Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Mar 1994
Juxtacardiac pleural pressure during positive end-expiratory pressure ventilation: an intraoperative study in patients with open pericardium.
This study was conducted to measure the cardiac constraining effect of the lungs during positive end-expiratory pressure and relate extracardiac pleural pressure (radial stress) to airway pressure, right atrial pressure and left ventricular filling. ⋯ In postoperative patients with open pericardium, pulmonary capillary wedge pressure minus extracardiac pleural pressure predicts left ventricular end-diastolic area during positive end-expiratory pressure. Further studies should be done to determine whether the observed relations between airway pressure and extracardiac pleural pressure and between right atrial pressure and extracardiac pleural pressure may give clinically useful estimates of left ventricular preload during positive end-expiratory pressure.
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J. Am. Coll. Cardiol. · Mar 1994
Echocardiography during infusion of dobutamine for identification of reversibly dysfunction in patients with chronic coronary artery disease.
The aim of this study was to test whether the contractile response of akinetic myocardium to low dose dobutamine is useful for detecting myocardial viability in patients with coronary artery disease and persistent left ventricular dysfunction. ⋯ Echocardiography during infusion of low dose dobutamine is a safe and accurate method for identifying reversible dysfunctioning myocardium and predicts early reversibility of wall motion after surgical revascularization in selected patients with coronary artery disease with chronic left ventricular dysfunction.
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J. Am. Coll. Cardiol. · Mar 1994
The causes of dilated cardiomyopathy: a clinicopathologic review of 673 consecutive patients.
The purpose of this study was to document the various causes of dilated cardiomyopathy in a large group of adult patients with congestive heart failure. ⋯ Idiopathic dilated cardiomyopathy is a common cause of congestive heart failure. Specific heart muscle diseases occur with much less frequency.
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J. Am. Coll. Cardiol. · Mar 1994
Aortic intramural hemorrhage visualized by transesophageal echocardiography: findings and prognostic implications.
This study describes the transesophageal echocardiographic and follow-up findings in patients with aortic intramural hemorrhage. ⋯ Intramural hemorrhage represents a variant of aortic dissection and may be an early finding in patients who develop classic aortic dissection or rupture. Transesophageal echocardiography is an excellent method for the detection of intramural hemorrhage and for monitoring these patients.
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J. Am. Coll. Cardiol. · Mar 1994
Randomized Controlled Trial Comparative Study Clinical TrialReexamination of the role of endogenous opiates in silent myocardial ischemia.
This study was designed to examine the role of beta-endorphin and met-enkephalin in the pathophysiology of silent myocardial ischemia, with emphasis on their role in the physiologic response to stress. ⋯ Beta-endorphin and met-enkephalin were similar in patients with painful and silent ischemia, and naloxone infusion did not influence anginal symptoms despite effective opiate receptor blockade and a reduction in somatic pain tolerance. These findings suggest that endogenous opiates do not play an important role in modulating symptoms in myocardial ischemia. The increase in beta-endorphin with exercise that coincided with an increase in plasma cortisol is most likely due to its release from the anterior pituitary gland as part of the physiologic stress response.