Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of Early Invasive and Conservative Treatment in Patients With Non-ST-ElevatiOn Acute Coronary Syndromes [PRESTO-ACS] Vascular Substudy).

Transradial access (TRA) decreased bleeding after coronary interventions compared with femoral access (FA). However, no large study focused on arterial access-related outcomes in patients with acute coronary syndromes, although procedure-related bleeding significantly impaired prognosis. The aim was to evaluate access site-related outcomes of patients who underwent an invasive coronary procedure in the PRESTO-ACS Study.

Comparison of two different methods for the evaluation of left ventricular ejection fraction in patients with coronary artery disease.

The evaluation of left ventricular ejection fraction (LVEF) may be troublesome in difficult clinical settings in patients with coronary artery disease (CAD). The aim of this study was to compare 2 simple geometrical and nongeometrical methods of LVEF evaluation that could overcome the typical technical limitations of ultrasound examination. The authors studied 26 patients with proven CAD (63+/-10 years) who underwent left ventricular (LV) catheterization and coronary angiography during the hospital stay.

[Long-term clinical assessment of single-lead VDD electric stimulation].

Background: During the last decade single lead VDD pacing has been progressively affirmed as an electrotherapy of choice in patients with advanced atrioventricular block without alterations of the sinus function. It combines the benefits of P-synchronous ventricular pacing with an easy implant procedure when compared to the conventional DDD approach. The aim of this study was to evaluate the validity of such an approach in a large population of patients, all implanted in a single center.

[The long-term effects of dual-chamber stimulation in 8 patients with hypertrophic obstructive cardiomyopathy and symptoms refractory to medical therapy].

Background: The issue of DDD pacing as a therapeutic option for patients with obstructive hypertrophic cardiomyopathy is still under debate. Moreover, some authors stress the concept of the placebo effect of electrical therapy in this particular setting.

Methods: We retrospectively evaluated 8 symptomatic patients with obstructive hypertrophic cardiomyopathy despite medical therapy, who underwent DDD pacemaker implantation as an adjunctive therapeutic strategy.

Comparison of coronary angiographic narrowing in stable angina pectoris, unstable angina pectoris, and in acute myocardial infarction.

Coronary angiographic findings were compared in patients who presented with acute myocardial infarction (AMI, n = 75), unstable angina pectoris (UAP, n = 36), or stable angina pectoris (SAP, n = 36) for > or = 2 years without evidence of any previous acute event and with an angiogram within 2 years of the initial symptoms. Angiograms were evaluated blindly for severity, extent (depending on the percentage of each coronary segment showing atherosclerosis), and pattern (discrete, < 3 loci of narrowings involving < 50% of any segment; diffuse, anything exceeding this). Patients in the SAP group had more narrowed arteries (2.

[Circadian rhythm of the heart rate and autonomic nervous system stimulation tests in patients with systemic lupus erythematosus].

We studied 19 women (mean age 35 +/- 13 years) with systemic lupus erythematosus (SLE), in order to evaluate whether or not alterations in the circadian rhythm of heart rate (HR) occur in patients with pathologic responses to stimulation tests of the autonomic nervous system (ST-ANS). The duration of SLE was 5.3 +/- 5 years.

Reproducibility in circadian rhythm of ventricular premature complexes.

To evaluate the existence and reproducibility of a circadian rhythm of ventricular premature complexes (VPCs), 38 patients (mean age 57 +/- 17 years) with greater than or equal to VPCs/hour were studied with 24-hour electrocardiogram Holter monitoring. Nineteen patients had coronary artery disease and 19 had structurally normal hearts. A second Holter electrocardiogram was recorded in all patients from 2 to 47 days (mean 11) after the first.

Resumption of sinus rhythm during general anaesthesia in an elderly patient with chronic atrial fibrillation: a case report.

