American heart journal
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American heart journal · Nov 1989
Pulmonary artery distensibility and blood flow patterns: a magnetic resonance study of normal subjects and of patients with pulmonary arterial hypertension.
Pulmonary artery distensibility was studied with spin-echo magnetic resonance imaging in 20 normal subjects of variable age and in four patients with pulmonary arterial hypertension. The distensibility was found to be significantly lower (8%) in patients with pulmonary arterial hypertension than it was in normal subjects (23%). No age-related difference occurred. ⋯ There were also other variations in the flow pattern among normal individuals. All patients with pulmonary arterial hypertension had a markedly irregular ante- and retrograde flow and a large retrograde flow (average 26%). Magnetic resonance imaging offers a noninvasive way to evaluate pulmonary arterial hypertension as well as to quantitate pulmonary and aortic flows in, for example, left-to-right shunts.
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American heart journal · Aug 1989
Prognostic significance of the signal-averaged ECG depends on the time of recording in the postinfarction period.
Serial recordings of the signal-averaged ECG and the 24-hour ambulatory ECG were obtained from 156 patients with acute myocardial infarction up to 5 days (phase 1), 6 to 30 days (phase 2), and 31 to 60 days (phase 3) after the infarction. Left ventricular ejection fraction by radionuclide ventriculography was also determined in phase 2. The signal-averaged ECG was abnormal during one or more of the three phases in 51 patients (31%). ⋯ None of these 11 patients had an arrhythmic event. Stepwise logistic regression showed that an abnormal signal-averaged ECG in phase 2 has the most significant relation to late arrhythmic events. Both an abnormal signal-averaged ECG and a left ventricular ejection fraction less than 40%, but not complex ventricular arrhythmias, were independent significant risk factors for late arrhythmic events.(ABSTRACT TRUNCATED AT 250 WORDS)
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American heart journal · Aug 1989
Young adult survivors of sudden cardiac arrest: analysis of invasive evaluation of 22 subjects.
Twenty-two young adult (mean age 27.8 +/- 5.3 years) survivors of sudden cardiac arrest underwent invasive cardiac assessment. Initial evaluation by cardiac catheterization, coronary angiography, and hemodynamic studies identified two groups of young survivors. The first consisted of 13 (60%) subjects who had definable structural cardiac or lung disease accountable for a cardiac arrest event. ⋯ Electrophysiologic testing demonstrated in three of these patients the presence of Wolff-Parkinson-White syndrome. The electrophysiologic studies had a higher yield in reproduction of life-threatening arrhythmias among the subjects in the second group as opposed to the first group. The observation that 10 subjects (45%) from both groups had preceding symptoms varying from palpitations and chest pain to syncope and recurrent cardiac arrest events, is in contradiction to previous findings in the literature and raises a question of appropriate evaluation of young adults with cardiac symptoms.