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Publications (39)222.41 Total impact

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    ABSTRACT: Background: The teaching provided by medical school faculty members has not to date been measured systematically. To address this shortcoming, we propose the Relative Value Scale in Teaching (RVST). Description: RVST assigns a relative weight to each teaching activity. Each teacher accrues relative value units (RVUs) for each teaching activity according to the formula, RVU = hours x weight. Total RVUs for each teacher are then summed. Evaluation: Feedback was provided by faculty focus groups, relating the activities of diverse types of teachers to a common point of reference, and seeking to attain consensus among the faculty. Conclusions: RVST provides a quantitative instrument for measuring the teaching activities of faculty. This instrument can be used for setting teaching expectations; for promotion and tenure decisions; for compensating teachers for teaching; for balancing teaching responsibilities among the faculty; and for distributing college funds among the departments.
    Teaching and Learning in Medicine 01/1998; 10(1):40-43. DOI:10.1207/S15328015TLM1001_7 · 1.12 Impact Factor
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    ABSTRACT: Myocardial function with ultrastructure and high energy phosphate levels in dogs was correlated after 24 hours of sepsis using live Klebsiella aerogenes. All animals developed progressive hemodynamic deterioration over a 24 hour period. Mean arterial pressure decreased from 148 +/- 7 mmHg to 85 (P less than 0.01) and cardiac output decreased from 3.43 +/- .31 to 1.6 +/- 0.5 L/min. Left ventricular stroke work decreased from 48.2 +/- 5 to 18.1 +/- 6 gm-meters (P less than 0.001). Systemic and pulmonary vascular resistances were increased at 24 hours (3,538 +/- 27 to 7,404 +/- 1,400 dyne/sec/cm-5 (P less than 0.01), and 185 +/- 20 and 619 +/- 90 dyne/sec/cm-5 (P less than 0.001), respectively. Left ventricular function curves at 24 hours showed a fixed low output. However, myocardial ultrastructure was preserved and high energy phosphate levels remained normal. These observations correlate well with the changes seen clinically in early gram negative sepsis in hypovolemic patients. Thus, this appears to be a suitable model for further investigation of the effects of gram negative sepsis on myocardial performance, ultrastructure, and maintenance of energy stores.
    Journal of the National Medical Association 11/1989; 81(10):1033-40. · 0.91 Impact Factor
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    ABSTRACT: Intimal cell proliferation is a "hallmark" of atherosclerosis. Myointimal hyperplasia in arteries has been shown to be dependent on age after vascular endothelial denudation and injury associated with vascular transplantation. Because myointimal thickening is greater in aged rats than in younger rats, and aortic segments from old rats transplanted into young syngeneic recipients have a greater myointimal proliferative response to injury than its host environment, the authors examined the cell cycle distributions of old and young rat arterial smooth muscle cells (SMCs) by flow-cytometric analysis. They observed that there is an apparent age-dependent variation in the cell cycle distribution. Moreover, old SMCs have a greater percentage of their population in the S phase and not G2/M, compared with young SMCs; and there is a decrease in the percentage of old cells in the G0/G1 phase as compared with young SMCs. These differences may reflect the cellular changes observed during myointimal hyperplasia following vascular injury. It is concluded that our data support the hypothesis that the proliferation of SMCs is dependent, in part, on those processes related to aging as well as to the phenotypic state of the cell.
    American Journal Of Pathology 05/1988; 131(1):132-6. · 4.60 Impact Factor
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    ABSTRACT: Old Fischer 344 rats are more susceptible to vascular lesions after arterial endothelial injury than are young animals. Thus, 20-26-mo-old Fischer 344 rats developed greater and more persistent intimal proliferative lesions than did 2-5-mo-old rats after aortic endothelial denudation. 3 d after deendothelialization, intimal thickness was increased two-fold in both old and young animals. However, 14 d after endothelial injury, intimal thickness had increased nearly five times in old animals, but had regressed to normal in young animals. Intimal thickness of young aortic grafts transplanted into young recipients did not differ significantly from adjacent host aorta or autotransplanted aortic segments 6 wk after surgery. In contrast, intimal thickness of old grafts transplanted into young recipients was eight times greater than adjacent young host aorta 6 wk after surgery. The density of cell nuclei in the intima of old grafts was also much greater than that in young grafts. Thus, in two experimental models of vascular injury, old rats have consistently had greater myointimal hyperplasia than young rats. The increased proliferative response of aortic smooth muscle cells after vascular injury of old animals may contribute to the increased prevalence of vascular disease with age.
