In studying the dynamics of the heart beat, the relationship between electrical and mechanical events in the cardiac cycle has been of fundamental importance. The basic concepts of this relationship have been defined by Lewis (1925) and Wiggers (1923) and their co-workers. Sir Thomas Lewis provided indirect information on these events in the right auricle of man. Animal experiments, supplemente...

Pulmonary arterial hypertension (PAH) is a progressive disease that ultimately leads to right heart failure and death. PAH is defined as a mean pulmonary arterial pressure ≥ 25 mm Hg with a pulmonary capillary wedge pressure ≤ 15 mm Hg at rest. The diagnosis of PAH is one of exclusion; diagnostics include an extensive history, serology, chest radiograph, pulmonary function tests, ventilation/pe...

The five patients presented were considered to have mitral stenosis because of a history of dyspnea on exertion or paroxysmal atrial fibrillation, the presence of a loud first heart sound with an "opening snap," a loud pulmonary component of the second heart sound, electrocardiographic evidence of right axis deviation and left atrial enlargement or radiological evidence of cardiomegaly, especia...

A 65-year-old man was referred with refractory heart failure. A 27-mm Carbomedics bileaflet valve for mitral valve stenosis had been implanted 20 years earlier. The electrocardiogram showed atrial fibrillation with severe bradycardia (30-50/min). Transthoracic echocardiography demonstrated both prosthetic leaflets opening in late diastole (Picture A, arrows), and the anterolateral leaflet inter...

Electrocardiograms have been recorded by unipolar leads from the great veins and cavities of the right heart during cardiac catheterization in 30 of 130 cases of congenital and rheumatic heart disease. These intracardiac electrograms have given information that has proved useful in diagnosis. Further, continuous monitoring on an oscilloscope of these tracings, rather than of records from surfac...

BACKGROUND Heart transplantation is the most effective treatment for well-selected patients with endstage heart failure. Unfortunately, transplant candidates with pulmonary hypertension (PHT) are often not considered for heart transplantation. This study was performed to assess the value of prostaglandin E(1) (PG-E(1)) for reduction of PHT and to predict the postoperative outcome, compared to p...

BACKGROUND Plasma concentrations of B-type natriuretic peptide (BNP-32) and its precursor (proBNP) are increased in chronic heart failure. Accordingly, BNP-32 and proBNP are both being implemented as clinical markers. AIM To determine the molar relation of BNP-32 and proBNP in different cardiovascular regions. METHODS AND RESULTS Blood samples were obtained from different cardiovascular reg...

OBJECTIVE Paucity of data exists between mean right atrial pressure (RAP) and inferior vena cava (IVC) size and collapsibility in pediatric patients with congenital heart disease. METHODS In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneou...

Intracavitary potentials of the human left ventricle were studied in 8 patients by the technic of retrograde ulnar artery or, in one case, pulmonary vein catheterization. The intracavitary potentials from the left ventricle were of the QS variety and confirm Wilson's concept of the earlier de-polarization of the intraventricular septum from left to right. IN RECENT years the genesis of the huma...