46. Alcoholic cardiomyopathy: A histochemical and electron microscopic study

106 43.

College Measurement

of Left

Man by Thermodilution, FRANCIS J. F.A.c.c.,

LANE,

Left

and

M.D.

aortic

Normal

EDV

fraction

in all.

infusion

resulted

rate.

and increase However,

Progressive

a

(MCSR) force

mented

shortening

to the

hypertensive

isoproterenol These

studies

and indicate mines depends

vaso-

in normal

of sub-

increased

EDV

mean

in-

not

change

definitive right

the

of norepinephrine;

thus

volume

response

dynamics

setting

in which

44.

The

Effect

of

Polybrene

Triglycerides

M.D., F.A.c.c., Polybrene

in Man,

neutralizes

with

enzyme

intravenously

(lipoprotein

cholesterol, plasma

adults, free

measured.

There

at times accompanied

was a progressive

in slightly

rise

in the tri-

by a parallel

over half the subjects.

No such

rise occurred

on control

studies

in the same

uals

polybrene.

These

results

without

lipoprotein enously stream

functions

synthesized in man.

important pertinent

lipase

factor

Since

from

elevated

triglycerides

to the prevention

the

blood are an

findings

of atherosclerosis.

are

oxygen

double-

ventricle

with

the pre- and

saturation

findings,

and right

in the first 48 hours

patient

have all shown and

showing

to

after

evidence

of

Alcoholic

improvement.

The

method

of

is described.

Cardiomyopathy:

G. HIBBS,

have

of the anastomosis

embolism.

Microscopic

a

presently

complications

thrombosis

arterial

from

patients

significant

of these problems

Electron

resulted

24

correctable

chylothorax,

46.

A Histochemical V.

Study,

J.

FERRANS,

PH.D. and D. G. WEILBAECHER,

B.S., New Orleans. Observations

action

were

microscopy technics:

PAS

; benzpyrene, for

malic,

microscopy.

The

hydrate

stains

diffuse,

irregular

of

DPN

isocitric

mitochondrial

reaction

re-

sulfate esterase; succinic,

dehydrogenase. of varying

sizes

by fluorescence and

Electron

the

There

in the intensity

enzymes.

of

histo-

; autofluores-

acetate

unremarkable.

decrease

six

plasma1

diaphorase;

was shown

esterase

following

of lipids

and lactic

cells

of

by means

violet;

of lipid droplets

were

hearts

and Nile-blue

; cY-naphthyl

deposition

in the myocardial

the

the

cresyl

microscopy

oxidase;

glutamic,

Diffuse

by

phosphine

lipofuscin

cytochrome

on

cardiomyopathy and

for the fluorescence cence

made

with alcoholic

chemical

that

of endog-

triglycerides

the

individ-

indicate

in the removal

in atherogenesis,

rise in

anomaly,

radiologic

The

and

electron

were

Fallot

transposi-

the early postoperative

state,

each

peripheral

the serum glycerol

defects of

was made between

postoperatively

included

patients

factor

surviving

year

Nonfatal

hour

acids,

clearing

cardiac

single

arrhythmia.

surviving

Polybrene

and

fatty

lipemia

glycerides, cholesterol,

lipase).

over a two to three

in 45 postabsorptive

and endogenous

and the post heparin

artery Haven

to blood flow into the right lung. One late

one

M.D., R.

heparin

fat-clearing

triglycerides,

Endogenous

Los Angeles.

was injected period

on

HYMAN ENGELBERG,

on the

tetralogy

Ebstein’s and

clinical

management

Serum

vessels,

were five deaths

obstruction

and

they are given.

The

was not possible),

ventricle,

arterial

operation

to catechola-

Observations

atresia,

repair

postoperative

death

this

to the

stenosis.

cardiac

MCSR.

blood

cava-pulmonary

presented.

a comparison

There

pulof

period at the Yale-New

are

In the 25 patients period,

shunt.

tricuspid

tion of the great

force, similar

on the hemodynamic

(when

left shunt.

to emptying

ventricular

were

agent.

resistance

the cardiac

Center

treated

cava-right rationale

only venous

undergoing

over a six year

outlet

vena The

for

benefit

the work of the left side and

a low pressure

Medical

comparable

the work of the right side of the

increasing

30 patients

side of the heart

by superior

anastomosis.

