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  • 1
    ISSN: 1432-1971
    Keywords: Duchenne muscular dystrophy ; Late potential ; Signal-averaged ECG ; Ventricular arrhythmia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relationship between late ventricular potentials (LP) and myocardial ischemic changes or ventricular arrhythmias was investigated in patients with Duchenne muscular dystrophy (DMD). Twenty-six DMD patients aged 10–33 years (mean 18.2 years) and 27 agematched healthy volunteers were studied. Ventricular arrhythmias were detected by 24-h Holter ECGs and LPs were determined using signal-averaged ECGs. In DMD patients filtered QRS duration, late duration, and low-amplitude signal under 40 μV were significantly prolonged compared with those of the controls. The root mean square voltage of the f-QRS complex in the last 40 ms was lower in DMD patients than in the controls. None of the control subjects had LP. However, LP was detected in 8 (31%) of the 26 DMD patients. The patients with LP had more frequent ST-T depression and ventricular arrhythmias than the patients without LP. LP had 60% sensitivity and 87% specificity for documented ventricular arrhythmias. It is concluded that LP in DMD patients indicates the presence of substrate for ventricular arrhythmias associated with local myocardial fibrosis, and is useful in identifying those at high risk for malignant ventricular arrhythmias.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2013
    Keywords: Key words Acidosis ; Smooth muscle ; Coronary artery ; Ca2+-activated K+ channels
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Although acidosis induces vasodilation, the vascular responses mediated by large-conductance Ca2+-activated K+ (KCa) channels have not been investigated in coronary artery smooth muscle cells. We therefore investigated the response of porcine coronary arteries and smooth muscle cells to acidosis, as well as the role of KCa channels in the regulation of muscular tone. Acidosis (pH 7.3–6.8), produced by adding HCl to the extravascular solution, elicited concentration-dependent relaxation of precontracted, endothelium-denuded arterial rings. Glibenclamide (20 µM) significantly inhibited the vasodilatory response to acidosis (pH 7.3-6.8). Charybdotoxin (100 nM) was effective only at pH 6.9–6.8. When we exposed porcine coronary artery smooth muscle cells to a low-pH solution, KCa channel activity in cell-attached patches increased. However, pretreatment of these cells with 10 or 30 µM O, O′-bis(2-aminophenyl)ethyleneglycol-N,N,N′,N′-tetraacetic acid tetrakis(acetoxymethyl)ester (BAPTA-AM), a Ca2+ chelator for which the cell membrane is permeable, abolished the H+-mediated activation of KCa channels in cell-attached patches. Under these circumstances H+ actually inhibited KCa channel activity. When inside-out patches were exposed to a [Ca2+] of 10–6 M [adjusted with ethyleneglycolbis(β-aminoethylester)-N,N,N′,N′-tetraacetic acid (EGTA) at pH 7.3], KCa channels were activated by H+ concentration dependently. However, when these patches were exposed to a [Ca2+] of 10–6 M adjusted with BAPTA at pH 7.3, H+ inhibited KCa channel activity. Extracellular acidosis had no significant direct effect on KCa channels, suggesting that extracellular H+ exerts its effects after transport into the cell, and that KCa channels are regulated by intracellular H+ and by cytosolic free Ca2+ modulated by acute acidosis. These results indicate that the modulation of KCa channel kinetics by acidosis plays an important role in the determination of membrane potential and, hence, coronary arterial tone.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1615-2573
    Keywords: Azygos continuation ; Omphalocele ; Subaortic innominate vein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report an unusual form of absence of the inferior vena cava (IVC) in a patient with a repaired omphalocele. Two sets of bilateral paravertebral veins served as the channels of systemic venous return from the lower half of the body. These veins were narrower than typical azygos or hemiazygos continuation in the absence of the IVC, with the result that a catheter from the femoral vein could not reach the right atrium (RA). Other associated venous-side anomalies were present, including a chamber between the hepatic vein (HV) and RA, narrowing and angulation at the junction between the HV and the chamber, and a subaortic innominate vein. All these anomalies were demonstrated by two-dimensional and color Doppler echocardiography. The recognition of these venous anomalies is important for cardiac catheterization or IVC cannulation for cardiopulmonary bypass in patients with omphalocele.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1615-2573
    Keywords: Tetralogy of Fallot-Intracardiac repair-Treadmill test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Exercise performance was examined in 14 patients with a prior history of surgical repair for tetralogy of Fallot. Using a Bruce protocol, we evaluated the time course of oxygen uptake and heart rate in these patients and compared them with a standard curve obtained from 63 sex- and age-matched healthy children. Five of the 14 patients had unusual findings. The heart rate increased rapidly in four of them, while the oxygen uptake increased gradually (95% confidence lower limit). It is hypothesized that a reduction in stroke volume during exercise was responsible for these abnormal findings. The remaining unusual finding was in a patient who was known to have myocardial fibrosis and vacuolization. In this particular case, the time course of oxygen uptake and heart rate were both below the 95% coefficient of variation from the beginning to the end of exercise. In patients who have undergone surgical repair for tetralogy of Fallot, the analysis of oxygen uptake time course and the heart rate may provide valuable information for the longterm follow-up.
    Type of Medium: Electronic Resource
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