Japanese heart journal
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Japanese heart journal · Jan 2003
Effects of smoking on pulmonary functions and arterial blood gases following coronary artery surgery in Turkish patients.
The effects of smoking on postoperative lung volumes, arterial blood gas tensions, and pulmonary complications were studied prospectively in 213 consecutive Turkish patients undergoing elective coronary artery bypass graft surgery. One hundred and seventeen patients were current smokers (19 females, 98 males, mean age. 59.0 +/- 6.1 years. group 1) and 96 were nonsmokers (40 females, 56 males mean age. 59.6 +/- 5.8 years, group 2). Demographic data and the anesthesia and surgical methods were similar in both groups. ⋯ As a result. we revealed that cigarette smoking affects pulmonary functions by causing obstructive type respiratory problems and by worsening existing restrictive type respiratory problems postoperatively. The postoperative deterioration in blood gas measurements of smokers was also statistically significant compared with nonsmokers. In addition, the incidence of pulmonary complications in smokers was 2-fold greater than in nonsmokers and was related to the number of cigarettes consumed daily, leading to prolongation of the postoperative intubation period, and ICU and hospital stays.
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Japanese heart journal · May 2002
Case ReportsA subacute left ventricular free wall rupture after thrombolytic and glycoprotein IIb/IIIa inhibitor treatment: an overlooked finding of left ventriculography.
Subacute left ventricular free wall rupture is a rare complication in acute myocardial infarction. With the increasing use of thrombolytic agents and glycoprotein IIb/IIIa inhibitors, this complication has been increasing recently. We report a case of subacute cardiac rupture with frank pericardial effusion receiving thrombolytic and glycoprotein IIb/IIIa inhibitor therapies.
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Japanese heart journal · Mar 2002
Comparative StudyAssessment of diabetic autonomic neuropathy using twenty-four-hour spectral analysis of heart rate variability: a comparison with the findings of the Ewing battery.
A power spectral analysis of heart rate variability has been applied in order to assess diabetic autonomic neuropathy and high frequency spectra are thus considered to possibly reflect vagal nerve integrity in patients with diabetes mellitus. The purpose of this study was to investigate the relationship between the findings of high frequency spectra analysis and the results of the Ewing battery. We performed 24-hour power spectral analysis using an ambulatory ECG monitoring system and standard tests in order to assess diabetic autonomic neuropathy (Ewing battery) in 18 diabetic patients to compare their diagnostic values for diabetic autonomic neuropathy. ⋯ These values markedly decreased even in patients classified as having early vagal damage when compared with those classified as normal. High frequency spectra during night closely reflected the intrinsic vagal nerve integrity in patients with diabetes mellitus. High frequency spectra during night or a 24-hour period is a simple and sensitive measure of diabetic autonomic neuropathy and is considered to be a useful modality for detecting even early changes in autonomic dysfunction.
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Japanese heart journal · Sep 2001
Lengthening of intraatrial conduction time in atrial fibrillation and its relation with early recurrence of atrial fibrillation.
Intraatrial conduction delay in atrial fibrillation (AF) that is considered a component of atrial electrical remodeling has been demonstrated previously in experimental models and it is considered an important factor for the induction or stabilization of AF. However, it is not known if this phenomenon exists in human AF. The present study aimed to compare intraatrial conduction time (IACT) in patients with chronic atrial fibrillation who were converted to sinus rhythm and a matched control group, and to investigate its relation with early AF recurrence. ⋯ On the other hand, only IACT 2 patients with maintained sinus rhythm were found to be higher than those of the control group. The present study indicated that intraatrial conduction was disturbed in patients with AF, a finding which is consistent with those of previous experimental studies. Additionally, such a phenomenon may be a risk factor for the early recurrence of AF after cardioversion to sinus rhythm.
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Japanese heart journal · Mar 2001
Predictive risk factors for pulmonary oxygen transfer in patients undergoing coronary artery bypass grafting.
The ratio of arterial oxygen tension to inspired oxygen fraction (PaO2/FiO2) is a useful indicator for weaning patients from mechanical ventilation and a reliable predictor of pulmonary dysfunction after cardiac surgery. The aim of this study was to elucidate the patient characteristics and variables that affect the PaO2/FiO2 ratio. Between 1994-1998, 167 patients who underwent coronary artery bypass grafting (CABG) were examined retrospectively. Spearman's correlation coefficients were calculated between the PaO2/FiO2 ratio and intubation period, and length of ICU stay. Patients were then divided into two groups with a PaO2/FiO2 ratio < 350 and PaO2/FiO2 ratio > or = 350. Univariate analysis of the putative risk factors was performed. A logistic regression model was developed to evaluate factors that would influence the PaO2/FiO2 ratio. A significant correlation was observed between the PaO2/FiO2 ratio and intubation period, and length of ICU stay. Univariate predictors of a PaO2/FiO2 ratio < 350 were low body weight, low preoperative PaO2 long operation time, high FiO2, low postoperative PaO2 history of smoking, hypertension and opening of pleura (p < 0.05). Excellent prediction was found with a model consisting of preoperative PaO2 and hypertension. ⋯ The results of this study suggest that patients with a low preoperative PaO2 or hypertension may need more careful peri- and postoperative management since these factors are closely associated with the PaO2/FiO2 ratio.