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The vascular endothelium: A new horizon
370
LITERATURE REVIEW
(the Framingham Heart Study). Am J Cardiol72:11831187,1993
pulmonary function. Ann Thorac Surg 56:1107-1109, 1993
In a study of 722 patients (mean age 75 years) without clinical cardiac disease, heart rate was found to be a major determinant of Doppler indexes of diastolic left ventricular filling. Heart rate was inversely associated with peak velocity E, E/A ratio, and directly associated with peak velocity A and atrial filling fraction. PR interval was a minor determinant and inversely associated with time velocity integral E/A and directly associated with atrial filling fraction. The independent contribution of heart rate and PR interval to Doppler-assessed left ventricular diastolic filling in the elderly suggests that heart rate and PR interval be considered when assessing ventricular diastolic flow patterns to avoid misdiagnosis of diastolic dysfunction.
Thirty-three consecutive patients undergoing median sternotomy for a variety of surgical indications were studied. On the fifth postoperative day, FEV, and FVC were reduced similarly (40% to 47%) in patients with and without internal mammary artery harvesting. Postoperative pain (assessed by numeric rating scale) was significantly greater in the internal mammary harvest group (6.35 v 3.82), but did not affect postoperative pulmonary function.
Bashir Y, Sneddon JF, Staunton HA, et al: Effects of long-term oral magnesium chloride replacement in congestive heart failure secondary to coronary artery disease. Am J Cardiol72:1156-1162,1993 Oral magnesium supplementation increased serum magnesium and potassium concentrations in 21 patients with stable congestive heart failure receiving loop diuretics in a randomized, doubleblind, crossover trial. The frequency of asymptomatic ventricular arrhythmias was reduced by magnesium supplementation. A minor decrease in systemic vascular resistance and arterial blood pressure occurred during magnesium therapy. Cardiac index was unchanged.
Cernaianu AC, Olah A, Cilley JH, et al: Effect of sodium nitroprusside on paraplegia during crossclamping of the thoracic aorta. Ann Thorac Surg 56:1035-1038,1993 Ten dogs received sodium nitroprusside infusion or no treatment during 45 minutes of thoracic aortic cross-clamping. Mean proximal arterial pressure (112 v 142 mmHg) and distal arterial pressures (15 v 23 mmHg) were significantly lower in the nitroprusside-treated animals. Somatosensory evoked potentials returned significantly faster in the nontreated group than in the nitroprussidetreated animals. Neurologic outcome was improved in control animals.
Cohen HA, Moore P, Jones C, et al: Effect of internal mammary harvest on postoperative pain and
REVIEW ARTICLES
Bloor BC: General pharmacology of az-adrenoceptors. Anaesth Pharm Rev 1:221-232,1993 In this, the first paper in an issue devoted to az-adrenergic agonists, adrenergic receptor classification is reviewed and OLIadrenoceptor functions described by organ system. Therapeutic applications of cYz-adrenoreceptor agonists and antagonists are discussed. Other articles in this issue, authored by authorities in this field, concern the cardiovascular and respiratory effects of (~2. adrenoreceptor agonists, agonist use during general anesthesia and pain therapy, and the pharmacology of dexmedetomidine. a more selective cY*-adrenoreceptor agonist than clonidine.
Davies MG, Hagen PO: The vascular endothelium: A new horizon. Ann Surg 218:593-609,1993 This easily readable yet comprehensive review examines the physiology of vascular endothelium and illustrates the role endothelial cells play in coagulation, immunologic, and inflammatory processes, and in regulation of vessel wall structure. Endothelium derived relaxing factors, endothelin, and other chemical and humoral regulators of endothelial vasomotor function are discussed. The second half of the article reviews the pathophysiologic role of the endothelium in major cardiovascular diseases as well as in vasospasm, reperfusion injury, and intimal hyperplasia.