    Journal of Experimental Medicine 11/1986; 164(4):1171-8. · 13.91 Impact Factor
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    ABSTRACT: With the onset of ischemia, the length of myocardial segments increases rapidly, distorting ventricular geometry. Permanent stretching and thinning of infarcted zones have been termed infarct expansion. Although these changes are noted within minutes in vivo, infarct expansion may not be seen for days in postmortem preparations. The apparent postmortem reversal of early infarct expansion suggests that early expansion may be a functional phenomenon, reversible in the early hours of infarction. Alternatively, reversal of expansion may be a postmortem artifact, concealing the importance of underlying structural abnormalities. Myocardial infarction was produced in five dogs by occluding the left anterior descending coronary artery. Ultrasound sonomicrometers were used to measure myocardial segment end-diastolic length in the infarct and normal zones. After 3 hours of ischemia, the heart was arrested in diastole and biopsy specimens were taken from the normal and infarct zones. Sarcomere length was measured from electron photomicrographs, and myofiber width was measured from light photomicrographs. After 3 hours of ischemia, infarct zone segment length had increased significantly more than normal zone length (116 +/- 11 [SD] versus 103 +/- 4% of control length, p less than 0.05), whereas 2 minutes after cardiac arrest, both the infarct and normal zones returned to preischemic segment length, demonstrating apparent reversibility of early infarct expansion. However, histologic study revealed that the infarct zone myofibers were significantly thinner than normal zone myofibers (7.9 +/- 0.3 versus 9.4 +/- 0.3 micron, p less than 0.001) and sarcomere length in the infarct zone was significantly longer than that in the normal zone (1.9 +/- 0.2 versus 1.5 +/- 0.2 micron, p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
    Journal of the American College of Cardiology 11/1985; 6(4):839-44. DOI:10.1016/S0735-1097(85)80492-7 · 15.34 Impact Factor
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    ABSTRACT: High-potassium cardioplegic solutions (CSs) may induce endothelial cell damage in vascular grafts, promoting graft thrombosis after coronary bypass operations. We studied prostacyclin (PGI2) production by saphenous veins as a marker of endothelial cell function in a model mimicking actual operative conditions. Fresh saphenous vein segments from patients who had undergone coronary bypass were cut in half; each part was perfused and incubated sequentially with CS (with 20, 40, or 80 mEq potassium/L) or a control buffer (5 mEq potassium/L) at 4 degrees C for 30 minutes (perfusion I), buffer at 37 degrees C for 15 minutes (perfusion II), and buffer plus 25 microM sodium arachidonate at 37 degrees C for 15 minutes (perfusion III). This permitted evaluation of changes in PGI2 production during or after exposure to CS, in basal and stimulated conditions. CS with 20 mEq potassium/L did not alter PGI2 production as compared with control buffer. CS with 40 mEq potassium/L decreased PGI2 production during perfusions I and II. CS with 80 mEq potassium/L also decreased sodium arachidonate-stimulated PGI2 production. Endothelial coverage (immunoperoxidase staining for factor VIII antigen) was intact at all potassium concentrations tested. Thus potassium in CSs can depress endothelial PGI2 production without causing immediate endothelial detachment. This effect may favor thrombosis in bypass grafts.
    Surgery 10/1985; 98(3):465-71. · 3.11 Impact Factor
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    ABSTRACT: Mice of the autoimmune strain MRL/1, the congenic strain MRL/n, and two control strains, Balb/c and C57BL/6 mice, were fed diets which varied in the content of lipid and cholesterol. Serum cholesterol levels were highest in mice fed diets containing cholesterol and lowest in mice fed laboratory "chow." Animals fed diets that increased serum cholesterol had decreased production of prostacyclin by vascular tissue and increased production of thromboxane A2 by platelets. Prostacyclin production by heart tissue in response to arachidonic acid showed a negative correlation (r = -0.86) with serum cholesterol. In contrast, serum thromboxane demonstrated a positive correlation (r = 0.70) with serum cholesterol. The prevalence of autoimmune vasculitis seen in MRL/lpr mice was not affected by diet. However, MRL/lpr mice fed a high-fat, cholesterol-containing diet had intimal vascular lesions containing foam cells typical of arteriosclerosis. It is suggested that diets that raise serum cholesterol may influence the nature of autoimmune-mediated vascular disease by altering the balance between thromboxane and prostacyclin.
