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To evaluate the difference in left ventricular (LV) pump function during predischarge exercise testing between postmenopausal women and age-matched men with myocardial infarction, global and regional ejection fraction, LV end-diastolic volume, and the ratio of systolic blood pressure to LV end-systolic volume were investigated using radionuclide angiography in 25 postmenopausal women and 37 age-matched men. There were no significant differences in the resting radionuclide angiographic indexes between women and men. Global and regional ejection fraction of noninfarcted area, and the ratio of systolic blood pressure to LV end-systolic volume decreased at peak exercise in women, but these indexes increased in men. Although there was no significant difference in the amount of change in LV end-diastolic volume during exercise between the 2 groups, the amount of increase in LV end-systolic volume was significantly larger in women than in men. The ratio of systolic blood pressure to LV end-systolic volume had a curvilinear relation with LV end-diastolic volume at rest and peak exercise, but the ratio of systolic blood pressure to LV end-systolic volume was larger at any LV end-diastolic volume in men than in women during exercise. Thus, lower global ejection fraction and the ratio of systolic blood pressure to LV end-systolic volume during exercise in postmenopausal women compared with age-matched men indicate that gender may have played an important role in the LV remodeling process. (Am J Cardiol 1994;73:11-15)

To evaluate the difference in the process of left ventricular functional recovery after successful percutaneous transluminal coronary angioplasty (PTCA), 25 patients with sudden onset of acute Q wave anterior myocardial [...]

To elucidate the incidence and clinical factors related to the occurrence of pericardial effusion in infarction-associated pericarditis, 303 consecutive patients with their first Q-wave anterior myocardial infarction were examined carefully [...]

To assess the difference in left ventricular performance during exercise between anterior (11 patients) and inferior (10 patients) myocardial infarction (MI) of equivalent size, patients performed a supine bicycle exercise [...]

To evaluate the clinical characteristics of patients with anteroseptal myocardial infarction (MI) initially presenting with pulmonary edema, we analyzed 58 patients with anteroseptal MI who underwent emergency coronary arteriography that [...]

To investigate the serial changes of the infarcted and the noninfarcted areas, first-pass radionuclide angiocardiography was performed in 16 patients with uncomplicated anterior myocardial infarction (MI) at four weeks, one [...]

During recovery from dynamic exercise, systemic oxygen extraction rapidly decreases below the resting level in patients with heart failure, which leads to a subsequent increase in mixed venous oxygen saturation [...]

To evaluate whether PAF is related to the precipitation of pulmonary edema after myocardial ischemia, we studied the effect of a specific PAF antagonist, CV-6209, on the extravascular lung water [...]

Predictive Valve during Negative Low-Level Exercise Three Weeks Postinfarction To evaluate whether the response of left ventricular pump function during low-level exercise in the early postinfarction period can anticipate its [...]

To evaluate the difference in pulmonary gas exchange in patients with and without right ventricular infarction, 147 consecutive patients with their first inferior wall Q-wave acute myocardial infarction were studied. [...]

Many activities in daily life require a significant component of static muscular contraction, and isometric (static or sustained) exercise produces hemodynamic responses that are different from those of dynamic exercise. [...]

To assess the clinical significance of pericardial effusion in Q-wave inferior wall acute myocardial infarction, 185 consecutive patients were examined by means of electrocardiogram, echocardiogram and hemodynamic monitoring. A pericardial effusion was present in 44 patients and was absent in 141 patients. Electrocardiographic right ventricular infarction ([greater than or equal to]1 mm of ST-segment elevation and Q wave in [V.sub.4]R) was detected in 54 patients, with 20 patients having pericardial effusion. Patients with pericardial with effusion had significantly more left ventricular segments with advanced asynergy, lower cardiac output, higher pulmonary artery wedge pressure and higher incidence of right ventricular infarction than those without pericardial effusion. There were 17 inhospital deaths. Although there was no significant difference in the mortality rate between patients with and without right ventricular infarction, a significantly higher hospital mortality rate was observed in patients with pericardial effusion compared to those without it (23 vs 5%). Pericardial effusion was selected with age and pulmonary artery wedge pressure as important variables associated with hospital mortality by the discriminant analysis. Patients who developed pericardial effusion, regardless of right ventricular infarction, had more extensive myocardial damage, and hence, pericardial effusion was one of the predictors of increased hospital mortality.

