检索结果-内蒙古大学图书馆

Compared with control subjects, the systemic sympathetic nervous system is activated in patients with mitral regurgitation

引用

AMERICAN HEART JOURNAL 2003年第6期145卷 1078-1085页

作者： Mehta, RH Supiano, MA Oral, H Grossman, PM Montgomery, DS Smith, MJ Starling, MR Univ Michigan Ann Arbor MI 48109 USA Vet Affairs Healthcare Syst Ann Arbor MI USA

Background Whether the systemic sympathetic nervous system is activated as a compensatory mechanism in response to mitral regurgitation (MR) in humans is unknown: We tested the hypotheses that the systemic sympathetic nervous system would be activated in patients with MR in comparison with control subjects and that this activation would occur early in the disease process as a compensatory mechanism for chronic left ventricular (LV) volume overload. Methods We studied 37 patients with MR who underwent right heart catheterization and biplane cineventriculography to obtain LV end-diastolic and end-systolic volumes, ejection fractions, and regurgitant volumes. In these 37 patients with MR and in 3 control subjects, an [H-3]-norepinephrine ([H-3]-NE) infusion and multiple arterial blood samples provided data for a 2-compartment modeling analysis to calculate extravascular NE release rates (NE2). Results The mean NE2 (2.05 +/- 0.76 mug/min/m(2)) in the patients with MR was greater than that in the control sub/m(2), projects (1.48 +/- 0.75 mug/min/m(2), P = .007). Furthermore, the mean NE2 values were also greater in the patients with MR who were in clinical class I (P = .05), with a pulmonary capillary wedge pressure <12 mm Hg (P = .05) or a LV ejection fraction ≥0.60 (P = .06) compared with the control subjects. The mean NE2 values were increased further in patients with MR who had a LV ejection fraction <0.60 (P = .02). Conclusions The systemic sympathetic nervous system is activated in patients with MR in comparison with control subjects, and this activation appears to occur early in the disease process as a compensatory mechanism for LV volume overload.

关键词：方差分析心脏导管插入术心室/放射摄影术二尖瓣闭锁不全/代谢二尖瓣闭锁不全/病理生理学去甲肾上腺素/诊断应用去甲肾上腺素/代谢去甲肾上腺素/药代动力学统计学非参数交感神经系统/代谢交感神经系统/病理生理学拟交感神经药/诊断应用拟交感神经药/药代动力学成年人老年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Duration of positive urine for cocaine metabolite after ophthalmic administration: Implications for testing patients with suspected Horner syndrome using ophthalmic cocaine

引用

AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第6期131卷 742-747页

作者： Jacobson, DM Berg, R Grinstead, GF Kruse, JR Marshfield Clin Fdn Med Res & Educ Dept Neurol & Ophthalmol Marshfield WI 54449 USA Marshfield Clin Fdn Med Res & Educ Dept Clin Res Marshfield WI 54449 USA Marshfield Clin Fdn Med Res & Educ Forens Toxicol Lab Marshfield WI 54449 USA

PURPOSE: To determine the duration of positive urine for benzoylecgonine, the major metabolite excreted in the urine, after topical ophthalmic administration of cocaine as one would perform for testing the presence of Horner syndrome. METHODS: Two drops of cocaine 10% were applied to each eye of 50 normal subjects. Urine samples were collected 4 to 6, 24, 48, 72, and 96 hours later. Each sample was assayed for benzoylecgonine using a screening competitive enzyme donor immunoassay followed by a highly specific and sensitive confirmatory gas chromatography-mass spectrometry assay. We employed assays and cutoff levels that fulfilled guidelines required by the Substance Abuse: and Mental Health Services of the United States Department of Health and Human Services to mimic measures that exist for federal workplace drug testing. RESULTS: Of the 50 subjects, there were 25 women and 25 men, ranging in age from 19 to 59 years (median age, 40 years), Positive screening samples were obtained in 47 of 50 subjects (94%) 4 to 6 hours, 35 of 50 (10%) 24 hours, and 1 of 50 (2%) 48 hours after topical application of cocaine. None of the samples tested positive at 72 hours or beyond. Using the confirmatory assay's cutoff as the gold standard for a positive test, the sensitivity of the screening assay was 96% 4 to 6 hours, 90% 24 hours, and 14% 48 hours after topical application. Urine benzoylecgonine concentration was negatively correlated with body mass index and positively correlated with urine creatinine concentration. CONCLUSIONS: Patients should be informed that their urine may test positive for cocaine, if assayed according to US federal guidelines and using the protocol employed in this study, up to 2 days after undergoing testing for Horner syndrome. (Am J Ophthalmol 2001;131: 742-747. (C) 2001 by Elsevier Science Inc. All rights reserved.).

