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61.
应用99mTc-甲氧基异丁基异腈(MIBI)对29例受检者进行首次通过法心室显像,测定左室射血分数(LVEF),并与同期平衡法心室显像测得的LVEF进行相关分析。结果:首次通过法和平衡法心室显像测得的LVEF分别为(46.5±16.7)%、(49.1±16.1)%(P>0.05)。相关分析结果显示,二者有明显的相关(r=0.787,P<0.01)。结果表明:99mTc-MIBI为心肌显像剂,采用首次通过法心室显像,在观察心肌血流改变的同时,可准确可靠地评价左室收缩功能状态。 相似文献
62.
A. Zuckermann M.D. M. Grimm Regine Ahner Paul Simon Peter Buxbaum G. Laufer E. Wolner 《European Surgery》1996,28(3):176-177
Summary
Background Pregnancy is prossible in female patients who underwent cardiac transplantation but is associated with unpredictable risks.
Methods A 23-year old female patient underwent cardiac transplantation because of dilatative cardiomyopathy.
Results Against our advice, she became pregnant 4 months after transplantation. Following an uneventful pregnancy, spontaneous vaginal
delivery occurred 13 months after transplantation. The patient gave birth to a healthy new-born in good physical condition.
Thereafter, the patient refused to attend any further routine follow-up control. 9 months after delivery, the patient was
admitted to hospital in severe cardiac shock. Biopsy showed a serious, acute rejection which was treated with a course of
methylprednisolone. Clinically, the patient recovered within 1 week, but died from acute myocardial infarction 1 day after
discharge from hospital.
Conclusions Only women without a history of rejection episodes, with good kidney function, good graft function, and high compliance should
be counselled to become pregnant.
相似文献
63.
MICHAL J. KANTOCH ROXANE McKAY MICHAEL J. TYRRELL 《Pacing and clinical electrophysiology : PACE》1993,16(9):1887-1891
An 11-year-old girl who underwent Mustard's operation for complete transposition of the great arteries in infancy, developed Mobitz type II second-degree AV block 81/2 years later. A transvenous, active fixation left ventricular lead was inserted and connected to a rate responsive pacemaker. Two years later the lead dislodged due to the child's growth. A new active fixation electrode was positioned in the left ventricle below the pulmonary valve, leaving an electrode loop in the ventricle. Such an approach may prevent lead dislodgement due to growth after intraatrial repair for transposition of the great arteries, but regular radiological or echocardiographic follow-up of lead position is recommended in these patients. 相似文献
64.
J. Pepke-Zaba T. W. Higenbottam A. T. Dinh Xuan J. P. Scott T. A. H. English J. Wallwork 《Transplant international》1990,3(1):108-112
Abstract. Twenty-one patients were studied at rest and during exercise after heart transplantation to compare cardiac output measured by thermodilution and impedance cardiography. Exercise was performed on a bicycle ergometer over a limited range of work load (25 and 50 watt) whilst metabolic gas exchange was recorded. One patient was studied at rest whilst his circulation was maintained by a Jarvik-7 artificial heart. The values of cardiac output measured by impedance cardiography corresponded closely with the flow rate from the artificial heart. There was also close agreement between the impedance and thermodilution measurements of cardiac output at rest and during exercise. Both measurements followed the changes in heart rate and oxygen consumption. Both thermodilution and impedance cardiography methods elicited good reproducibility of cardiac output measurements at rest and during exercise. These observations suggest that the noninvasive and continuous record of cardiac output obtained by impedance cardiography can be used for the postoperative monitoring of heart transplant recipients. 相似文献
65.
兔心肌挫伤心功能障碍与心肌细胞内Ca2+和线粒体ATP酶的变化 总被引:2,自引:1,他引:1
目的:探讨心肌细胞内游离钙([Ca^2 ]i)和心肌ATP酶变化在心肌挫伤(MC)后心功能障碍发生机制中的意义。方法:随机选取兔36只,分为6组:正常对照、伤后2、4、8、12、24h,每组6只。经右颈总动脉插管至左心室测左室压力。采用BIM-II型生物撞击机致成MC模型。在上述时相点测定左室压力,并测定心肌细胞内[Ca^2 ]i和心肌匀浆组织及线粒体ATP酶活力。结果:心脏收缩/舒张功能受到损害,心肌细胞内[Ca^2 ]i升高,心肌匀浆组织及线粒体ATP酶下降,相关分析表明心功能障碍与心肌细胞内[Ca^2 ]i含量升高呈明显负相关,与ATP酶活性降低呈明显正相关。结论:MC后心脏功能下降,心肌细胞内[Ca^2 ]i含量升高和ATP酶活性下降可能是其原因之一。 相似文献
66.
