blood flow in the ischemic canine heart.

The inotropic and vasodilating effects of amrinone can upset the balance of O2 supply and demand by changing those components in opposite directions simultaneously. We used a canine model of acute coronary artery occlusion to test our hypothesis that early administration of amrinone (before failure of the heart) would have beneficial effects on hemodynamic status and regional metabolism during ischemia, even before heart failure. Twenty dogs anesthetized with thiamylal were subjected to 50%, 75%, and 100% occlusion of the left anterior descending coronary artery. Half of the dogs were given a bolus injection of amrinone (0.75 mg/kg) 1-2 min before each occlusion, immediately followed by continuous infusion (10 micrograms.kg-1 x min-1) during occlusion; the other half did not receive amrinone (control). Hemodynamic and metabolic variables were measured in the ischemic area (the left anterior descending coronary artery) and in a nonischemic area (the circumflex vein). Amrinone not only decreased heart rate, left ventricular systolic and end-diastolic pressures, and mean pulmonary arterial pressure during constrictions but also maintained contractility, stroke volume index, and stroke volume index/left ventricular end-diastolic pressure before and during constrictions. Regional myocardial blood flow in ischemic areas decreased with amrinone during constrictions but was still higher than in untreated animals. Regional ischemic and nonischemic metabolic variables (metabolism of intracoronary potassium, CO2, O2, glucose, and lactate) were similar for both groups and changed to the same extent. Amrinone appears to improve left ventricular performance and increase blood flow to ischemic myocardium while not worsening regional metabolic effects during various grades of ischemia in the dog.

Amrinone↗

PubMed1975

Changes in intramyocardial ST segment voltage and gas tensions with regional myocardial ischemia in the dog.

This study was designed to evaluate the sensitivity of changes in myocardial carbon dioxide and oxygen tensions as indicators of regional myocardial ischemia and also to determine to what extent these changes can be related to changes in intramyocardial ST segment voltage. Changes in ST segment voltage recorded in unipolar epicardial electrodes proved to be a less-sensitive indicator of underlying myocardial ischemia than were changes in ST segment voltage recorded in unipolar intramyocardial electrodes. In 9 dogs, regional ischemia was produced by placing a variable constrictor on the left circumflex coronary artery; circumflex flow was monitored. Myocardial carbon dioxide and oxygen tensions were measured using a mass spectrometer. Unipolar electrograms were recorded using a multicontact plunge electrode. With progressive degrees of proximal stenosis, ranging from a critical stenosis, which is associated with a decrease in mean flow of less than 15%, to a severe stenosis associated with and 80% decrease, ST voltage increased 21 mv and carbon dioxide tension increased 84 mm Hg, but oxygen tension decreased only 7 mm Hg. The study suggests that increases in intramyocardial ST segment voltage, an index of myocardial ischemia, are associated with parallel increases in myocardial carbon dioxide tension, each providing a more sensitive quantitative correlate of regional myocardial ischemia than do decreases in oxygen tension. The local accumulation of carbon dioxide may be an important pathophysiological mechanism in myocardial ischemia.

Animals↗