关键词：气相色谱-质谱法霍纳综合征/诊断霍纳综合征/尿免疫酶技术眼药水容积渗克分子浓度拟交感神经药/投药和剂量拟交感神经药/诊断应用时间因素女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

A pilot study to assess the safety of dobutamine stress echocardiography in the emergency department evaluation of cocaine-associated chest pain

引用

ANNALS OF EMERGENCY MEDICINE 2001年第1期38卷 42-48页

作者： Dribben, WH Kirk, MA Trippi, JA Cordell, WH Indiana Univ Dept Emergency Med Indianapolis IN 46204 USA Indiana Univ Sch Med Indianapolis IN USA Indiana Poison Ctr Indianapolis IN USA Methodist Hosp Dept Cardiol Indianapolis IN USA

Study objective: Chest pain in the setting of cocaine use poses a diagnostic dilemma. Dobutamine stress echocardiography (DSE) is a widely available and sensitive test for evaluating cardiac ischemia. Because of the theoretical concern regarding administration of dobutamine in the setting of cocaine use, we conducted a pilot study to assess the safety of DSE in emergency department patients with cocaine-associated chest pain. Methods: A prospective case series was conducted in the intensive diagnostic and treatment unit in the ED of an urban tertiary-care teaching hospital. Patients were eligible for DSE if they had used cocaine within 24 hours preceding the onset of chest pain and had a normal ECG and tropinin I level. Patients exhibiting signs of continuing cocaine toxicity were excluded from the study. Ail patients were admitted to: the hospital for serial testing after the DSE testing in the intensive diagnostic and treatment unit. Results: Twenty-four patients were enrolled. Two patients had inadequate resting images, one DSE was terminated because of inferior hypokinesis, another DSE was terminated because of a rate-related atrial conduction deficit, and 1 patient did not reach the target heart rate. Thus, 19 patients completed a DSE and reached their target heart rates. None of the patients experienced signs of exaggerated adrenergic response, which was defined as a systolic blood pressure of greater than 200 mm Mg or the occurrence of tachydysrhythmias (excluding sinus tachycardia). Further suggesting lack of exaggerated adrenergic response, 13 (65%) of 20 patients required supplemental atropine to reach their target heart rates. Conclusion: No exaggerated adrenergic response was detected when dobutamine was administered to patients with cocaine-related chest pain.

关键词：强心药/诊断应用胸痛/化学诱导胸痛/病理生理学胸痛/超声检查可卡因相关性障碍/并发症诊断鉴别多巴酚丁胺/诊断应用超声心动描记术/方法超声心动描记术/标准心电描记术急诊处理/方法急诊处理/标准运动试验/方法运动试验/标准心率/药物作用高血压/化学诱导心肌缺血/化学诱导心肌缺血/病理生理学心肌缺血/超声检查试点项目前瞻性研究安全拟交感神经药/诊断应用心动过速/化学诱导成年人人类中年人

来源：评论

学校读者我要写书评

暂无评论

Cardiac positron emission tomography imaging with [¹¹C]hydroxyephedrine, a specific tracer for sympathetic nerve endings, and its functional correlates in congestive heart failure

引用

AMERICAN JOURNAL OF CARDIOLOGY 1999年第5期84卷 568-574页

作者： Vesalainen, RK Pietilä, M Tahvanainen, KUO Jartti, T Teräs, M Någren, K Lehikoinen, P Huupponen, R Ukkonen, H Saraste, M Knuuti, J Voipio-Pulkki, LM Univ Turku Dept Med Turku Finland Univ Turku Dept Clin Pharmacol Turku Finland Univ Turku Dept Clin Physiol Turku Finland Turku PET Ctr Turku Finland Tampere Univ Hosp Dept Clin Physiol Tampere Finland