Using an information-theoretic approach, causality between the systolic amplitude in blood pressure and the frequency of the heart beat was analyzed. Blood pressure and ECG were noninvasively recorded in young, healthy subjects. Three successive measurements were performed: during spontaneous breathing and during paced respiration—at frequencies both higher and lower than that of spontaneous respiration. We demonstrate that the amplitude and frequency of the cardiac rhythm are synchronized for most of the time. The synchronization is stronger during paced respiration at a frequency lower than that of spontaneous breathing. Episodes where the cardiac frequency was driven by the systolic pressure were also detected during slow, paced respiration. 相似文献
67.
Yoshito Tomimaru Ken Kodama Jiro Okami Kazuyuki Oda Koji Takami Masahiko Higashiyama 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(5):193-198
Objective Postoperative pericardial effusion commonly occurs after open heart surgery. However, after general thoracotomy such as pulmonary
resection, there have been few reports of pericardial effusion. The purpose of this study is to investigate patients with
pericardial effusion following pulmonary resection.Methods: Among 2,385 patients with pulmonary resection for lung neoplasm in our institute, eight patients, whose pericardium had
never been opened during the operation, developed pericardial effusion. The clinical characteristics of the eight patients
were analyzed.Results: Pericardial effusion after pulmonary resection was divided into two subtypes: pericardial effusion in three patients with
left thoracotomy occurring within 30 days postoperatively, and pericardial effusion in the remaining five patients with right
thoracotomy occurring more than 30 days postoperatively. Pericardiotomy or pericardiocentesis was performed in three symptomatic
patients, and the remaining five asymptomatic patients were treated with diuretics. Pericardial effusion disappeared in three
of the five patients about 1–3 months after the conservative treatment, while, in the remaining patients, because pericardial
effusion had increased gradually, pericardiocentesis was performed.Conclusion: From our experience, the treatment strategy of drainage for early pericardial effusion and diuretics for late pericardial
effusion seems to be appropriate. (Jpn J Thorac Cardiovasc Surg 2006; 54:193-198) 相似文献
68.
69.
J. Ludwig T. Halbrügge G. Vey J. Walter K. -H. Graefe 《European journal of clinical pharmacology》1989,37(5):493-500
Summary The total body clearance and fractional extraction of isoprenaline (ISO) have been determined, and the relation between these parameters and cardiac output established. Whether desipramine, an inhibitor of neuronal uptake, altered the plasma catecholamine response to ISO was also investigated.Seven healthy subjects were given i.v., infusions of ISO in two, consecutive 25-min periods, at constant dose rates of 31–43 and 80–124 pmol·kg–1·min–1, respectively. The total-body (ER), pulmonary (ERp) and forearm (ERf) fractional extractions and the total body clearance (CL) of ISO were obtained from measurements of cardiac output and the steady-state ISO concentration in mixed central venous, arterial and forearm venous plasma.ISO-induced increases in cardiac output resulted in increases in CL, decreases in ER and no consistent change in ERf. ERp did not differ from zero. ISO also produced a dose-dependent increase in the mixed venous plasma concentrations of noradrenaline and 3,4-dihydroxyphenylglycol (DOPEG), and a decrease in that of adrenaline. Pretreatment with desipramine did not alter any of the pharmacokinetic parameters of ISO. Desipramine, however, reduced the mixed venous baseline plasma levels of noradrenaline (47%) and DOPEG (40%), and tended to reduce that of adrenaline (34%). It enhanced the plasma noradrenaline response 2.4-fold, abolished the plasma DOPEG response and did not alter the plasma adrenaline response to ISO.Hence, owing to its haemodynamic effects, ISO modifies its own pharmacokinetics which involve non-neuronal removal processes only. The increased DOPEG in plasma resulting from the ISO-induced increase in noradrenaline release was presynaptic in origin. Desipramine appears to reduce sympathetic activity. The enhancement by desipramine of the ISO-induced increase in plasma noradrenaline points towards recapture by neuronal uptake of at least 58% of the noradrenaline released in response to ISO. 相似文献
70.
21例心内直视术后急性心包填塞的临床分析 总被引:1,自引:1,他引:0
目的:分析21例心内直视术后急性心包填塞的临床特点,探讨其发生原因、预防、救治及其二次开胸的早期指征。方法:对1991年1月-2005年12月心内直视术(共1096例)后21例急性心包填塞二次开胸(发生率1.92%)病例进行总结分析。结果:急性心包填塞患者经二次剖胸解除心包填塞后17例痊愈出院,4例死亡,二次剖胸手术死亡率为19.05%。二次剖胸手术者所患疾病包括先天性心脏病6例,瓣膜病13例,大血管手术1例,心脏移植1例。结论:减少心内直视术后出血、渗血是避免术后发生急性心包填塞的关键,早期诊断并尽早行二次剖胸手术可明显降低围手术期死亡率。 相似文献