European heart journal
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European heart journal · Nov 1983
Comparative StudyDifferential diagnosis of hypertrophic cardiomyopathies: typical (subaortic) hypertrophic obstructive cardiomyopathy, atypical (mid-ventricular) hypertrophic obstructive cardiomyopathy and hypertrophic non-obstructive cardiomyopathy.
Previous clinical studies in patients with hypertrophic cardiomyopathies predominantly comprised patients with typical subaortic HOCM and in many other studies patients with 'hypertrophic' cardiomyopathies were investigated; i.e. no distinction was made between patients with the typical obstructive, the atypical obstructive and the non-obstructive forms of hypertrophic cardiomyopathy. In addition, in the more differentiated studies, the differential diagnosis between HOCM and HNCM was based mainly on the presence and absence of the subaortic pressure gradient. This is also true for the clinical characterization of both types of hypertrophic cardiomyopathy. ⋯ Therefore a comparative study in 353 patients with hypertrophic cardiomyopathies was designed to characterize the clinical picture of patients with HNCM and with atypical HOCM in relation to typical HOCM with special reference to the differential diagnosis. The study revealed a profoundly different diagnostic profile of the three subsets of hypertrophic cardiomyopathies. The distinction between the three subsets may serve as a more differentiated basis for clinical studies related to diagnosis, therapeutic approaches, long-term follow-up observations and prognostic evaluation of patients with hypertrophic cardiomyopathies.
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European heart journal · Nov 1983
Hypertrophic obstructive and non-obstructive cardiomyopathy in Japan. Diagnosis of the disease with special reference to endomyocardial catheter biopsy.
There were 84 confirmed cases of congestive (or dilated) cardiomyopathy (CCM or DCM), 57 of hypertrophic nonobstructive cardiomyopathy (HNCM) and 52 of hypertrophic obstructive cardiomyopathy (HOCM) collected from 15 cardiology divisions of university or national hospitals in Japan. Out of the 193 patients with cardiomyopathy, 145 (75%) were male and 48 (25%) female (M/F ratio = 3:1). The mean age of the patients was 34.1 years. ⋯ The heart size on conventional radiography was within normal limits or slightly enlarged; the mean cardiothoracic ratio was 0.52 in HNCM and 0.54 in HOCM. A cumulative survival rate in 149 patients with hypertrophic cardiomyopathy demonstrated that the 10-year survival rate after the time when the diagnosis was made was 34.2% for CCM, 81.7% for HNCM and 84.4% for HOCM. Autopsy studies in 11 patients with hypertrophic cardiomyopathy revealed that marked fibre disarray of the heart could be detected by the endomyocardial biopsy of the right ventricular septum in 40% at most of the patients with hypertrophic cardiomyopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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European heart journal · Nov 1983
Clinical course and prognosis of patients with typical and atypical hypertrophic obstructive and with hypertrophic non-obstructive cardiomyopathy.
In a total of 339 patients with hypertrophic cardiomyopathies (typical HOCM, n = 224; atypical HOCM, n = 30; HNCM, n = 80) the clinical course, the Sokolow-Lyon index in the ECG and the prognosis as demonstrated by cumulative survival rates were analysed to get more differentiated information for the characterization of these myocardial disorders. No change in the type of hypertrophic cardiomyopathy was found, indicating different clinical entities. ⋯ Surgical treatment appears to be the therapy of choice, at least in the advanced stage of the disease refractory to medical treatment. In addition, strong evidence was obtained that surgical treatment improved the prognosis in patients with typical HOCM.
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European heart journal · Oct 1983
Case ReportsSuppression of demand pacemakers due to spurious signals generated by inactive endocardial electrodes.
We report a case of oversensing observed in a patient with a VVI pacemaker. This phenomenon was provoked by an inactive lead whose tip was in close apposition with the tip of the stimulating electrode. ⋯ In the latter they assumed a P-like shape. Withdrawal of the temporary lead restored normal pacing.
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European heart journal · Jul 1983
Comparative StudyHaemodynamic consequences of intrinsic sympathomimetic activity and cardioselectivity in beta-blocker therapy for hypertension.
The relevance of intrinsic sympathomimetic activity (ISA) and cardioselectivity for the acute and long-term haemodynamic effects of beta-blocker therapy for hypertension was assessed from reports in the literature. The beta-blockers included in this survey are pindolol, practolol, alprenolol, oxprenolol, acebutolol, penbutolol, metoprolol, atenolol, propranolol and timolol. Forty-four acute and 41 long-term studies in 430 and 482 subjects respectively, were analysed. ⋯ Thus, the absolute value of vascular resistance during beta-blocker therapy is determined by the degree of ISA, irrespective of the quality of cardioselectivity. Consequently, beta-blockers with sufficient ISA to prevent disturbance of tissue perfusion at rest reduce the characteristically elevated vascular resistance in longstanding arterial hypertension in contrast with beta-blockers lacking this property. This can have implications for the long-term prognosis of this condition.