No abstract available.
Myocardial Infarction*

No abstract available.

No abstract available.
Fibrinolytic Agents*

No abstract available.
Death, Sudden, Cardiac*

In order to define the relation between echocardiographically determined left atrial size and atrial fibrillation(AF) in rheumatic mitral valvular heart disease, 44 patients with mitral valvular heart disease with AF, 29 patients with mitral valvular heart disease without AF, 24 patients with idiopathic AF and 24 normal controls were studied. In mitral valvular heart disease with AF group, AF was more common when the absolute left atrial internal diameter(LAID) was above 50 mm(86.4%) than in mitral valvular heart disease without AF group(41.4%). In addition, although the values of LAID, LA(left atrium)/Aortic Root ratio and LA/BSA(body surface area) are higher in mitral valvular heart disease with AF group than in mitral valvular heart disease without AF group(p<0.05), there was no correlation between LAID and BSA(r=0.06). These findings suggest that an absolute value of LAID is a more important factor in the development of AF in mitral valvular heart disease than LAID considered in conjunction with BSA and that an absolute LAID of 50 mm may be used as a reliable guide to therapeutic and prophylactic intervention in AF associated with mitral valular heart disease.
Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans

Fiftyeight patients with cardiac neurosis were studied to evaluate the effects of Carteolol 10mg/day. Systolic blood pressure was declined to 122.7+/-17.2mmHg from 137.1+/-23.2mmHg, diastolic blood pressure was declined to 79.6+/-11.1mmHg from 88.2+/-17.5mmHg. Pulse rate was decreased from 83.0+/-10.2 to 73.9+/-6.8per minute. The most frequent subjective symptom was palpitation (74.1%) and effectiveness of therapy for subjective symptom was 91.4%, for usefulness was 93.1%. There was no significant serious side reaction observed. We concluded that Carteolol therapy for the patients with cardiac neurosis could be useful and safe with a small dosage.
Blood Pressure ; Carteolol* ; Heart Rate ; Humans ; Neurocirculatory Asthenia*

Intravascular injection of hydrogen peroxide produces oxygen microbubbles suitable for echocardiographic contrast enhancement. To evaluate the effect of a method of myocardial contrast 2-D-echocardiographic delineation of myocardium during acute coronary occlusion, injection of a fresh mixture of 2ml of 0.2% H2O2 and 1ml of heparinized dog blood into aortic root were made in 12 poenchest dogs 10 minutes after occlusion of left anterior descending coronary artery distal to the first diagonal branch and left ventricular short axis 2-D echocardiographic images at the midpapillary muscle level were obtained. On injection of H2O2 blood mixture normally perfused myocardium was enhanced in echodensity but the area of malperfusion did not change in echodensity. The borderlines between the area of normal perfusion and malperfusion was well delineated. The malperfused area measured at mid papillary muscle level by planimetry area method was 29.7+/-6.0% and 32.6+/-6.7% by endocardial circumferential length method. There was a linear correlation between planimetric estimate of area of malperfusion by H2O2 contrast echocardiography and visual determination of regional wall motion abnormality by 2-D echocardiography(r=0.93, P<0.001). There was no change in heart rate before, during and after H2O2 injection. Infection of H2O2 blood mixture caused bradycardia(8.3%), second degree A-V block(16.6%) and ventricular fibrillation(8.3%). H2O2 clearance was achieved in 3-10 minutes. These findigs suggest that H2O2 enhanced myocardial contrast ehocargiography using 2ml of 0.2% H2O2 and 1ml of blood muxture is an accurate, reproducible, real-time in vivo method of quantifying the extent of myocardial perfusion defect during acute coronary occlusion in dog.
Animals ; Axis, Cervical Vertebra ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Echocardiography* ; Heart Rate ; Heparin ; Hydrogen Peroxide* ; Hydrogen* ; Microbubbles ; Myocardium ; Oxygen ; Papillary Muscles ; Perfusion*