Late potentials have been reported to be affected by body size or left ventricular mass. To our knowledge, however, the effect of subadipose tissue, which is known to influence QRS [...]

The interrelations of oxygen delivery ([DO.sub.2]), oxygen consumption ([VO.sub.2]) and hemoglobin-oxygen affinity assessed by [P.sub.50] were investigated in 43 patients with acute myocardial infarction. As [DO.sub.2] declined due to low cardiac output, a significant decrease in [VO.sub.2] (r = 0.75, p [is less than]0.001) and a significant increase in [P.sub.50] (r = -0.74, p [is less than]0.001) were observed. In the [DO.sub.2] range between 300 and 450 ml/min/[m.sup.2], in which the [DO.sub.2] of 32 survivors and 11 nonsurvivors overlapped, the [P.sub.50] of nonsurvivors was significantly higher than that of survivors (31.5 [+ or -] 1.6 vs 27.9 [+ or -] 1.5 torr, p [is less than]0.001), but there were no significant differences in any other oxygen transport variable. As a result of differences in [P.sub.50], [VO.sub.2] in this range was significantly higher in nonsurvivors compared to survivors (169 [+ or -] 17 vs 148 [+ or -] 13 ml/min/[m.sup.2], p [is less than]0.001). These data suggest that a normal or increased [VO.sub.2] alone does not ensure survival in patients with acute myocardial infarction, and increased [P.sub.50] leads to an increase in [VO.sub.2]. Nevertheless, the interpretation of an increased [P.sub.50] in patients with acute myocardial infarction must be made with caution, even with adequate [DO.sub.2] and [VO.sub.2], because it may imply a precarious oxygen transport/requirement balance in peripheral tissue and, hence, a fatal outcome. (Am J Cardiol 1989;64:975-979), Oxygen is necessary for the body's tissues and measurement of the amount of oxygen consumed by the heart (oxygen consumption, VO2) after a heart attack, or myocardial infarction (MI), is important for assessing the extent of damage. Under normal conditions the heart can adjust its metabolic rate to compensate for decreased supply if delivery of oxygen (DO2) to it is reduced. After certain acute illnesses, such as septic shock, however, it appears that VO2 remains dependent on DO2 as normal compensatory mechanisms fail. One mechanism that then comes into play is a decrease in hemoglobin-oxygen affinity, the measure of how tightly bound oxygen in the blood is to its carrier molecule, hemoglobin. If the hemoglobin-oxygen affinity decreases, oxygen detaches from its hemoglobin and is more readily available for use by oxygen-starved tissues. However, medical treatment aimed primarily at increasing both VO2 and DO2 - delivery of oxygen to the organ as a whole - may fail to take into account possible damage to the heart cells' metabolic machinery, which is no longer able to effectively use the excess oxygen it receives. To measure compensatory changes in hemoglobin-oxygen affinity (P50, which increases when affinity decreases) after an MI, 43 patients who had received treatment within 24 hours after the onset of chest pains were assessed by means of a catheter inserted into the pulmonary artery, which carries blood to the lungs after it has circulated through the body. Oxygen tension (a measure of the amount of oxygen in the blood relative to other gases in the blood), carbon dioxide tension, oxygen saturation (the amount of oxygen bound to hemoglobin) and hemoglobin concentration were measured and used to compute P50, the overall measure of hemoglobin-oxygen affinity. Results showed that increased oxygen extraction had a significant correlation with an increase in P50; so, too, did an increase in VO2 and DO2. When survivors (32) were compared with nonsurvivors (11), they had a higher DO2; but when the records from both groups for patients with approximately equal DO2 were compared, the P50 of nonsurvivors was higher, with no differences in other measures. This suggests that increased P50 may itself be a predictor of death after MI for patients whose DO2 and VO2 values lie in the middle range (extreme values of DO2 and VO2 are still good predictors of mortality). If the compensatory increase in P50 during impaired DO2 is not enough to meet tissue needs, an oxygen debt may be incurred that can lead to irreversible tissue damage even with increased VO2. This debt may increase in patients with more serious myocardial infarctions. (Consumer Summary produced by RMI, Inc.)

To evaluate DT during a low-level exercise test, the relation between DT and heart rate was studied by ear densitography in the late phase of hospitalization for acute MI. None [...]