Extravascular lung water in patients with mitral stenosis: relationship to pulmonary capillary wedge pressure and Kerley B lines.

To evaluate the relationship between extravascular lung water, pulmonary capillary wedge pressure, and chest radiographic findings, extravascular lung water (EVLW) was assessed using double indicator-dilution techniques in 34 adult patients with mitral stenosis. Seven patients were studied 6 to 12 months after successful mitral valve replacement. In the 27 preoperative patients, septal lines were found to be indicative of elevated EVLW only in the presence of intravascular congestion.

Mitochondrial phosphate transport. Large scale isolation and characterization of the phosphate transport protein from beef heart mitochondria.

The phosphate transport protein from beef heart mitochondria has been purified on a large scale by hydroxylapatite chromatography in the presence of sodium dodecyl sulfate and urea. As shown by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (silver stain), the pure phosphate transport protein preparation consists of two protein bands (alpha and beta, ratio 1:1) with similar mobilities (34 kDa) which display identical peptide maps if fragmented with either CNBr or HCl/dimethyl sulfoxide/HBr. The complete amino acid composition of phosphate transport protein is presented.

Effect of blood pH and ischemia on kinetic constants for cerebral glucose transport.

In 117 experiments, the isolated canine brain was subjected either to 4-min pulses with blood ranging from pH 6.8 to 7.8, 30 min of hypoxia (PaO2 30 mmHg or 40 mmHg), or 30 min of complete ischemia followed by 60 min of perfusion with normal oxygenated blood.

Effects of airway pressure and lung volume on left ventricular transmural pressure-volume relationships in humans.

Positive airway pressure, combined with increased lung volume, decreases left ventricular compliance in dogs. To determine whether airway pressure or lung volume influences left ventricular diastolic properties in humans, we examined two consecutive cineangiograms with simultaneous esophageal and left ventricular pressure recordings in 14 patients. Both studies were performed during sustained inspiration, one with atmospheric airway pressure, and one with positive airway pressure (9.

Mechanism of increase in left ventricular end-diastolic pressure after contrast ventriculography in patients with coronary artery disease.

Elevation in left ventricular (LV) end-diastolic pressure (EDP) after contrast ventriculography (CV) has been proposed as a form of stress intervention in patients with coronary artery disease (CAD). The mechanism of this change has not been delineated. Accordingly, we performed two studies in CAD patients.

Radionuclide analysis of pulmonary blood volume: the response to spontaneous angina pectoris and sublingual nitroglycerin in patients with coronary artery disease.

By manually assigning pulmonary regions of interest and deriving pulmonary time-activity (volume) curves, we were able to make count estimates of pulmonary blood volume (PBV) from gated cardiac blood pool scans. Five patients with coronary heart disease developed angina spontaneously while under a gamma camera. This produced an increase in cardiac volumes (p less than 0.

Radionuclide evaluation of the systolic blood pressure/end-systolic volume relationship: response to pharmacologic agents in patients with coronary artery disease.

To assess the response of the relationship between systolic blood pressure and end-systolic volume to pharmacologic agents with known cardiac effects, we studied 21 patients with known coronary heart disease by means of gated radionuclide angiograms during the infusion of phenylephrine. Each individual was studied during the infusion of phenylephrine twice, once as a control and the second time after the administration of either intravenous dobutamine, topical nitroglycerin ointment, or intravenous propranolol. Eight individuals received 10 micrograms/kg/min of dobutamine, which reduced resting cardiac volumes (p less than 0.

Increased blood oxygen affinity decreases canine brain oxygen consumption.

We have studied the effect of increased blood O2 affinity on O2 delivery to the isolated canine brain. After surgical isolation, the brain, enclosed in the calvarium, was perfused alternately from two pump-oxygenators with normal blood (P 50 [7.4] = 30 +/- 2 torr [S.

Comparison of single-plane and biplane contrast analyses of right ventricular function and size.

To evaluate the utility of single and biplane right ventricular (RV) contrast angiograms, we evaluated 25 canine RV casts and 31 cineangiograms performed in patients during standard contrast ventriculograms. Both standard single and biplane formulae were utilized. In the 25 canine RVs, absolute volume was determined by water displacement.

Pulmonary blood volume: correlation of equilibrium radionuclide and dye-dilution estimates.

In fifteen prospective patients with aortic stenosis undergoing transseptal cardiac catheterization, dye-dilution and count-based estimates of pulmonary blood volume (PBV) were performed. Three radionuclide methods were evaluated. Two were based on electrocardiogram (ECG)-gated imaging of the thorax, where pulmonary counts (PC) were corrected for frame-time, venous radioactivity, and either (1) the number of processed heart beats or (2) the total duration of acquisition.

A method for measuring mean circumferential fiber shortening rate from gated blood pool scans.

Ejection fraction and ejection rate are easily obtained from gated cardiac images, but no method is available for calculating mean circumferential fiber shortening rate. We assumed that the cube root of left ventricular end-diastolic volume or counts is proportional to the minor axis of the left ventricle at end-diastole or end-systole. Mean circumferential fiber shortening rate is then equal to the [cube root of the end-diastolic volume (count) minus cube root of end-systolic volume (count)] divided by [cube root of end-diastolic volume (count) multiplied by the ejection time].

Peak rate of left-ventricular ejection by a gated radionuclide technique: correlation with contrast angiography.

Gated radionuclide cardiac blood-pool imaging can produce reliable estimates of left-ventricular (LV) volume and ejection fraction. The ventricular volume curve can be used to develop normalized ejection rates, since count volumes and framing times are known. To test the accuracy of the peak ejection rate (maximum dv/dt), as derived by a standard computer algorithm, we studied 15 patients with coronary artery disease by both contrast ventriculography and radionuclide angiography.

Brain metabolism after 30 minutes of hypoxic or anoxic perfusion or ischemia.

In 48 separate experiments, isolated canine brain preparations were subjected to 30 min of either hypoxic (PaO2 congruent to 20 mmHg) perfusion, anoxic (PaO2 < 10 mmHg) perfusion, or total ischemia followed by reperfusion for up to 2 h with normal oxygenated blood. Unlike ischemia and anoxia, energy metabolism was sufficient during hypoxia to maintain substantial levels of ATP (48% of normal), sustain normal ion gradients, and prevent edema formation. Posthypoxia metabolism was adequate to clear accumulated lactate, enable recovery of normal tissue glucose levels, and allow return to normal levels of glycolytic intermediates.

Normal left ventricular function with total occlusion of right and left main coronary arteries.

This report describes a unique case of normal left ventricular function in a patient with total proximal occlusion of the entire native coronary circulation in addition to an occluded left anterior descending bypass graft. Coronary flow was maintained by a sequential saphenous vein graft to the obtuse marginal and posterior descending arteries, with collateral filling of the left anterior descending vessel. Myocardial function was preserved, presumably because of the relatively gradual process of native coronary occlusion, allowing time for development of adequate collateral perfusion.

Fracture of pacing electrode mimicking failure of pulse generator.

To our knowledge, this is the first reported case of spontaneous fracture of a pacing electrode with decreased amplitude of the pacing artifact, failure to capture, and intact sensing. We postulate that the difference in impedance of the pacemaker for sensing and stimulation may account for this phenomenon.