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Impaired Negative Chronotropic Response to Adenosine in Patients with Inappropriate Sinus Tachycardia (2002)

STILL, AINO-MAIJA ; HUIKURI, HEIKKI V. ; AIRAKSINEN, K.E. JUHANI ; [et al.]

Oxford, UK : Blackwell Science Inc

Journal of cardiovascular electrophysiology 13 (2002), S. 0

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ISSN: 1540-8167

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Adenosine and Inappropriate Sinus Tachycardia. Introduction: Adenosine is an endogenous nucleoside that has an important role in the diagnosis and treatment of several cardiac arrhythmias. However, its effects on inappropriate sinus tachycardia (IST) are not well established. Methods and Results: In this study, the response to intravenous adenosine (0.1 to 0.15 mg/kg) was studied in 18 patients (age 46 ± 15 years) with IST. In a subset of patients (n = 5), the direct effects of adenosine were assessed during pharmacologic beta-adrenergic and cholinergic blockade. Atrial cycle length (ACL) was measured before adenosine injection, at the time of the greatest cycle length prolongation, and during the maximum rebound acceleration of heart rate. Eighteen subjects (age 46 ± 11 years) with normal sinus rhythm undergoing clinically indicated electrophysiologic study served as controls. Adenosine did not terminate IST in any patient. The maximum dose of adenosine prolonged the sinus interval significantly, from 780 ± 128 msec to 985 ± 225 msec (P 〈 0.001) in the control subjects. In contrast, adenosine caused no significant lengthening of atrial cycle length (527 ± 69 msec vs 590 ± 148 msec; P = NS) in the patients with IST. Similar difference in the response to adenosine was seen during the pharmacologic autonomic blockade. The reflex increase of the sinus rate (rebound effect) was greater in the control subjects than in the patients with IST (21.2% ± 9.7% vs 8.5% ± 8.8%; P 〈 0.001). Conclusion: The usual negative chronotropic effect of adenosine was impaired in the patients with IST. This may have important diagnostic implications and provide new insight into the mechanism(s) of IST.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1540-8167.2002.00557.x

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2

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Complications Related to Permanent Pacemaker Therapy (1999)

KIVINIEMI, MIKKO S. ; PIRNES, MARKKU A. ; ERÄNEN, H. JAAKKO K. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

Pacing and clinical electrophysiology 22 (1999), S. 0

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ISSN: 1540-8159

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: This study evaluates complications related to permanent endocardial pacing in the era of modern pacemaker therapy. There is only limited information available about the complications related to modern cardiac pacing. Most of the existing data are based on the 1970s and are no longer valid for current practice. The recent reports on pacemaker complications are focused on some specific complication or are restricted to early complications. Thus, there are no reports available providing a comprehensive view of complications related to modern cardiac pacing. Four hundred forty-six patients, who received permanent endocardial pacemakers between January 1990 and December 1995 at Kuopio University Hospital, were reviewed retrospectively using patient records. Attention was paid to the occurrence of any complication during the implantation or follow-up. An early complication was detected in 6.7%, and 4.9% of patients were treated invasively due to the early complication. Late complication developed in 7.2% and reoperation was required in 6.3% of the patients. Complications related to the implantation procedure occurred in 3.1%. Inadequate capture or sensing was observed in 7.4% of the patients. Pacemaker infection was detected in 1.8% and erosion in 0.9% of the patients. An AV block developed in 3.6% (1.6%/year) patients who received an AAI(R)-pacemaker due to sick sinus syndrome. There was no mortality attributable to pacemaker therapy. A great majority (68%) of the complications occurred within the first 3 months after the implantation. Complications associated to modern permanent endocardial pacemaker therapy are not in-frequent.Elevan percent of patients needed an invasive procedure due to an early or late complication.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1540-8159.1999.tb00534.x

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3

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Left ventricular function in dogs 1 year after coarctectomy (1991)

Leskinen, Markku ; Uhari, Matti ; Tarkka, Matti ; [et al.]