(2) decrease

heart without

hematocrit,

In AS, however,

to increase

lungs,

and WILLIAM W.

M.D.

offers

is to (1) deliver

aug-

produced

of an inotropic did

procedure

systolic

shortening

rarely

treated

Artery JOHN E.

Corm.

of the right operation

artery

pulmonary

markedly.

define

that

progres-

Norepinephrine

but

effect

failed

been

shunt

failed to increase.

expected

a fixed

lesions

no other

have

pressure

reduction

model,

isoproterenol

offered

with

derived.

increased

Certain which

first

produced

Pulmonary

in 30 Patients,

New Haven,

M.D.,

(3) create

and

Vena Cava-Right Clinical Results

FENN, M.D., EDWARD CALL, JR.,

or increased

circumferential

in normals,

normals

valve

and

were

creased In

fraction

residual

infusion

fraction

spherical

force

but MCSR

rate,

in ejection

in 6 of 8, while ejection

rate

blood

in AS isoproterenol

assuming

was nor-

norepinephrine

Isoproterenol

increased

EDV

ventricular

subjects,

increased

EDV.

jects.

with an aver-

in unchanged

with

and

19 ml./MZ.

normal

in heart

dilatation

Superior

Anastomosis:

monary

in 6 with increased

either

increased

and in 11 with

of 0.64. In AS the EDV

In

coincident

reaction

45.

was

18 subjects

(AS).

was 103 f

fraction

(EDV)

in

of the left ventricle,

stenosis

age residual

volume

by thermodilution

mal in 5 and increased

By

RICHARD GORLIN? M.D.,

end-diastolic

at rest

no disease

severe

sively

in

L. GLENS.,

ventricular

EDV,

Volume

Boston.

measured with

Venkcular

WILLIAM C. ELLIOTT, M.D.,

News

carbowas

a

of staining microscopy

THE AMERICANJOURNAL OF CARDIOLOGY

College News dcinollstrated which

the nature

consisted

ruption

of the mitochondrial

of mitochondrial

of the mitochondrial

structure

of the viral

cases.

significance

The

cristae.

myofibrils

resembling

bodies

swelling

were

were

uniformly output

Changes

minimal.

found

of these

damage, and

dis-

in the

Particles

in one of these

observations

will

be

discussed. 47.

Diffusion

in Patients

with

Mitral

ARTHUR H. L. FROM, M.D. and YANG WANG,

Stenosis,

M.D., Minneapolis. Many

studies

have

suggested

that

block

patients

alveolar-capillary

stenosis.

Most

technics

rather

such

patients

with predominant

state

(SA02)

supine

rest

mined

CO

the

mitral

diffusion

third

In

minute

or increased

43

with

values in this group averaged

steady

of constant

the

SAO,

exercise.

deter-

remained The

exercise,

but the resting

only 1 had an exercise patients with

bleeding

there

marked

SAO,

decrease

in

the

and the SAOz changes

fixed

severity

output

artery There

(PA)

was

of mitral

pressure

no

stenosis,

These

data sug-

with mitral stenosis do not have

alveolar-capillary

that the occasionally

diffusion

decreased

SAO,

exhibited

a moderate

persisted

platelet

degree

and renal function sodium

potassium

administration chronic signs

heparinization

The

no priming

defect

and

at rest may re-

Hect hypoventilation. Twenty-four

Assistance F.A.c.c.,

in

Hours

of

PIERRE

Dogs,

*49.

The

gram

in

can be maintained simple

Electrocardiogram Congenital

and

Heart

In spite of the rapid number

of congenital and other

heart

simple

the evaluation

GALLETTI,

centers),

instrumental

for the study

there

M.D.,

are

stitutions.