    American Journal Of Pathology 11/1984; 117(1):125-30. · 4.60 Impact Factor
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    ABSTRACT: Mice of the autoimmune, lymphoproliferative strain MRL/lpr and the congenic, nonlymphoproliferative strain MRL/n were fed one of six diets from weaning on-ward. These mice were sacrificed at 3 or 5 months of age. Low fat diets resulted in lower cholesterol and higher triglyceride levels than did cholesterol-containing high-fat diets. Caloric restriction of MRL/lpr mice was associated with an increased plaque-forming cell response to trinitrophenylated polyacrylamide beads, less lymphoproliferation, and less severe glomerulonephritis. Diet did not affect the incidence of autoimmune vasculitis in MRL/lpr mice sacrificed at 5 months. MRL/lpr mice fed a low-fat, calorically restricted diet from 5 months of age to death lived longer than mice which were fed ad libitum a cholesterol-containing, high-fat diet. At death, MRL/lpr mice fed the former diet had the autoimmune vasculitis which had been evident in mice killed at 5 months, whereas mice fed the latter diet, in addition to the vasculitis, had a high incidence of atherosclerotic lesions of intrarenal and aortic branch arteries.
    American Journal Of Pathology 11/1984; 117(1):110-24. · 4.60 Impact Factor
  • Arleen B. Rifkind, Adolfo Firpo, Daniel R. Alonso
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    ABSTRACT: Hepatic histologic changes and induction of mixed function oxidases were examined and compared after administration to the chick embryo of four highly purified polychlorinated biphenyl (PCB) congeners: 3,4,3',4'-tetrachlorobiphenyl (TCB) and 3,4,5,3',4',5'-, 2,4,5,2',4',5'-, and 2,3,6,2',3',6'-hexachlorobiphenyls (HCBs). The major histopathologic change was hepatocyte swelling as evidenced by sinusoidal narrowing. It was observed within 24 hr after PCB administration at doses as low as 5 nmol/egg for 3,4,3',4'-TCB and 3,4,5,3',4',5'-HCB and only at doses of 5000 nmol/egg and higher for 2,4,5,2',4',5'-HCB. 2,3,6,2',3',6'-HCB was inactive. The histopathologic change was predominantly perivascular in distribution. It was accompanied by increased hepatic water content. Occasional hepatocytes showed nuclear pyknosis and cytoplasmic eosinophilia, but there was little histologic evidence of frank necrosis and no biochemical evidence, since serum glutamic-oxalic and glutamic-pyruvic transaminases and lactic dehydrogenase did not increase. Hepatic glutathione (GSH) levels were not significantly altered by 3,4,3',4'-TCB or 3,4,5,3',4',5'-HCB, indicating that GSH depletion does not have a significant role in the production of hepatotoxic changes by PCBs. Measurement of the degree of pathologic change indicated that 3,4,3',4'-TCB and 3,4,5,3',4',5'-HCB were three to four orders of magnitude more potent than 2,4,5,2',4',5'-HCB both as hepatotoxins and as inducers of the cytochrome P-448 mediated mixed function oxidases, aryl hydrocarbon hydroxylase, and 7-ethoxyresorufin deethylase. 2,3,6,2',3',6'-HCB was inactive as an inducer as well as as a hepatotoxin. The findings indicate that hepatotoxic changes are selectively produced in the chick embryo by those PCBs that also induce cytochrome P-448 mediated mixed function oxidases and in that respect resemble other manifestations of PCB toxicity (e.g., subcutaneous and pericardial edema and thymic involution) in both the chicken and other species. The results support the hypothesis that a common initial mechanism leads both to cytochrome P-448 type induction and to diverse manifestations of polyhalogenated hydrocarbon toxicity.
    Toxicology and Applied Pharmacology 03/1984; 72(2):343-54. DOI:10.1016/0041-008X(84)90319-3 · 3.63 Impact Factor
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    ABSTRACT: Repeat cardiac surgery is significantly more difficult than the original surgery. Pericardial closure to limit adhesion formation between the heart and mediastinal structures and thus reduce the increased difficulty of reoperation has been considered. To investigate the feasibility of effecting loose pericardial closure with homologous pericardial grafts, glutaraldehyde-preserved pericardial allografts were implanted in 10 mongrel dogs. After a mean period of 6.7 months (range 6 to 8 months) the grafts were studied grossly and histologically. Adhesion formation was minimal and the adhesions were easily dissectible. The allografts evoked no significant inflammatory response. No infections resulted from graft placement. It is concluded that glutaraldehyde-preserved pericardial allografts may be useful to effect pericardial closure and deserve further investigation in this regard.
