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The AJC 25 years ago—November 1961
The AJC 25 YearsAgo--November1961 WILLIAM C. ROBERTS, MD
The AJC in November 1961 contained 21 articles occupying 145 pages, including 11 experimental [nonhuman) studies on the role of salt in systemic hypertension. This piece will comment on 3 articles. The lead article by Boiteau and Allenstein1 from Duarte, California, described clinical features in 3 patients with "hypertrophic subaortic stenosis" with emphasis on the diagnostic usefulness of the pulse contour of the central aorta and radial artery. Normally, this contour is similar to the contour of the left ventricular pressure tracing, namely, it has an inverted U-shape. In contrast, the 3 patients with obstructive hypertrophic cardiomyopathy had a rapidly rising upstroke slope "demonstrating an early ejection of blood at the opening of the aortic valve" (Fig. 1}. Chapman and associates2 from Houston, Texas, described results of left ventricular aneurysmectomyusing a pump oxygenator for cardiopulmonary bypass in 14 men aged 45 to 63 years (mean 55) with "clinical benefits" in the 11 survivors. The aneurysms involved the anterior wall in 13 patients and the aneurysms ranged in size (recorded in 7} from 8 to 12 cm in diameter. The authors concluded that "surgical excision and ventricular repair is a feasible and rational surgical treatment for ventricular aneurysm following myocardial infarction when the lesion is of sufficient size to cause impairment of cardiac function." Kaplan and associates3 from Cincinnati, Ohio, described an intravascular polarographic anode which detected ascorbic acid and its value in detecting and localizing right-to-left intravascular shunts. This technique, in general use for about 2 decades, was of particular value in infants because it obviated the need for blood sampling. E. Grey Dimond,4 President of The American College of Cardiology in 1961, pointed out in the "President's Column" that the College at the time consisted of 2,000 members and had a staff of 2.5 persons. In contrast, the College in 1986 consisted of over 14,500 members and had a full-time staff of 78 persons.
right-to-left shunts with an intravosculor polorographic anode sensitive to ascorbic acid. Am I Cardiol 1961;8:659-663. 4. Dimond EG. The thin thread of organization. Am [ Cordial 1961;8:763.
T
120
100
CA 80
60
I 4O
40
2 0 ~" L
20
o
1
,
140
I~0
' ~
0
1. Boiteau GM, Allenstein BJ. Hypertrophic subaortic stenosis. Clinical and hemodynamic studies with special reference to pulse contour measurement.
Am ] Cordial 1961;6:614-623. 2. Chapman DW, Amad K, Cooley DA. Ventricular aneurysm, Fourteen cases subjected to cardiac bypass repair using the pump oxygenator. Am l Gardiol
1961;6:633-646. 3. Kaplan S, Clark LC Jr, Edwards FK, Gallaher ME, Fox PP. Localization of
1051
t
C a s e 7_
•
240 200
i
~ 160
,~
Cose 3,
References
0
Case I
0
0
~
--
__
Before surgery ...... After s~rgcr v
FIGURE 1. Upper 2 panels, arterial pulse contour In 2 c a s e s of hypertrophic subaorUc stenosis. Note the rapid upstroke time, the parallelism between the central aorta (CA) and radial artery ( R A ) ascent in cases 1 and 2 and the synchronism between the central aorta and left ventricular ( L V ) u p s t r o k e in c a s e 3 (lower panel) before and after surgery.
The AJC in November 1961 contained 21 articles occupying 145 pages, including 11 experimental [nonhuman) studies on the role of salt in systemic hypertension. This piece will comment on 3 articles. The lead article by Boiteau and Allenstein1 from Duarte, California, described clinical features in 3 patients with "hypertrophic subaortic stenosis" with emphasis on the diagnostic usefulness of the pulse contour of the central aorta and radial artery. Normally, this contour is similar to the contour of the left ventricular pressure tracing, namely, it has an inverted U-shape. In contrast, the 3 patients with obstructive hypertrophic cardiomyopathy had a rapidly rising upstroke slope "demonstrating an early ejection of blood at the opening of the aortic valve" (Fig. 1}. Chapman and associates2 from Houston, Texas, described results of left ventricular aneurysmectomyusing a pump oxygenator for cardiopulmonary bypass in 14 men aged 45 to 63 years (mean 55) with "clinical benefits" in the 11 survivors. The aneurysms involved the anterior wall in 13 patients and the aneurysms ranged in size (recorded in 7} from 8 to 12 cm in diameter. The authors concluded that "surgical excision and ventricular repair is a feasible and rational surgical treatment for ventricular aneurysm following myocardial infarction when the lesion is of sufficient size to cause impairment of cardiac function." Kaplan and associates3 from Cincinnati, Ohio, described an intravascular polarographic anode which detected ascorbic acid and its value in detecting and localizing right-to-left intravascular shunts. This technique, in general use for about 2 decades, was of particular value in infants because it obviated the need for blood sampling. E. Grey Dimond,4 President of The American College of Cardiology in 1961, pointed out in the "President's Column" that the College at the time consisted of 2,000 members and had a staff of 2.5 persons. In contrast, the College in 1986 consisted of over 14,500 members and had a full-time staff of 78 persons.
right-to-left shunts with an intravosculor polorographic anode sensitive to ascorbic acid. Am I Cardiol 1961;8:659-663. 4. Dimond EG. The thin thread of organization. Am [ Cordial 1961;8:763.
T
120
100
CA 80
60
I 4O
40
2 0 ~" L
20
o
1
,
140
I~0
' ~
0
1. Boiteau GM, Allenstein BJ. Hypertrophic subaortic stenosis. Clinical and hemodynamic studies with special reference to pulse contour measurement.
Am ] Cordial 1961;6:614-623. 2. Chapman DW, Amad K, Cooley DA. Ventricular aneurysm, Fourteen cases subjected to cardiac bypass repair using the pump oxygenator. Am l Gardiol
1961;6:633-646. 3. Kaplan S, Clark LC Jr, Edwards FK, Gallaher ME, Fox PP. Localization of
1051
t
C a s e 7_
•
240 200
i
~ 160
,~
Cose 3,
References
0
Case I
0
0
~
--
__
Before surgery ...... After s~rgcr v
FIGURE 1. Upper 2 panels, arterial pulse contour In 2 c a s e s of hypertrophic subaorUc stenosis. Note the rapid upstroke time, the parallelism between the central aorta (CA) and radial artery ( R A ) ascent in cases 1 and 2 and the synchronism between the central aorta and left ventricular ( L V ) u p s t r o k e in c a s e 3 (lower panel) before and after surgery.