Springer

Pediatric cardiology 12 (1991), S. 150-154

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ISSN: 1432-1971

Keywords: Coarctation ; Ventricular function ; Time intervals ; Loading

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary Juxtaductal aortic coarctation was surgically created in beagle puppies at the age of 2 months and resected at the age of 10 months, after the development of good collateral circulation. Control dogs undergoing sham operations on each occasion were studied in the same environment. Cardiac catheterization was performed 1 year after the coarctectomy to evaluate the recovery of the heart. Cardiac output, heart rate, end-diastolic pressure, andV max were similar in both groups of seven dogs, but the systolic pressure gradient (SPG) over the operated area during isoproterenol infusion was significantly higher in the coarctectomized group, with a mean of 8.9±6.3 (SD) vs. 0.1±0.3 mmHg (p〈0.05). The preejection period [PEP, 58±8 vs. 47±5 ms (p〈0.01)], electromechanical delay [EMD, 18±3 vs. 13±3 ms (p〈0.05)], and isometric contraction time [ICT, 39±7 vs. 32±4 ms (p〈0.05)], were all significantly longer in the coarctation group after isoproterenol infusion. The results demonstrate that, even though cardiac output increased adequately during loading and mechanical pumping efficiency was preserved, excitation-contraction coupling was still prolonged. Thus, an anatomical successful coarctectomy, even at the age of 10 months, does not fully restore left ventricular function in dogs after chronic experimental coarctation.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF02238521

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4

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Anabolic steroids alter the haemodynamic effects of endurance training on the canine left ventricle (1987)

Rämö, Pauliina ; Kettunen, Raimo ; Timisjärvi, Jouni ; [et al.]

Springer

Pflügers Archiv 410 (1987), S. 272-278

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ISSN: 1432-2013

Keywords: Treadmill exercise ; Cardiac catheterization ; Ventricular volumes ; Contraction mechanics

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract The effects of six week, high-dose anabolic steroid treatment (methandienone, 1.5 mg/kg/day) on the changes in left vetricular function induced in dogs by endurance training were studied by a catheterization technique under anaesthesia. Pacing, isoproterenol and dextran infusions were used as loading tests (respectively). Dogs were randomized into an exercise group (EG,n=7) and an exercise-steroid group (ESG,n=7), the latter receiving anabolic steroids as well as participating in the training program. In a standardized submaximal exercise test, the heart rate of unanaesthetized dogs was lower both in the EG (p〈0.001) and in the ESG (p〈0.01) after the training period than before it. In the EG the resting systemic vascular resistance (SVR) before haemodynamic interventions was lower (p〈0.05) and left ventricular stroke work (SW) was higher (p〈0.05) after the training period than before. In the ESG, left ventricular ejection fraction (EF) decreased with training and anabolic steroid treatment (p〈0.05). After the training period isoproterenol increased the maximum velocity of the cardiac contractile element significantly more (p〈0.05) in the EG than in the ESG. Also SW increased in the EG (29%,p〈0.001), but not in the ESG (−11%, NS). Endurance training increased the left ventricular end-diastolic and stroke volumes during isoproternol infusion, but this training effect was attenuated by simultaneous anabolic steroid treatment (p〈0.05 between the groups in both case). During the isoproterenol test SVR decreased less in ESG than in EG (p〈0.05 between). In volume loading tests, the ESG worked on a higher level of stroke work at a given end-diastolic volume when compared to the EG (p〈0.001). This was related to a higher mean aortic ejection pressure and systemic vascular resistance measured in the ESG. In conclusion, the improved cardiac performance and peripheral adaptation after endurance training are partly attenuated by the simultaneous use of anabolic steroids in dogs.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00580276

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5

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Bendel, Stepani ; Kettunen, Raimo ; Hartikainen, Juha ; [et al.]

Springer

European journal of nuclear medicine 26 (1999), S. 1304-1309

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ISSN: 1619-7089

Keywords: Key words: Coronary bypass operation ; Perfusion ; Single-photon emission tomography ; Viability

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract. To study its usefulness as a tracer for assessment of the perfusion and viability of myocardium, 15-(p-iodophenyl)pentadecanoic acid (IPPA) was compared with technetium-99m sestamibi (MIBI). Dual-tracer single-photon emission tomography rest imaging was performed no more than 2 months before and 3 months after coronary artery bypass grafting in 28 patients with previous anterior (n=13) or inferior (n=15) infarction. The size of MIBI and IPPA defects decreased from 14%±12% and 13%±9% to 10%±11% and 9%±7%, respectively (P〈0.001 for both). The MIBI uptake increased in the infarct zones from 35%±11% to 43%±8% (P〈0.001), and in the peri-infarct zones from 50%±11% to 55%±10% (P〈0.05). The IPPA uptake increased in the infarct zones from 37%±11% to 44%±13% (P〈0.001), and in the peri-infarct zones from 51%±11% to 57%±12% (P〈0.05). In nine patients with improved regional echocardiographic wall motion score after bypass surgery, the pre-operative uptake values of both MIBI and IPPA in the infarct and peri-infarct zones were on average slightly but not significantly higher than in 19 patients with no observed improvement in regional wall motion score. In patients with improved regional wall motion, the MIBI scans and the IPPA scans showed (non-significant) decreases in defect size and increases in infarct and peri-infarct zone uptake after bypass surgery. Similar (in some cases significant) changes were observed in the patients without improvement in wall motion. Thus IPPA and MIBI provided similar information about perfusion and viability in pre- and postoperative evaluation of patients with clinically evident myocardial infarction and with normal global ejection fraction. Regardless of the tracer used, the resolution capability of the dual-tracer method with a rest imaging protocol was not sufficient to differentiate viable from non-viable infarction defects in unselected individual patients with a normal ejection fraction.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/s002590050587