    Journal of Surgical Research 02/1984; 36(1):50-4. DOI:10.1016/0022-4804(84)90066-0 · 2.12 Impact Factor
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    ABSTRACT: We studied the ability of a single oral dose of aspirin to inhibit prostacyclin synthesis by human arterial and venous tissue and to inhibit thromboxane A2 synthesis by platelets in 70 patients who were undergoing aortocoronary bypass. A dose of 40, 80, or 325 mg of aspirin was administered 12 to 16 hours before surgery. The generation of thromboxane in serum--which provides an estimate of platelet thromboxane production--was reduced from the control value by 77, 95, and 99 per cent after single doses of 40, 80, and 325 mg of aspirin, respectively. By contrast, prostacyclin production in aortic tissue that was removed at operation was reduced by only 35, 38, and 75 per cent, respectively, in response to these doses. Production of prostacyclin in saphenous-vein tissue (not tested after 40 mg of aspirin) fell only slightly and not significantly after 80 mg but was reduced by 85 per cent after 325 mg. These findings indicate that a low dose of aspirin (40 to 80 mg) can largely inhibit platelet aggregation and thromboxane synthesis but has much less effect on prostacyclin production in arterial and venous endothelium.
    New England Journal of Medicine 05/1983; 308(14):800-5. DOI:10.1056/NEJM198304073081402 · 54.42 Impact Factor
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    ABSTRACT: Autoimmune-prone B/W mice, which are known to develop severe glomerulonephritis and vasculitis, also are found to develop arteritis and proliferative and fatty-proliferative lesions of the aorta and its branches as well as renal inflammatory lesions. High intake of saturated fat in the diet enhances the development of these atherosclerotic and autoimmune lesions significantly in female mice, whereas restriction of dietary calories and fat inhibits their development. Ad lib feeding of laboratory chow, high in fiber and low in fat, does not foster development of vascular lesions but does permit the development of autoimmune renal disease.
    Proceedings of the National Academy of Sciences 03/1983; 80(3):874-7. DOI:10.1073/pnas.80.3.874 · 9.81 Impact Factor
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    ABSTRACT: Although patients with acute inferior myocardial infarction often manifest S-T segment depression in precordial electrocardiographic leads, the pathophysiologic abnormalities associated with this finding are poorly understood. To examine this problem, electrocardiographic findings on admission were compared with results of radionuclide cineangiography performed within 38 hours of the onset of symptoms in 25 patients with inferior infarction. Summation of S-T depression in leads V1 through V4 permitted the separation of patients into two groups: Group A (11 patients with 0.20 mV or less of S-T depression) and Group B (14 patients with 0.45 vM or more of S-T depression). The radionuclide cineangiogram revealed inferior wall dysfunction in all patients. Additional posterolateral dysfunction was seen in 13 patients, all in Group B. Patients in Group B had a relatively larger infarction (peak creatine kinase Units - 756 +2- 358 in Group A versus 1,566 +/- 983 units in Group B, p less than 0.01) and greater functional impairment (ejection fraction - 45 +/- 12 in Group A versus 33 +/- 12 in Group B, p less than 0.01). The relation between precordial S-T segment depression and posterolateral dysfunction appears to be largely independent of electrocardiographic evidence of "true posterior infarction." Thus moderate or severe anterior precordial S-T depression in patients with acute inferior infarction is a sensitive and specific indicator of relatively extensive myocardial damage, primarily involving the posterolateral region.
    The American Journal of Cardiology 01/1982; 48(6):1009-15. DOI:10.1016/0002-9149(81)90313-1 · 3.43 Impact Factor
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    ABSTRACT: Arteries are capable of producing significantly larger quantities of prostacyclin than are veins. To test the hypothesis, whether prostacyclin production by the vessel wall is related to blood pressure and flow, we measured the amounts of PGI2 released and synthesized by venous segments transplanted for 6 weeks into the arterial circulation. These results were compared with the production of prostacyclin by normal veins and arteries. In 20 dogs a segment of jugular vein was interposed into the carotid system; a sham dissection was done on the opposite side. "Arterialized" vein grafts showed prominent intima lined by endothelium, medial smooth muscle cell proliferation and fibrotic proliferation in adventitia. Spontaneous and arachidonic acid-stimulated prostacyclin production (measured by radioimmunoassay for 6-keto-PGF1 alpha) was not significantly different between arterialized venous autografts and jugular veins. Significantly larger amounts of prostacyclin were synthesized by the carotid artery. Thus, histologic changes and rheologic effects occurring in vein grafts transposed to the arterial site do not affect prostacyclin production.
