Increased intensity of the murmur of hypertrophic obstructive cardiomyopathy with carotid sinus pressure.


:In a prospective study murmurs increased in intensity with carotid sinus pressure in 18 of 26 patients with hypertrophic obstructive cardiomyopathy (HOCM) (sensitivity, 69.2 percent for the 26 patients, 85.7 percent for the 21 patients in whom heart rate and blood pressure decreased with carotid sinus pressure). On the other hand, the murmur remained constant or decreased in all but one of 104 patients with valvular aortic stenosis, mitral insufficiency, hypertrophic nonobstructive cardiomyopathy, and systolic murmurs of miscellaneous origins (specificity, 99 percent; positive predictive value, 94.7 percent). Catheterization, indirect arterial pressure tracings, and echocardiographic studies indicated that carotid sinus pressure-induced bradycardia was associated with increased left ventricular outflow tract obstruction. The carotid sinus pressure-induced increase in the murmur is probably multifactorial: decreased aortic pressure and impedance; increased contractility immediately on sudden slowing of heart rate; further increase in obstruction as the mitral valve systolic anterior movement is enhanced; and delayed vasodilatation maintaining the obstruction even after return of heart rate to precarotid sinus pressure values. An increase in a systolic murmur with carotid sinus pressure is characteristic of HOCM.






Klein HO,DiSegni E,Dean H,Beker B,Bakst A,Kaplinsky E




Has Abstract


1988-04-01 00:00:00
















  • Methylated Genes in Sputum Among Older Smokers With Asthma.

    abstract:OBJECTIVE:The epigenetic basis for human asthma is not well studied, particularly among older adults. This study investigated the methylation profiles in sputum DNA among older adults with asthma, using a population of smokers. METHODS:This was a cross-sectional study using the Lovelace Smokers Cohort, a population of...


    pub_type: 杂志文章


    authors: Sood A,Petersen H,Blanchette CM,Meek P,Picchi MA,Belinsky SA,Tesfaigzi Y

    更新日期:2012-08-01 00:00:00

  • Gas exchange and pulmonary hemodynamics during lung resection in patients at increased risk: relationship with preoperative exercise testing.

    abstract:STUDY OBJECTIVES:To evaluate the intraoperative evolution of patients with COPD during lung resection and to test whether exercise testing could be helpful in the prediction of the intraoperative course. DESIGN:Prospective study. SETTING:University teaching hospital. PATIENTS:Forty patients (mean [+/- SD] age, 65 +/...


    pub_type: 杂志文章


    authors: Ribas J,Jiménez MJ,Barberà JA,Roca J,Gomar C,Canalís E,Rodriguez-Roisin R

    更新日期:2001-09-01 00:00:00

  • Tension fecal pneumothorax in a postpartum patient.

    abstract::A 20-year-old woman developed severe shortness of breath 4 h after a cesarean section. Chest roentgenogram showed a pleural effusion and tension pneumothorax; insertion of a chest tube drained liquid stool. At surgery she was found to have a left diaphragmatic defect with herniation, strangulation, and perforation of ...


    pub_type: 杂志文章


    authors: Lacayo L,Taveras JM 3rd,Sosa N,Ratzan KR

    更新日期:1993-03-01 00:00:00

  • Loss of caveolin and heme oxygenase expression in severe pulmonary hypertension.

    abstract::Caveolae are cell plasma membrane microdomains implicated in organizing and concentrating many signaling molecules. In the lung, caveolae are in endothelium, smooth muscle, fibroblasts, and pneumocytes. Caveolin is the main structural protein of caveolae. Caveolin 1 is down-regulated in transformed cells and may be a ...


    pub_type: 杂志文章


    authors: Achcar RO,Demura Y,Rai PR,Taraseviciene-Stewart L,Kasper M,Voelkel NF,Cool CD

    更新日期:2006-03-01 00:00:00

  • Patent ductus arteriosus with hypoplastic lung.

    abstract::A median sternotomy approach was used for closure of patent ductus arteriosus associated with a hypoplastic right lung. The anterior approach to the left ductus is indicated if left thoracotomy is contraindicated. ...


    pub_type: 杂志文章


    authors: Rao B,Gootman N,Silbert D,Wisoff BG

    更新日期:1976-06-01 00:00:00

  • Tetralogy of Fallot with discrete fibrous subaortic stenosis.

    abstract::This is the first reported case of discrete fibrous subaortic stenosis in tetralogy of Fallot. Transaortic excision of the subaortic membrane was readily accomplished. To detect this and other forms of left ventricular outflow-tract obstruction in tetralogy of Fallot before surgery, routine selective left ventriculogr...


    pub_type: 杂志文章


    authors: Sanders JH,Van Praagh R,Sade RM

    更新日期:1976-04-01 00:00:00

  • The physiologic evaluation of patients with lung cancer being considered for resectional surgery.

    abstract::The preoperative physiologic assessment of a patient being considered for surgical resection of lung cancer must consider the immediate perioperative risks from comorbid cardiopulmonary disease, the long-term risks of pulmonary disability, and the threat to survival due to inadequately treated lung cancer. As with any...


    pub_type: 指南,杂志文章,实务指引


    authors: Beckles MA,Spiro SG,Colice GL,Rudd RM,American College of Chest Physicians.