The

experience

procedures

femoral

artery,

was maintained

intermittently breathing consisted (Klung), tubing.

anesthetized,

spontaneously.

two

slowly

two roller It

was

units),

pumps

primed saline

oxygenator

and

Homologous dextrose

Silastic

isotonic

saline-

blood solutions

(one were

over the whole

perfusion

period

for fluid loss through

sampling

oozing,

and ventilation.

IA&WARY 1964

dogs circuit

and s/is inch I.D. an

to

in 11

extracorporeal

with

solution.

administered

to compensate diuresis

The

of a two mm2. Teflon@ membrane

dextrose-dextran to

for 24 hours normothermic

The

extracorporeal

helpful

cardiovascular

available

We plan to present

with

Ga. vein

are availare clinical

at

in

disorders.

and vectorcardiography

and

R.

P.R.

(some of which

of congenital

Electrocardiography

Atlanta,

jugular

MARIO

of a significant

approaches

disease

expensive

sideration

from

re-

ROBERTO RODR~QUEZ,

development

of new diagnostic

ALEXANDER, GINETTE KERN and RUTH B. GEERING, bypass,

for

Vectorcardio-

Disease,

M.D. and CARLOS GIROD, M.D., San Juan,

congenital

heart-lung

safely

equipment

blood.

GARCIA-PALMIERI, M.D., F.A.c.c.,

JESUS F. MARTINEZ, DANIELE AIDAN, WAYNE

Partial

These assistance

are not

practically

accumulated

all

by

in-

investi-

tools are help-

ful.

Cardiopulmonary M.

from

prolonged

anesthesia.

gators has shown that these diagnositic 48.

difficulty

damage

mechanical

with

the were

exhibited

main

atelectasis,

that

periods

of

required

of 1 I animals

long-lasting

and lungs

useful

anemia of hepatic

1 in the series

with

and

ob-

the animals

Tests

pulmonary

demonstrate

to the heart clinically quiring

with

associated

experiments

but

seldom

Eight

damage.

was

140,000/ was

(pH, pC!O,, chloride,

levels)

and only

neurologic

of

The maintenance

balance

of any drug.

survivors, of

count

of hemolytic

were normal.

metabolic

limits

final plasma

tendency

one to two weeks.

an adequate and

within

period,

able only in large medical

or PA resistance,

with exercise.

gest that most patients

cardiac

pulmonary exercise.

PA wedge

a significant

below 93 per cent. In all

during

between

PA pressure,

with

was 98 per cent and

was a relatively

saturation

correlation

average

final

in the postperfusion

which

well

(average

or clotting

cardiac

by about 40 per

resting

96 per cent and exceeded

93 in all but 2 cases. In 10 the SAOz fell slightly

oxygen

160 mg.%,

perfusion,

systemic

remained

by the organism

No

underwent

during

damage

hemoglobin

encountered

and

obtained

so as to rcducr

oxygen uptake

mms.).

Fifty-three

exercise. stenosis

arterial

and their oxygen saturations

manometrically.

unchanged

used

mitral

were

and

is usually

with

pulmonary

samples

supine leg exercise,

there

in the systemic with

catheterization; blood

have

changes

saturation

cardiac

in

studies

than

oxygen

artery

Blood

compensation

served

Pulmonary

an

cent.

set at 600 ml.jmin.,

and pulmonary

flow was

a modified

cardiovascular the hemodynamic

anatomic

defects

plane

that

were

firmed

obtained

by cardiac

tion and/or 50.

The

Stenosis,

defects.

The tracings from

screening

of contracings

type of findings

will include

patients

with

only those

defects

surgical

con-

interven-

at autopsy.

Emphysematous WALTER

illustrate

axis in the frontal

Illustrative

catheterization,

findings

con-

in association

We will

the most characteristic

will be presented.

of the

into

electrocardiographic

in a preliminary

cardiovascular

representing

the

findings.

in the main electric

are helpful

genital

taking

alteration

and

and vectorcardiographic how differences

classification

diseases

S.

GRAF,

QRS M.D.,

Loop

in

F.A.c.c.,

Mitral LEWIS