    Prostaglandins 10/1981; 22(3):485-98. DOI:10.1016/0090-6980(81)90108-8
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    W H Horner, D R Alonso, J G Jacobstein
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    ABSTRACT: An isolated-heart preparation has been adapted to permit rapid evaluation of, and imaging by, myocardial tracers. The rabbit heart provided a mass large enough for imaging and serial biopsies. Coronary arteries could be selectively ligated and provided landmarks for epicardial ST segment mapping. Uptake ratios between a tissue sample and normal myocardium (T/N), obtained using Tc-99m glucoheptonate as an infarct-seeker, increased with duration of the ischemic period, which was followed by reflow. After 25 min of occlusion the T/N was 4.5; after 40 min T/N = 6; after 60 min T/N = 8; and after 120 min T/N = 19. This well-controlled adjunct to in vivo studies allows evaluation of myocardial imaging agents without interfering with systemic effects or blood and tissue background. Functional and structural changes can be sequentially measured and correlated with the localization of various radiopharmaceuticals.
    Journal of Nuclear Medicine 07/1980; 21(6):523-8. · 5.56 Impact Factor
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    Circulation 03/1980; 61(2):228-36. DOI:10.1161/01.CIR.61.2.228 · 14.95 Impact Factor
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    ABSTRACT: The relative effectivenss of hypothermic potassium (K) cardioplegia in conjunction with either continuous or intermittent aortic cross-clamping was evaluated in 20 mongrel dogs. Isovolumetric left ventricular (LV) contractions and myocardial biopsies were obtained before and after a total of 90 minutes of aortic cross-clamping. The dogs were randomly divided into four groups of five dogs each as follows: Group I, continuous 90 minute cross-clamping and multidose K at 4 degrees C (40 mEq/L); Group II, intermittent cross-clamping consisting of six 15 minute periods of cross-clamping separated by 5 minute reperfusion periods and K cardioplegia at 4 degrees C given at the start of each cross-clamping period; Group III, continuous 90 minute cross-clamping and multidose buffered saline at 4 degrees C; Group IV, intermittent cross-clamping, consisting of six 15 minute periods of cross-clamping separated by 5 minute reperfusion periods and buffered saline at 4 degrees C given at the initiation of each cross-clamp period. Group I dogs had the best myocardial performance, with no difference between control values of peak LV pressure and dP/dtmax and those recordings obtained 60 minutes after release of the aortic cross-clamp. Significant depression of LV function was noted in all other groups. Examination of force-velocity and length-tension relationships confirmed better myocardial performance in Groups I and II (multidose K at 4 degrees C) than in Groups III and IV (buffered saline at 4 degrees C). Groups I and III (continuous cross-clamping) had no de-rease in diastolic LV compliance after cross-clamping, whereas compliance was decreased in both Groups II and IV (intermittent cross-clamping) at higher preloads (p less than 0.05 and p less than 0.025, respectively). The wet weight/dry weight myocardial ratios were lower in Groups I and III (continuous cross-clamping) than in Groups II and IV (intermittent cross-clamping). Although creatine phosphate (CP) concentrations were rapidly restored by reperfusion in all groups, adenosine triphosphate (ATP) and glycogen myocardial stores were better preserved at the end of cross-clamping in Groups I and II (multidose K at 4 degrees C). Although LV diastolic compliance was decreased and myocardial water content was increased in Groups II and IV (intermittent cross-clamping), no differences in the minimal extent of subendocardial hemorrhage, edema, and contraction-band necrosis were observed among any of the groups examined electron microscopically. The present study identifies continuous aortic cross-clamping with multidose K at 4 degrees C as a superior method of myocardial protection.