    更新日期:2003-01-01 00:00:00

  • Emergence of new forms of totally drug-resistant tuberculosis bacilli: super extensively drug-resistant tuberculosis or totally drug-resistant strains in iran.

    abstract:BACKGROUND:The study documented the emergence of new forms of resistant bacilli (totally drug-resistant [TDR] or super extensively drug-resistant [XDR] tuberculosis [TB] strains) among patients with multidrug-resistant TB (MDR-TB). METHODS:Susceptibility testing against first- and second-line drugs was performed on is...


    pub_type: 杂志文章


    authors: Velayati AA,Masjedi MR,Farnia P,Tabarsi P,Ghanavi J,ZiaZarifi AH,Hoffner SE

    更新日期:2009-08-01 00:00:00

  • The effect of exercise on ischemic mitral regurgitation.

    abstract::This study investigated the effect of dynamic exercise on mitral regurgitation (MR) as assessed by color flow Doppler imaging and tested the hypothesis that MR increases in patients with left ventricular (LV) function worsening during exercise. We studied 513 patients (390 men, 123 women:mean age [+/-1 SD] 58+/-11 yea...


    pub_type: 杂志文章


    authors: Peteiro J,Freire E,Montserrat L,Castro-Beiras A

    更新日期:1998-10-01 00:00:00

  • Potassium-induced cardioplegia in patients undergoing correction of congenital heart defects.

    abstract::Beginning in July 1977, cold potassium-induced cardioplegia has been used in 60 consecutive patients undergoing correction of congenital heart defects in whom the aorta was cross clamped. Ages ranged from 4 weeks to 18 years (mean 5.8 years); 40 percent were less than 24 months of age. Surgery included correction of v...


    pub_type: 杂志文章


    authors: Crawford FA Jr,Barnes TY,Heath BJ

    更新日期:1980-08-01 00:00:00

  • Methodology for guideline development for the Seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.

    abstract::This article describes the methodology for the Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines. Guideline authors began by specifying the population, the intervention and alternative, and the outcomes for each clinical question, and d...


    pub_type: 杂志文章


    authors: Schünemann HJ,Munger H,Brower S,O'Donnell M,Crowther M,Cook D,Guyatt G

    更新日期:2004-09-01 00:00:00

  • A Longitudinal Cohort Study of Aspirin Use and Progression of Emphysema-like Lung Characteristics on CT Imaging: The MESA Lung Study.

    abstract:BACKGROUND:Platelet activation reduces pulmonary microvascular blood flow and contributes to inflammation; these factors have been implicated in the pathogenesis of COPD and emphysema. We hypothesized that regular use of aspirin, a platelet inhibitor, would be associated with a slower progression of emphysema-like lung...


    pub_type: 杂志文章,多中心研究


    authors: Aaron CP,Schwartz JE,Hoffman EA,Angelini E,Austin JHM,Cushman M,Jacobs DR Jr,Kaufman JD,Laine A,Smith LJ,Yang J,Watson KE,Tracy RP,Barr RG

    更新日期:2018-07-01 00:00:00

  • Is the mortality higher in the pulmonary vs the extrapulmonary ARDS? A meta analysis.

    abstract:BACKGROUND AND AIM:ARDS can occur from the following two pathogenetic pathways: a direct pulmonary injury (ARDSp); and an indirect injury (ARDSexp). The predisposing clinical factor can influence the pathogenesis and clinical outcome of ARDS. This metaanalysis was aimed at evaluating whether there is any difference in ...


    pub_type: 杂志文章,meta分析,评审


    authors: Agarwal R,Srinivas R,Nath A,Jindal SK

    更新日期:2008-06-01 00:00:00

  • Comparison of the effects of salmeterol and formoterol in patients with severe asthma.

    abstract:STUDY OBJECTIVE:Several studies have demonstrated the superiority of salmeterol and formoterol to either regular treatment with albuterol or placebo. However, to date there have been no trials comparing the efficacy of salmeterol and formoterol in patients with severe asthma. DESIGN:We undertook a randomized, placebo-...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Nightingale JA,Rogers DF,Barnes PJ

