Objective. Assessment of the outcome of patients deemed suitable for single-vessel coronary balloon angioplasty who were surgically revascularised. Design. Retrospective analysis of the clinical course of such patients who had an elective coronary bypass operation before angioplasty was routinely available at this hospital. Patients. One hundred consecutive subjects who had undergone single coronary bypass grafting between 1978 and 1983 were entered, and 60 selected as potential candidates for angioplasty using clinical and angiographic criteria.
This study compared the effect of halothane and opiate anaesthesia on myocardial necrosis and reperfusion injury after coronary artery bypass surgery in patients. Except for the halothane and opiates, a similar anaesthetic technique was used in the two groups (10 patients each), including pre-induction beta-adrenergic blockade. The demographic data of the groups were similar and results indicated that there was no difference in the incidence of post-cardiopulmonary bypass arrhythmias. The creatine kinase myocardial fraction (CK-MB) in both groups increased after induction of anaesthesia (from 2,6 ï¿½ 0,9 to 5,6 ï¿½ 1,5%, mean and SEM for the opiate group and 1,3 ï¿½ 0,2 to 7,8 ï¿½ 1,7% for halothane patients).
This study investigated the possibility that, independently of other criteria, light microscopic bivariate morphometry could distinguish between the histologically similar myofibre pathology extant in dilated (congestive) cardiomyopathy (DCM) and systemic hypertension (HYP). Left ventricular tissue, taken at necropsy from the hypertrophic hearts of 30 patients who had died as a consequence of DCM and 18 with HYP, was subjected to bivariate myofibre morphometry. The cross-nuclear fibre diameter (FD) and nuclear diameter (ND) were determined for each of 150 myofibres per specimen and their mean FD/ND co-ordinates plotted. The bivariate relationship between FD and ND for each group of specimens was expressed as linear regressions and the limits for the distribution of DCM specimen means were calculated and depicted in the form of an ellipse.
At Ga-Rankuwa Hospital, which serves an underdeveloped area where rheumatic heart disease is common, 101 adults of both sexes with rheumatic mitral regurgitation (MR) were studied on the basis of criteria defined for isolated or dominant significant MR. The objectives were to define: (i) the prevalence of six common complications, viz. left ventricular disease and dysfunction, atrial fibrillation, systemic embolism, infective endocarditis, pulmonary hypertension, left atrial dilatation; and (ii) the interaction of these complications with the natural history of the disease.
Eight volunteers who had been on a post-coronary rehabilitation programme for more than 1 year at the Sports Research Institute, University of Pretoria, were placed on an elimination and rotation diet. The diet eliminated all refined, processed, manufactured and fried foods in order to reduce the rapid absorption of glucose and the resultant insulin reaction. One or two types of foods, in their natural state, were eaten at each meal. No item of food was repeated in any 1 week; the foods eaten were thus rotated. Beverages, especially those containing caffeine, were not allowed. The diet resulted in a significant lowering of blood pressure and serum lipid levels compared with 8 controls who continued with the normal rehabilitation programme. The ischaemic pattern on the electrocardiogram of 2 of the trialists improved within 5 weeks.
Hypertension is a major disease in the black populations of sub-Saharan Africa and the USA. The prevalence of hypertension varies from 1-30% in the adult population. Differences in blood pressure between black and white patients have been documented. In this review genetic, endocrine andï¿½ environmental characteristics, renal physiology and cardiac function are reviewed. Racial differences in renal physiology and socio-economic status seem to account for blood pressure differences. Black hypertensive patients in sub-Saharan Africa are prone to cerebral haemorrhage, malignant hypertension leading to uraemia and congestive heart failure, whereas coronary artery disease is uncommon. Responses to hypotensive agents like l3-blockers and angiotensin-converting enzyme inhibitors are poor unless these agents are combined with a thiazide diuretic. Black hypertensive patients respond best to diuretics, vasodilators or calcium channel blockers. A profiled approach to the treatment of hypertension is suggested.