To assess the efficacy of amiodarone on chronic atral fibrillation(AF) and to evaluate the relation between the ability to convert AF to sinus rhythm (SR) with amiodarone therapy and left atrial(LA) size and atrial fibrillatory wave forms, 22 patients with AF, aged 40 to 60 years(mean 47.5 years), were studied. Nine patients(40.9%) had mitral valvaular heart disease, 6(27.3%) hypertension, 5(18.2%) lone AF and 2 (9.1%) cadiomyopathy. Amiodarone therapy with either 600mg for 1 week, 200mg for 4 weeks in 5 consecutive patients, or 800mg for 1 week, 400mg for 4 weeks and 200mg for 6 weeks in 17 patients, converted AF to SR in 9(40.9%) patients 3 to 6 weeks after amiodarone was started on. In either group, patients who achieved conversion had smaller LA size(mean 43.7mm) than those who failed conversion(mean50.2mm)(P<0.05). Those who had LA size less than 45mm achieved conversion of AF to SR in 70%, comparing to 16.7% in patients with LA size more than 46mm(P<0.05). Among patients who achieved conversion, LA size was less than 46mm in 77.8% comparing to 23.1% in patients who failed conversion on Amiodarone. Those with coarse AF(46.2mm), althogh the difference was not significant statistically. There was no converstion in patients with LA size greater then 58mm and in patients with coarse AF who concomittantly had MVD. These findings suggest that the efficacy of amiodarone was related to LA size, and to the atrial fibrillation wave form in patients with mitral valvular heart disease.
Amiodarone* ; Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans ; Hypertension

Aggressive treatment of hypertension has been proved to reduce morbidity and mortality. Data from recent clinical trials indicate that, for all stages of hypertension, the target BP should be a maximum BP <140/90 mmHg, with diastolic BP values as low as 70 mmHg. For patients with diabetes mellitus or chronic renal disease, this target value should be even lower, <130/80 mmHg. As significant morbidity and mortality attributable to hypertension occur in patients who are not diagnosed as having hypertension but whose blood pressure is in prehypertension range, 120~139/80~89 mmHg, lowering BP levels in this group is recommended as well, with lifestyle modification or drug therapy for some indicated patients being first-line therapy. Because controlling BP to <140/90 mmHg often requires use of two or more agents, selection of drugs for combination therapy should be based not only on antihypertensive efficacy, but also on compelling indications and tolerability of the regimens. This review presents the latest findings on the antihypertensive therapy and emphasizes the importance of decreasing BP per the JNC-7 guidelines.
Blood Pressure ; Diabetes Mellitus ; Drug Therapy* ; Humans ; Hypertension ; Life Style ; Mortality ; Prehypertension ; Renal Insufficiency, Chronic

To investigate frequency of painful and/or silent myocardial ischemia(SMI) determined by ECG ST-segment depression(more than 1.0mm depression for 0.08 second after J point over 60 seconds) during unrestricted daily activities, 24-hour dynamic ECG was performed in 19 patients(11 males, 8 females) with chronic stable angina pectoris, aged 57.4 years(44 to 73 years). During 456 hours of recording, there were 154 episodes of SMI. Of these, 139 episodes(90.3%) were silent and 15 episodes(9.7%) accompaned chest pain. The higher incidence of SMI than previously published data is probably influenced by 1 patient who disclosed 56 episodes (excluding this, SMI 84.7%). Sixty one percent of episodes of SMI occurred during light activities such as slow walk, hand labor, eating or at rest(sitting at ease), smoking and sleep, and 39% during more strenuous activites such as walk, climbing stairs and physical exercise. In contrast, most of the painful myocardial ischemia(PMI) developed during climbing stairs, walk and physical exercise. Heart rate during episodes of SMI varied ranging from 85.2+/-13.7/min at rest to 115.5+/-19.2/ min druing climbing stairs. Mean ST-segment depressions during episodes of SMI and PMI were 2.0(1.0-4.0)mm and 2.6(1.2-7.0)mm, respectively, in 6 patients who disclosed both SMI and PMI on 24-hour ECG recordings. However, frequency of ischemic episodes was higher(9.0 vs 2.5/day) and duration was longer(13.8min vs 3.0min) in SMI. These findings indicate that transient SMI in patients with chronic stable angina pectoris occurs more frequently than painful myocardial ischemia. In addition, SMI develops during activities that increase heart rate(increased O2 demand) as well as during activites that do not increase heart rate(decreased O2 supply). Therefore, both O2 demand and supply mechanisms may be involved in the pathogenesis of transient SMI in Patients with chronic stable angina pectoris.
Angina, Stable* ; Chest Pain ; Depression ; Eating ; Electrocardiography ; Exercise ; Hand ; Heart ; Heart Rate ; Humans ; Incidence ; Male ; Myocardial Ischemia* ; Smoke ; Smoking