Conversion to sinus rhythm is a rare event in a patient with chronic atrial fibrillation. There are no reports in the literature of this happening during general anaesthesia. This case report presents such a case and discusses the possible aetiology.

Assessment of left atrial dimensions by cross sectional echocardiography in patients with mitral valve disease.

Left atrial dimensions were measured using cross sectional echocardiography in 37 patients with mitral valve disease and 30 normal subjects of similar ages. The anteroposterior (AP), superior-inferior (SI), and medial-lateral (ML) left atrial dimensions were determined at the end of ventricular systole using parasternal long and short axis and apical four chamber views (for SIa and MLa). To assess the reliability of these measurements cross sectional echocardiographic and angiographic left atrial volumes were compared in 19 patients with mitral valve disease, giving an excellent correlation.

Oral nifedipine in the long-term management of severe chronic heart failure.

We evaluated the hemodynamic effects of nifedipine in 10 symptomatic patients with chronic refractory heart failure due to idiopathic cardiomyopathy. Nifedipine significantly increased cardiac index (from 1.80 +/- 0.

Beta-thromboglobulin in patients with acute and chronic coronary artery disease.

Beta-thromboglobulin (beta TG) plasma levels were measured by radioimmunoassay in 14 patients with acute myocardial infarction (MI), in 13 with myocardial ischemia and recurrent episodes of angina and in 14 subjects with a past history of MI. Increased beta TG plasma values were observed in patients with acute MI and with myocardial ischemia whereas subjects with a past history of MI showed results not significantly different from normal subjects. Daily measurements in acute MI showed in five cases a second peak of beta TG values which suggests the occurrence of a deep vein thrombosis.

[Mexiletine in treatment of chronic ventricular refractary arrhythmias (author's transl)].

We studied the antiarrhythmic effect of oral Mexiletine in 20 patients with stable high-frequency ventricular arrhythmias refractory to therapeutic doses of conventional antiarrhythmic therapy. Arrhythmias were classified according to modified grading system of Lown and Wolf. The efficacy of Mexiletine was assessed with use of both the arrhythmic modified classification of Lown and Wolf and count of premature ventricular beats (PVB) from 24 hours ambulatory electrocardiographic recordings.

[The hemodynamic effects of nifedipine in congestive cardiomyopathy (author's transl)].

The Authors present the haemodynamic effects of nifedipina (Adalat-Bayer) in nine patients with congestive cardiomyopathy. Heart rate (HR), systemic vascular resistances (SVR) and mean aortic blood pressure (MABP) were significantly modified in all nine patients following the administration of the drug. Six of them showed an increase of cardiac index (CI) and a decrease of myocardial oxygen consumption (MVO2); three of them presented a decrease of CI and an increase of MVO2.

[Cardiac rupture: a not infrequent complication of acute myocardial infarction. Report of five cases (author's transl)].

Five cases of cardiac rupture (CR) in acute myocardial infarction (AMI) (four men and one woman aged between 49 and 86 years, mean 64) are described. The incidence of CR was 4,7% of 106 cases of AMI and 20,8% of causes of death. In all cases, pathologic observations well agreed with electrocardiographic site of infarction.

[Effect of potassium chloride on myocardial stimulation threshold and correlated electrophysiologic parameters (author's transl)].

The influence of KCl on different electrophysiologic parameters and myocardial stimulation threshold (MST) are considered in 9 patients with cardiac pacemaker. Reduction of MST during the diastolic period and the supernormal phase of excitability (SNP), depression of automaticity and slight bradycardia have been observed. The Authors, on the basis of kaliemia values and electrophysiologic parameters, emphasize the improvement of myocardial responsiveness when kaliemia does not exceed 6.

[Study of several electrophysiological effects of procainamide in man (author's transl)].

Several electrophysiological aspects of the effects of procainamide were analyzed, using a method which allows direct study in man. The following electrophysiological parameters were determined under normal conditions in pace-maker carriers: myocardial stimulation threshold (M.S.