Effect of various beta-adrenolytic drugs on heart rate and changes in left-ventricular systolic time intervals in patients with hyperthyroidism and simple goiter

The effects of a short-term application of various beta-adrenolytic drugs on heart rate and on the changes in subperiods of left ventricle contraction have been studied in 71 patients with untreated hyperthyroidism and in 72 patients with simple goiter. The following drugs were used: propranolol, metoprolol, atenolol, pindolol, nadolol and acebutolol. It was found that those betaadrenolytic drugs which have no sympathomimetic action cause a significant decrease in heart rate both in patients with hyperthyroidism and in those with simple goiter. The effect of these drugs on heart rate was not related to the changes in blood serum concentrations of thyroxine and triiodothyronine. None of the drugs tested influenced appreciably the contraction subperiods of left heart ventricle, both in the patients with hyperthyroidism and in those with simple goiter.     

Physiologic modulations of the systolic time intervals in the fetal lamb

To examine the modulation of fetal systolic time intervals of the ovine fetus in relation to fetal maturation, heart rate, respiratory activity, and circadian rhythm, studies were carried out on 13 fetal-maternal sheep preparations. The data obtained showed that there was a significant correlation between the ejection time (ET) and the RR intervals of the electrocardiogram. The pre-ejection period (PEP) and PEP/ET increased in relation to the fetal maturation (38 ms and 0.25 at 120 days to 52 ms and 0.33 at 145 days of gestation, respectively). When the circadian rhythmicity was analyzed, a relative tachycardia was in evidence during the 21- to 03-h period but systolic time intervals remained unchanged. Except for some tachycardia and cardiac rhythm variability, respiratory activity also had no influence on the systolic time intervals.     

Myocardial contractility in chickens (Gallus gallus): analysis of systolic time intervals

The avian cardiovascular system is of special interest because avian hearts are relatively larger than mammalian hearts, and activation of ventricular myocardium in birds has a "flash" pattern. Systolic time intervals and indices of myocardial contractility were examined in anaesthetized open-chest chickens by polycardiography, including synchronous recordings of electrocardiogram, phonocardiogram, and apex cardiogram. The asynchronous contraction time, isometric contraction time, pre-ejection period and ejection time were 26 +/- 3 (Mean +/- SD), 21 +/- 9, 47 +/- 12, and 83 +/- 23 ms, respectively, for heart rates of 260 +/- 57 bpm. The myocardial tension index, isometric contraction index and the pre-ejection period/ejection time ratio were 0.39 +/- 0.11, 0.42 +/- 0.10, and 0.54 +/- 0.14, respectively. A "flash" pattern of ventricular myocardial depolarization causes more rapid excitation and as a consequence shorter asynchronous contraction time of relatively larger chicken hearts compared with rabbit hearts. Inverse relation (P < 0.05) of the asynchronous contraction time to the heart rate in chickens is probably associated with the specific activation pattern of avian ventricles. Establishment of the values of systolic time intervals will facilitate a better understanding of cardiac function in birds. The obtained results are discussed in comparison with the rabbit. The indices calculated from the systolic time intervals show disadvantageous contractile function of chicken heart compared to rabbit heart.     

Left ventricular systolic time intervals and plasma noradrenaline concentrations during acute hypovolaemia in newborn infants

Left ventricular systolic time intervals and plasma noradrenaline concentrations were determined in twelve newborn infants during acute moderate hypovolaemia. Rapid withdrawal of 8.5 ml of blood per kg body weight shortened the left ventricular ejection time from 204 to 176 msec (P less than 0.001) and increased the plasma noradrenaline concentration from 3.4 to 4.0 nmol/l (P less than 0.05). Systemic blood pressure was unchanged. It is concluded that even a moderate reduction in blood volume is associated with marked changes in left ventricular dynamics. The shortening of left ventricular ejection time during hypovolaemia probably reflects left ventricular adaptation to decreased volumes and response to increased noradrenaline release.     

Termination of atrial flutter by directed transesophageal atrial pacing during transesophageal echocardiography.

INTRODUCTION: The purpose of this study was to evaluate termination of atrial flutter (AFL) by directed rapid transesophageal atrial pacing (TAP) with and without simultaneous transesophageal echocardiography (TEE) performed using a novel TEE tube electrode. MATERIALS AND METHODS, AND RESULTS: A total of 16 AFL patients (age 63+/-12 years; 13 males) with mean AFL cycle length of 224+/-24 ms (n=12) and mean ventricular cycle length of 448+/-47 ms (n=12) were analyzed using either an esophageal TO electrode (n=10) or a novel TEE tube electrode consisting of a tube with four hemispherical electrodes that is pulled over the echo probe (n=6). AFL could be terminated by directed rapid TAP using an esophageal TO electrode, leading to induction of atrial fibrillation (AF) (n=6), induction of AF and spontaneous conversion to sinus rhythm (SR) (n=3), and with conversion to SR (n=1). AFL could also be terminated by directed rapid TAP using the TEE tube electrode, with induction of AF (n=3) or induction of AF and spontaneous conversion to SR (n=3). CONCLUSION: AFL can be terminated by directed rapid TAP with hemispherical electrodes with and without simultaneous TEE. TAP with the directed TEE tube electrode is a safe, simple, and useful method for terminating AFL.     

Wide-screen fluorography in the diagnosis of ischemic heart disease and arterial hypertension

A study was made of the results of 2-projectional fluorography of the chest in 1290 men aged 40 to 60 (890 outpatients taking prophylactic cardiological check-up and 400 inpatients with CHD or essential hypertension). The detectability of cardiac and aortic pathology by prophylactic fluorography was 5-fold higher than pulmonary pathology. Changes of the heart, aorta and pulmonary hemodynamics in CHD and arterial hypertension were characterized. The results of fluorocardiometry in the groups of examinees with various CHD risk factors were presented.     

Radiologic diagnosis of pathologic pulmonary changes in ischemic heart disease]

Combined chest x-ray investigation was performed in 187 CHD patients. Different pulmonary changes were noted in postinfarction and atherosclerotic cardiosclerosis as a result of congested effects in lesser circulation: they depended upon a stage of disturbed circulation (the more circulatory decompensation was noticeable, the more marked were changes in lesser circulation). Pulmonary and cardiac changes in patients with postinfarction cardiosclerosis were more frequent and marked.     

Wavelet processing of systolic murmurs to assist with clinical diagnosis of heart disease

Despite advances in imaging technologies for the heart, screening of patients for cardiac pathology continues to include the use of traditional stethoscope auscultation. Detection of heart murmurs by the primary care physician often results in the ordering of additional expensive testing or referral to cardiology subspecialists, although many of the patients are eventually found to have no pathologic condition. In contrast, auscultation by an experienced cardiologist is highly sensitive and specific for detecting heart disease. Although attempts have been made to automate screening by auscultation, no device is currently available to fulfill this function. Multiple indicators of pathology are nonetheless available from heart sounds and can be elicited using certain signal processing techniques such as wavelet analysis. Results presented here show that a signal of pathology, the systolic murmur, can reliably be detected and classified as pathologic using a portable electrocardiogram and heart sound measurement unit combined with a wavelet-based algorithm. Wavelet decomposition holds promise for extending these results to detection and evaluation of other audible pathologic indicators.