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  • 1
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Slow pathways are used as both antegrade and retrograde conduction pathway in slow/slow atrioventricular nodal reentrant tachycardia (SS-AVNRT), and patients with SS-AVNRT have tachycardia ECGs mimicking atrioventricular reentrant tachycardia using concealed posteroseptal accessory pathway (PS-AVRT). Therefore, SS-AVNRT can be misdiagnosed as PS-AVRT, and the differential diagnosis is clinically important. Standard 12-lead ECGs during tachycardia were analyzed in patients with SS-AVNRT (n = 10) and PS-AVRT (n = 10). All these patients were diagnosed by electrophysiological study and underwent successful catheter ablation. Differences of the RP' intervals (dRP') between V1 and the inferior leads were evaluated. SS-AVNRT had significantly longer RP' intervals measured in V1 (167 ± 25.2 vs 137 ± 26.8 ms, SS-AVNRT vs PS-AVRT, respectively, P = 0.02), longer dRP' between V1 and II (dRP'[V1-II], 37 ± 14 vs 17 ± 6.7 ms, P = 0.0007), longer dRP'[V1-III] (39 ± 14 vs 17 ± 9.9 ms, P = 0.0011), and longer dRP'[V1-aVF] (39 ± 13 vs 20 ± 9.5 ms, P = 0.0008). The following criteria were suggested for differential diagnosis of SS-AVNRT from PS-AVRT: dRP'[V1-II] 〉25 ms (sensitivity and specificity: 80% and 100%, respectively), dRP'[V1-III] 〉23 ms (90% and 90%), dRP'[V1-aVF] 〉30 ms (90% and 90%). Differences of the RP' intervals between V1 and the inferior leads in the tachycardia ECGs were useful for differential diagnosis of SS-AVNRT from PS-AVRT. (PACE 2003; 26:2296–2300)
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Fasciculoventricular (FV) pathways are rare variants of preexcitation, and their ECGs may be misinterpreted as Wolff-Parkinson-White syndrome with anteroseptal accessory pathways (WPW-AS). We analyzed the electrocardiographic characteristics of the patients with FV pathways to find out the different findings from WPW-AS. Methods and Results: Five patients with FV pathways and four patients with WPW-AS who underwent electrophysiologic studies were evaluated. Intervals and amplitudes of each wave and QRS morphologies were analyzed in standard 12-lead ECGs of these patients by two independent cardiologists without the information of the electrophysiologic findings. PR intervals were longer in FV pathways (122 ± 11.0 vs 83 ± 21 ms, FV pathways vs WPW-AS, P = 0.017). In lead V1, narrower width of R waves (25 ± 6 vs 45 ± 13 ms, P = 0.037) and smaller amplitude of S waves (12.8 ± 8.3 vs 26.6 ± 7.4 mm, P = 0.037) were observed in FV pathways. The polarity of delta waves in V1 was flat or negative in contrast with the cases of WPW-AS in which the polarity was positive. Three of five patients had notching in the descending limb of S waves in V1, which was not observed in WPW-AS. Conclusion: FV pathways have different ECG characteristics from WPW-AS in PR interval and morphology of QRS complexes in lead V1 of the standard 12-lead ECG.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. The present study was undertaken to determine whether endothelial function or morphology was altered in aortic rings of rats after irradiation, to investigate the mechanism of radiation effects on the endothelium and to examine the effect of vitamin C treatment against radiation-induced damage of the endothelium.2. Female Sprague-Dawley rats were randomized into four groups (control, radiation, radiation + vitamin C, radiation + vitamin C + NG-nitro-L-arginine methyl ester (L-NAME); n = 10 for each group and n = 7 for the control group) and were irradiated with 10 Gy of 137Cs as a radiation source. Segments of the thoracic aorta were obtained and isometric tension, levels of 8-hydroxydeoxyguanosine (OH-dG) and immunohistochemical staining were measured.3. Irradiation significantly impaired the acetylcholine-induced vasodilation of aortic segments, an effect that could be prevented by pretreatment with vitamin C (500 mg/kg per day). This beneficial effect of vitamin C was abolished by the addition of L-NAME (100 μg/kg per day), an inhibitor of nitric oxide (NO) synthesis. Irradiation significantly increased the level of OH-dG in the aorta (1.02 ± 0.27 vs 2.61 ± 0.78 OH-dG/105 deoxyguanosine (dG) for control and irradiated tissues, respectively; P 〈 0.01), an increase that was prevented by vitamin C treatment (1.59 ± 0.23 OH-dG/105 dG; P 〈 0.01). Irradiation caused significant de-endothelialization (von Willebrand factor (vWF) staining was 93 ± 7 vs 100% in irradiated and control tissues, respectively; P 〈 0.05) and this was prevented by vitamin C treatment (vWF staining 98 ± 3%; P 〈 0.05).4. Radiation caused endothelial damage and impaired NO production through oxidative injury, resulting in a selective impairment of endothelial-dependent vasodilation that could be prevented by vitamin C, partly through anti-oxidant mechanisms.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 598 (1990), S. 0 
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1435-1803