The integrative mechanisms of autonomic dysfunction in congestive heart failure (CHF) remain poorly understood. We sought to study cardiac retention of [C-11]hydroxyephedrine (HED), a specific tracer for sympathetic presynaptic innervation, and its functional correlates in CHF. Thirty patients with mild to moderate heart failure underwent resting cardiac HED positron emission tomography imaging, spectrum analysis testing of systolic pressure and heart rate variability in the resting supine and 70 degrees head-up tilt positions, and testing of baroreflex sensitivity. Compared with control subjects, global myocardial HED retention index was reduced by 30% (p <0.01) in patients with CHF. The HED retention index did not correlate significantly with heart rate variability. However, it correlated with baroreflex sensitivity at rest (r = 0.43, p = 0.05) and with systolic pressure low-frequency (0.03 to 0.15 Hz) variability at head up tilt (r = 0.76, p <0.01), as well as with low-frequency systolic pressure variability response from baseline to tilt (r = 0.75, p <0.01). We conclude that cardiac HED retention is reduced in patients with CHF. This correlates with blunted vascular sympathetic effector responses during posture-induced reflex activation and baroreflex control of heart rate, suggesting an interdependence between cardiac presynaptic innervation abnormalities and neural mechanisms important to blood pressure maintenance in CHF. (C) 1999 by Excerpta Medica, Inc.

关键词：血压/生理学碳放射性同位素/诊断应用冠状动脉循环/生理学麻黄碱/类似物和衍生物麻黄碱/诊断应用心脏/神经支配心脏/放射性核素显像心率/生理学图像处理计算机辅助神经末梢/病理生理学神经末梢/放射性核素显像去甲肾上腺素/类似物和衍生物去甲肾上腺素/诊断应用压力感受器/病理生理学参考值反射/生理学交感神经系统/病理生理学交感神经系统/放射性核素显像拟交感神经药/诊断应用体层摄影术发射型计算机女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Evaluating risk in unstable angina:: role of pharmacological stress echocardiography

引用

EUROPEAN HEART JOURNAL 2000年第13期21卷 1041-1043页

作者： Piérard, LA Univ Hosp Liege Belgium

来源：评论

学校读者我要写书评

暂无评论

The evolution of stress echocardiography

引用

Cardiology Clinics 1999年第3期17卷 443-446页

作者： Feigenbaum, H. University Hospital 5420 Indianapolis IN 46202-5250 550 North University Boulevard United States

The feasibility of using echocardiography to identify stress induced wall motion abnormalities was first demonstrated with M-mode recordings. The practical use of such a test had to await the development of 2-dimensional echocardiography whereby more wall segments could be analyzed. From the early days of 2-dimensional echocardiography there have been a succession of technological and clinical advances which have made stress echocardiography a very clinically useful tool in the management of patients with known or suspected coronary artery disease. These developments included the realization that stress-induced wall motion abnormalities produce stunned myocardium permitting immediate post-treadmill echoes to be clinically useful, the use of pharmacologic stress, the introduction of digital recording techniques so that rest and stress images could be viewed side-by- side, and more recently the advent of new imaging technologies, such as harmonic imaging of tissue to provide higher quality of stress echocardiograms.

关键词：超声心动描记术/方法运动试验拟交感神经药/诊断应用血管舒张药/诊断应用人类

来源：评论

学校读者我要写书评

暂无评论

Hypersensitivity of cerebral artery response to catecholamine in patients with neurally mediated syncope induced by isoproterenol

引用

AMERICAN JOURNAL OF CARDIOLOGY 2000年第11期85卷 1376-+页

作者： Obara, C Kobayashi, Y Ueda, H Nakagawa, H Kikushiama, S Baba, T Ozawa, M Katagiri, T Showa Univ Sch Med Dept Internal Med 3 Tokyo Japan

To determine cerebral autoregulatory dysfunction in neurally mediated syncope induced by isoproterenol provocation, we studied the changes in cerebral autoregulation using transcranial Doppler ultrasonography during syncope, Isoproterenol already had changed in cerebral artery regulation before tilting, and emphasized the changes during syncope.

关键词：血流速度/生理学脑/血液供给儿茶酚胺类/生理学脑动脉/病理生理学心舒期/生理学异丙肾上腺素/诊断应用搏动血流/生理学拟交感神经药/诊断应用晕厥血管迷走神经性/诊断晕厥血管迷走神经性/病理生理学心缩期/生理学超声检查多普勒经颅血管阻力/生理学青少年成年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：