    Journal of Thoracic and Cardiovascular Surgery 02/1980; 79(1):44-58. · 3.99 Impact Factor
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    ABSTRACT: We tested the hypothesis that intraaortic balloon pumping (IABP) might improve the cardiorespiratory, metabolic, and hematological responses of 20 mongrel dogs (10 IABP-treated, 10 controls) during 24 hours of live Klebsiella aerogenes-induced sepsis. At 24 hours after bacterial infusion, left ventricular stroke work was better preserved in the IABP-treated group of animals, 36.6 ± 3.3 gm-m (minus 25.4% of baseline value), compared with controls, 23.5 ± 4.2 gm-m (minus 50.1% of baseline value) (p < 0.01). Myocardial performance curves constructed 24 hours after Klebsiella infusion were also better in the IABP group (p < 0.01).Severe tissue damage was observed in the liver and small bowel of the control animals, while relatively less injury was seen in these organs in the IABP-treated group. Metabolic acidosis was also more marked in control animals compared with IABP-treated animals following Klebsiella infusion. In addition, the initial decrease in white blood cell count following bacterial administration was followed by a later increase in circulating leukocytes only in IABP-treated animals. Electron microscopic studies of the left ventricle showed only minor intracellular edema in both experimental groups, while left ventricular high-energy phosphate stores were maintained at similar levels in both groups.These findings suggest that the early institution of IABP may play an important palliative role in the treatment of hypodynamic gram-negative sepsis. It can be speculated that IABP provides additional time during which more specific therapy, including appropriate antibiotics, can be instituted in an effort to control the disease process before the development of irreversible cellular destruction.
    The Annals of Thoracic Surgery 08/1979; 28(1):73-86. DOI:10.1016/S0003-4975(10)63397-8 · 3.63 Impact Factor
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    ABSTRACT: In the absence of thiamine deficiency, the specific effects of protein-calorie malnutrition on left ventricular (L.V.) function are unknown. Mature beagle dogs of both sexes were subjected to a hypocaloric, nitrogen-poor diet which resulted in a weight loss of approximately 40% after seven weeks. Following preparation of this nutritional model, myocardial contractility was assessed acutely by obtaining isovolumetric L.V. contractions on cardiopulmonary bypass at constant heart rate, mean aortic pressure, and at a wide range of end-diastolic volumes. These changes were compared to a matched group of animals which were normally fed. There were consistent decreases in L.V. compliance in malnourished animals compared with normals; indices of ventricular contractility per se (L.V. dp/dt, force-velocity relations, peak developed L.V. pressure) were also diminished in the experimental animals. Myocardial concentration of glycogen was diminished in malnourished compared to control animals. Light and electron microscopic examination confirmed the presence of myofibrillar atrophy in the presence of interstitial edema. These results suggest that protein-calorie malnutrition seriously interferes with normal L.V. function in the experimental animal by reducing compliance as a result of "starvation edema," and by reducing myocardial contractility associated with atrophy of the myofibers.
    American Heart Journal 07/1979; 97(6):733-44. DOI:10.1016/0002-8703(79)90008-5 · 4.56 Impact Factor
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    ABSTRACT: The present study was performed to evaluate scintigraphic imaging with technetium 99m-labeled glucoheptonate and serum enzyme levels of creatine phosphokinase isoenzyme (MB-CPK) in the early diagnosis of perioperative acute myocardial infarction associated with saphenous vein bypass graft operations. Myocardial imaging was done in 27 patients (50% of whom were considered high-risk) before operation and again 5 hours after operation. Four of these patients (15%) had both electrocardiographic and serum MB-CPK evidence of acute myocardial infarction, and all 4 had developed positive postoperative scintigrams. Four other patients had only elevated serum MB-CPK, and scintigrams became positive after operation in 3 of them. In addition, serum MB-CPK 6 hours after operation was 83 +/- 21 mIU/ml (mean +/- standard error of the mean) in patients with positive postoperative scans compared with 24 +/- 5 mIU/ml in those patients with negative postoperative scintigrams (p less than 0.001). Myocardial imaging with 99mTc-glucoheptonate in the perioperative period is rapid, safe, and atraumatic. Furthermore, our results suggest that it is a sensitive method for the early diagnosis of perioperative acute myocardial infarction, and, when imaging is combined with serum MB-CPK isoenzyme analysis, the reliability of the diagnosis of acute myocardial infarction is enhanced even further. Only 1 of the patients who showed perioperative myocardial damage had acute hemodynamic compromise or obvious impairment of recovery in the immediate postoperative period, and the 30-day mortality of the total group was 4% (1 of 27).
    The Annals of Thoracic Surgery 02/1979; 27(1):42-8. DOI:10.1016/S0003-4975(10)62969-4 · 3.63 Impact Factor