    更新日期:2002-05-01 00:00:00

  • Average volume-assured pressure support in obesity hypoventilation: A randomized crossover trial.

    abstract:BACKGROUND:Average volume-assured pressure support (AVAPS) has been introduced as a new additional mode for a bilevel pressure ventilation (BPV) device (BiPAP; Respironics; Murrysville, PA), but studies on the physiologic and clinical effects have not yet been performed. There is a particular need to better define the ...


    pub_type: 杂志文章,随机对照试验


    authors: Storre JH,Seuthe B,Fiechter R,Milioglou S,Dreher M,Sorichter S,Windisch W

    更新日期:2006-09-01 00:00:00

  • Mid-systolic sound associated with aortic insufficiency and bisferiens pulse.

    abstract::Systolic ejection clicks, often associated with cardiac disease, can be distinguished from mid-systolic clicks of mitral and tricuspid origin, which are frequently benign. A different mid-systolic sound has been recognized, with timing similar to the mid-systolic clicks, which is associated with aortic insufficiency. ...


    pub_type: 杂志文章


    authors: Robertson WS,Tavel ME

    更新日期:1983-01-01 00:00:00

  • Paradoxical trough effects of triple therapy with budesonide/formoterol and tiotropium bromide on pulmonary function outcomes in COPD.

    abstract:BACKGROUND:Lowest receptor occupancy for a drug occurs at trough prior to the next dose. Previous studies have focused on the effects of triple therapy at peak dose intervals using forced expiratory maneuvers. Impulse oscillometry (IOS) and body plethysmography (PLETH) are more sensitive than spirometry to assess inhal...


    pub_type: 杂志文章,随机对照试验


    authors: Williamson PA,Short PM,Clearie KL,Vaidyanathan S,Fardon TC,Howaniec LJ,Lipworth BJ

    更新日期:2010-09-01 00:00:00

  • Measurements of cardiac output in seriously ill patients using a CO2 rebreathing method.

    abstract::A CO2 rebreathing method for the measurement of cardiac output was evaluated by comparison with the direct Fick O2 method in 26 studies performed in 18 patients who were critically ill. The method requires measurement of CO2 output by collection of expired gas, of arterial PCO2, and of mixed venous PCO2 by rebreathing...


    pub_type: 临床试验,杂志文章


    authors: Davis CC,Jones NL,Sealey BJ

    更新日期:1978-02-01 00:00:00

  • O2 uptake kinetics in response to exercise. A measure of tissue anaerobiosis in heart failure.

    abstract::Oxygen uptake (VO2) reflects the rate of aerobic regeneration of high-energy phosphate compounds (primarily adenosine triphosphate [ATP]). Since lactate increase is thought to result from an inadequate rate of aerobic ATP regeneration, it might be expected that lactate increase would be associated with a delayed attai...


    pub_type: 杂志文章


    authors: Zhang YY,Wasserman K,Sietsema KE,Ben-Dov I,Barstow TJ,Mizumoto G,Sullivan CS

    更新日期:1993-03-01 00:00:00

  • A longitudinal study of lung function in nonsmoking patients with rheumatoid arthritis.

    abstract:STUDY OBJECTIVE:s: Patients with rheumatoid arthritis (RA) have a high prevalence of pulmonary function test (PFT) abnormality, but the long-term significance of this is unknown. We performed a longitudinal study of pulmonary function in asymptomatic, nonsmoking patients with active RA requiring disease-modifying drugs...


    pub_type: 杂志文章


    authors: Fuld JP,Johnson MK,Cotton MM,Carter R,Watkin SW,Capell HA,Stevenson RD

    更新日期:2003-10-01 00:00:00

  • Improved management of acute asthma among pregnant women presenting to the ED.

    abstract:BACKGROUND:A multicenter study in the late 1990s demonstrated suboptimal emergency asthma care for pregnant women in US EDs. After a decade, follow-up data are lacking. We aimed to examine changes in emergency asthma care of pregnant women since the 1990s. METHODS:We combined data from four multicenter observational s...


    pub_type: 杂志文章


    authors: Hasegawa K,Cydulka RK,Sullivan AF,Langdorf MI,Nonas SA,Nowak RM,Wang NE,Camargo CA Jr

    更新日期:2015-02-01 00:00:00

  • The diagnostic value of lysosomal enzyme patterns in bronchial aspirates of patients with suspected bronchial carcinoma.

    abstract::The measurement of the activity of acid hydrolases and of alkaline phosphatase in bronchial aspirates obtained through bronchoscopic procedures from a series of 300 patients forms the basis for a screening program to diagnose bronchial malignant neoplasms more effectively. We define such a screening test as one permit...