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6

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Cardiac adrenergic denervation in patients with non-Q-wave versus Q-wave myocardial infarction (2000)

Simula, Sakari ; Lakka, Timo ; Laitinen, Tomi ; [et al.]

Springer

European journal of nuclear medicine 27 (2000), S. 816-821

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ISSN: 1619-7089

Keywords: Key words: Myocardial adrenergic innervation ; Myocardial infarction ; Metaiodobenzylguanidine

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract. In spite of smaller infarct size and better preserved left ventricular function the long-term prognosis after a non-Q-wave infarction is not better than after a Q-wave infarction. In fact, the risk of sudden cardiac death is higher in patients with a non-Q-wave infarction than in patients with a Q-wave infarction. One possible reason for postinfarction arrhythmias is cardiac adrenergic denervation resulting from myocardial infarction. In this study we compared cardiac adrenergic innervation after non-Q-wave and Q-wave infarctions. Single-photon emission tomography using iodine-123 metaiodobentzylguanidine (MIBG) and technetium-99m sestamibi (MIBI) tracers were conducted in order to compare cardiac adrenergic denervation and myocardial perfusion in 12 patients with a non-Q-wave infarction and 15 patients with a Q-wave infarction. MIBG and MIBI defects were determined as regional uptake ≤30% of maximal myocardial activity. The size of MIBI defects calculated as a percentage of left ventricular mass was significantly smaller in patients with a non-Q-wave infarction than in patients with a Q-wave infarction (4%±3% vs 9%±7%, P〈0.05, respectively). According to the maximal serum creatine kinase activity, less myocardium was damaged in patients with a non-Q-wave infarction than in patients with a Q-wave infarction (502±436 IU/l vs 1878± 1265 IU/l, P〈0.001). In spite of this, the extent of MIBG defects was similar in patients with a non-Q-wave and patients with a Q-wave infarction (21%±18% vs 23%± 12%, respectively). In addition, the size of MIBG defect correlated with the infarct size (maximal creatine kinase activity) (r=0.52, P〈0.05) after a Q-wave infarction but not after a non-Q-wave infarction. In conclusion, despite a smaller infarct size in non-Q-wave infarct patients, the extent of cardiac adrenergic denervation was similar in patients with a non-Q-wave and patients with a Q-wave infarction. In addition, the extent of cardiac adrenergic denervation was related to the infarct size in patients with a Q-wave infarction but not in patients with a non-Q-wave infarction.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/s002590000278

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7

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Effects of training and anabolic steroids on collagen synthesis in dog heart (1991)

Takala, Timo E. S. ; Rämö, Pauliina ; Kiviluoma, Kai ; [et al.]

Springer

European journal of applied physiology 62 (1991), S. 1-6

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ISSN: 1439-6327

Keywords: Anabolic steorids ; Exertion ; Collagen ; Heart

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary The effects of endurance training and anabolic steroid (Methandienone 1.5 mg · kg−1 p. o. daily) and their combination on regional collagen biosynthesis and concentration in the hearts of male beagle dogs were studied by measuring prolyl 4-hydroxylase (PH) activity and hydroxyproline (HYP) concentration. The PH (P〈0.05) and HYP (P〈0.05) were both greater in the subendocardinal layer than in the subepicardium (EPI) of the left ventricular wall in controls, whereas opposite gradients (P〈0.05) were observed in the right ventricle. Endurance exercise caused an increase of PH activity in EPI of the left ventricular wall (P〈0.01). The HYP concentration increased in both layers of the right ventricle in the exercise plus steroid group (P〈0.05). The results suggest that transmural differences exist in the rate of collagen synthesis and concentration in canine cardiac ventricles and that endurance exercise may accelerate collagen synthesis in EPI of the left ventricle and the combination of exercise and anabolic steroid causes an increase in collagen concentration in the right ventricular wall.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00635624

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