ACKNOWLEDGMENT Papers reviewed in this issue were selected from those published in the following journals: American Heart Journal, American Journal of Cardiology, Anaesthetic Pharmacology Review, Annals of Surgery, Annals of Thoracic Surgery, Blood, Circulation, and Journal of Thoracic and Cardiovascular Surgery
LITERATURE REVIEW
(the Framingham Heart Study). Am J Cardiol72:11831187,1993
pulmonary function. Ann Thorac Surg 56:1107-1109, 1993
In a study of 722 patients (mean age 75 years) without clinical cardiac disease, heart rate was found to be a major determinant of Doppler indexes of diastolic left ventricular filling. Heart rate was inversely associated with peak velocity E, E/A ratio, and directly associated with peak velocity A and atrial filling fraction. PR interval was a minor determinant and inversely associated with time velocity integral E/A and directly associated with atrial filling fraction. The independent contribution of heart rate and PR interval to Doppler-assessed left ventricular diastolic filling in the elderly suggests that heart rate and PR interval be considered when assessing ventricular diastolic flow patterns to avoid misdiagnosis of diastolic dysfunction.
Thirty-three consecutive patients undergoing median sternotomy for a variety of surgical indications were studied. On the fifth postoperative day, FEV, and FVC were reduced similarly (40% to 47%) in patients with and without internal mammary artery harvesting. Postoperative pain (assessed by numeric rating scale) was significantly greater in the internal mammary harvest group (6.35 v 3.82), but did not affect postoperative pulmonary function.
Bashir Y, Sneddon JF, Staunton HA, et al: Effects of long-term oral magnesium chloride replacement in congestive heart failure secondary to coronary artery disease. Am J Cardiol72:1156-1162,1993 Oral magnesium supplementation increased serum magnesium and potassium concentrations in 21 patients with stable congestive heart failure receiving loop diuretics in a randomized, doubleblind, crossover trial. The frequency of asymptomatic ventricular arrhythmias was reduced by magnesium supplementation. A minor decrease in systemic vascular resistance and arterial blood pressure occurred during magnesium therapy. Cardiac index was unchanged.
Cernaianu AC, Olah A, Cilley JH, et al: Effect of sodium nitroprusside on paraplegia during crossclamping of the thoracic aorta. Ann Thorac Surg 56:1035-1038,1993 Ten dogs received sodium nitroprusside infusion or no treatment during 45 minutes of thoracic aortic cross-clamping. Mean proximal arterial pressure (112 v 142 mmHg) and distal arterial pressures (15 v 23 mmHg) were significantly lower in the nitroprusside-treated animals. Somatosensory evoked potentials returned significantly faster in the nontreated group than in the nitroprussidetreated animals. Neurologic outcome was improved in control animals.
Cohen HA, Moore P, Jones C, et al: Effect of internal mammary harvest on postoperative pain and
REVIEW ARTICLES
Bloor BC: General pharmacology of az-adrenoceptors. Anaesth Pharm Rev 1:221-232,1993 In this, the first paper in an issue devoted to az-adrenergic agonists, adrenergic receptor classification is reviewed and OLIadrenoceptor functions described by organ system. Therapeutic applications of cYz-adrenoreceptor agonists and antagonists are discussed. Other articles in this issue, authored by authorities in this field, concern the cardiovascular and respiratory effects of (~2. adrenoreceptor agonists, agonist use during general anesthesia and pain therapy, and the pharmacology of dexmedetomidine. a more selective cY*-adrenoreceptor agonist than clonidine.
Davies MG, Hagen PO: The vascular endothelium: A new horizon. Ann Surg 218:593-609,1993 This easily readable yet comprehensive review examines the physiology of vascular endothelium and illustrates the role endothelial cells play in coagulation, immunologic, and inflammatory processes, and in regulation of vessel wall structure. Endothelium derived relaxing factors, endothelin, and other chemical and humoral regulators of endothelial vasomotor function are discussed. The second half of the article reviews the pathophysiologic role of the endothelium in major cardiovascular diseases as well as in vasospasm, reperfusion injury, and intimal hyperplasia.
ACKNOWLEDGMENT Papers reviewed in this issue were selected from those published in the following journals: American Heart Journal, American Journal of Cardiology, Anaesthetic Pharmacology Review, Annals of Surgery, Annals of Thoracic Surgery, Blood, Circulation, and Journal of Thoracic and Cardiovascular Surgery