    pub_type: 杂志文章


    authors: Kühn SH,de Kock MA,Gevers W

    更新日期:1978-08-01 00:00:00

  • Prostacyclin but not phentolamine increases oxygen consumption and skin microvascular blood flow in patients with sepsis and respiratory failure.

    abstract::Inadequate tissue oxygenation may occur in critically ill patients with sepsis despite an apparently adequate O2 transport (QO2), and this may contribute to the development of an O2 debt and also to multiple organ failure. It has been shown that increasing QO2 by infusing a vasodilator may reveal this O2 debt in septi...


    pub_type: 杂志文章


    authors: Pittet JF,Lacroix JS,Gunning K,Laverriere MC,Morel DR,Suter PM

    更新日期:1990-12-01 00:00:00

  • Recurrent, self-limited, menstrual-associated bronchiolitis obliterans organizing pneumonia.

    abstract::A 39-year-old woman presented with recurrent acute illness, characterized by high-grade fever, pleuritic chest pain, and unilateral nodular infiltrate on chest radiograph. During the follow-up period, there were six similar episodes, each starting 2 to 3 days prior to her menstrual period and resolving within 5 to 10 ...


    pub_type: 杂志文章


    authors: Yigla M,Ben-Itzhak O,Solomonov A,Guralnik L,Oren I

    更新日期:2000-07-01 00:00:00

  • Effect of Balloon Pulmonary Angioplasty on Respiratory Function in Patients With Chronic Thromboembolic Pulmonary Hypertension.

    abstract:BACKGROUND:Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. Our objective was to investigate the effect of BPA on respiratory function. METHODS:We enrolled patients with inop...


    pub_type: 杂志文章


    authors: Akizuki M,Serizawa N,Ueno A,Adachi T,Hagiwara N

    更新日期:2017-03-01 00:00:00

  • The clinical utility of flexible bronchoscopy in the evaluation of chronic cough.

    abstract:STUDY OBJECTIVES:To assess the clinical utility of flexible bronchoscopy (FB) in the evaluation of patients with chronic cough and normal or nonlocalizing chest radiographic findings. DESIGN:Retrospective chart review. SETTING:Tertiary referral center. PATIENTS:Forty-eight patients with chronic cough and no other cl...


    pub_type: 杂志文章


    authors: Barnes TW,Afessa B,Swanson KL,Lim KG

    更新日期:2004-07-01 00:00:00

  • Evaluation of the Winthrop-University Hospital criteria to identify Legionella pneumonia.

    abstract:STUDY OBJECTIVE:To measure the ability of a set of clinical parameters, the Winthrop-University Hospital (WUH) criteria, to identify Legionella pneumonia while discriminating against bacteremic pneumococcal pneumonia at the time of hospitalization for community-acquired pneumonia (CAP). DESIGN:Retrospective case-contr...


    pub_type: 杂志文章


    authors: Gupta SK,Imperiale TF,Sarosi GA

    更新日期:2001-10-01 00:00:00

  • Pulmonary arterial wall distensibility assessed by intravascular ultrasound in children with congenital heart disease: an indicator for pulmonary vascular disease?

    abstract:BACKGROUND:Both pulmonary hypertension and pulmonary overflow are associated with functional and structural changes of the pulmonary arterial wall. Current techniques to evaluate the pulmonary vasculature neglect the pulsatile nature of pulmonary flow. STUDY OBJECTIVES:To determine whether the dynamic properties of th...


    pub_type: 杂志文章


    authors: Berger RM,Cromme-Dijkhuis AH,Hop WC,Kruit MN,Hess J

    更新日期:2002-08-01 00:00:00

  • Influence of three factors on the diagnostic effectiveness of transthoracic needle aspiration in pneumonia.

    abstract::Prior antibiotic therapy, size of the infiltrate, and the person who performed the technique were the three factors that we studied to assess their influence on the effectiveness of transthoracic needle aspiration (TNA). Ninety-one patients with a diagnosis of severe bacterial pneumonia, who underwent TNA, have been i...


    pub_type: 杂志文章


    authors: Zalacain R,Llorente JL,Gaztelurrutia L,Pijoan JI,Sobradillo V

    更新日期:1995-01-01 00:00:00

  • The value of portable chest roentgenography in adult respiratory distress syndrome. Comparison with computed tomography.

    abstract::In 17 patients with adult respiratory distress syndrome, we used data derived from computed tomographic (CT) scan densitometric analysis to validate the value of portable chest roentgenograms in objectively estimating the amount of pulmonary edema. Chest roentgenograms and CT scans were taken in the same ventilatory c...


    pub_type: 杂志文章


    authors: Bombino M,Gattinoni L,Pesenti A,Pistolesi M,Miniati M

    更新日期:1991-09-01 00:00:00