    Keywords: Key words Mitochondrial DNA – deletions – cardiomyopathy – aging – human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Mitochondrial DNA (mtDNA) mutations are not only responsible for organ dysfunction due to inefficient energy production but also indicators of metabolic and functional stresses in the organ. To analyze the significance of deletion mutation in human myocardium, we screened the presence of two common deletions (7.4 kb from 8637–16084 nt, 5.0kb from 8470–13477 nt) in four chambers using long PCR, and using serial-dilution PCR, measured the amount of deleted mtDNA in normal heart (NL) of brain-dead victims of road accidents (n = 9, age = 10–59) and failing hearts (CHF) of patients who underwent heart transplantation (n = 24, age = 17–63). Frequency of both deletions was higher in ventricles (Vt) than in atria (At) (Vt: At = 25/33 : 12/33 for 7.4 kb, 19/33 : 6/33 for 5 kb) (p 〈 0.05), whereas it was the same in the right and left chambers. In ventricles, both deletions were more frequent among older persons (〉 35 yrs) than in younger persons /≤ 35 yrs) (older : younger = 16/20 : 9/13 for 7.4 kb, 15/20 : 4/13 for 5 kb) (p 〈 0.05). In ventricles of failing heart, the 5-kb deletion was more frequent than in those of normal heart (CHF : NL = 17/24 : 2/9) (p 〈 0.05), whereas the 7.4-kb deletion was frequent both in failing and normal hearts (CHF : NL = 19/24 : 6/9). The association of mutation with aging or disease process observed in ventricles was not found in the atria. Although the amount of mutant mtDNA in the left ventricle tended to increase according to a disease process, it was small, at most 1.56% or 0.012% of total mtDNA for a 7.4- or 5-kb deletion, respectively. No deletion was found, however, in lymphocytes from any patient who underwent transplantation. In conclusion, deletion mutation of mtDNA is frequently, but in a small amount, found in the ventricle of older failing heart than in the atrium of younger normal heart. This suggests that hemodynamic stress, age, and disease are factors to induce mtDNA mutation that represents the indicator of stresses on the heart and might turn into a contributor of progressive heart failure under extreme conditions.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1615-2573
    Keywords: Takayasu arteritis ; Aortography ; Coronary angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Clinical and angiographic features of Takayasu arteritis were investigated in 129 Korean patients. This disease affects females more frequently than males, in a ratio of 6.6 to 1. Of the total number of patients, 51 were in the third decade, 27 in the fourth decade, and 23 in the second decade. Common clinical symptoms were headache (60%), exertional dyspnea (42%), dizziness (36%), and malaise or weakness (34%). Takayasu arteritis affected the abdominal aorta (46%) and descending thoracic aorta (37%) more frequently than the ascending aorta (1%) and aortic arch (2%) According to Ueno's classification based on aortographic findings, the 129 patients were divided into type I (37), type II (25), and type III (67). Among the 48 patients who had coronary angiography, 11 (23%) showed coronary arterial involvement. Because the clinical features are determined by the extent and severity of the specific artery involved in the occlusive phase of the disease, total aortography including coronary angiography is very important in the initial evaluation of Takayasu arteritis.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1619-7089
    Keywords: Key words: Thallium-201 gated single-photon emission tomography – Quantification – Ventricular volume – Ejection fraction – Reproducibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We investigated the reproducibility between thallium-201 and technetium-99m methoxyisobutylisonitrile (MIBI) gated single-photon emission tomography (SPET) for the assessment of indices of myocardial function such as end-diastolic and end-systolic volume (EDV, ESV), ejection fraction (EF) and wall motion. Rest 201Tl (111 MBq) gated SPET was sequentially performed twice in 20 patients. Rest 201Tl gated SPET and rest 99mTc-MIBI (370 MBq) gated SPET were performed 24 h apart in 40 patients. Wall motion was graded using the surface display of the Cedars quantitative gated SPET (QGS) software. EDV, ESV and EF were also measured using the QGS software. The reproducibility of functional assessment on rest 201Tl gated SPET was compared with that on 99mTc-MIBI gated SPET, and also with that between 201Tl gated SPET and 99mTc-MIBI gated SPET performed on the next day. The two standard deviation (2 SD) values for EDV, ESV and EF on the Bland-Altman plot were 29 ml, 19 ml and 12%, respectively, on repeated 201Tl gated SPET, compared with 14 ml, 11 ml and 5.3% on repeated 99mTc-MIBI gated SPET. The correlations were good (r=0.96, 0.97 and 0.87) between the two measurements of EDV, ESV and EF on repeated rest studies with 201Tl and 99mTc-MIBI gated SPET. However, Bland-Altman analysis revealed that the 2 SD values between the two measurements were 31 ml, 23 ml and 12%. We were able to score the wall motion in all cases using the 3D surface display of the QGS on 201Tl gated SPET. The kappa value of the wall motion grade on the repeated 201Tl study was 0.35, while that of the wall motion grade on the repeated 99mTc-MIBI study was 0.76. The kappa value was 0.49 for grading of wall motion on repeated rest studies with 201Tl and 99mTc-MIBI. In conclusion, QGS helped determine EDV, ESV, EF and wall motion on 201Tl gated SPET. Because the EDV, ESV and EF were less reproducible on repeated 201Tl gated SPET or on 201Tl gated SPET and 99mTc-MIBI gated SPET on the next day than on repeated 99mTc-MIBI gated SPET, functional measurement on 201Tl gated SPET did not seem to be interchangeable with that on 99mTc-MIBI gated SPET.
    Type of Medium: Electronic Resource
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