Peter T. Kuo

Polarographic Oxygen, the Epicardial Electrocardiogram and Muscle Contraction in Experimental Acute Regional Ischemia of the Left Ventricle

This study is the first attempt to correlate myocardial oxygen availability by the polaro-graphic method with direct electrocardiographic leads and cinematographic records of muscle contraction during experimental acute coronary branch occlusion and narrowing. The comparative insensitivity and slowness of the epicardial electrocardiogram as an index of acute regional ischemia is demonstrated. Special attention is given to the rates of myocardial oxygen change immediately following attainment of a significant degree of coronary obstruction, the effects of pure oxygen inhalation on the experimental situations, and alterations in coronary vein color following release of arterial occlusion.

Experimental Production of Syndrome of Obesity, Hyperinsulinemia and Hyperlipidemia in Monkeys

Summary A syndrome of obesity, high basal serum immunoreactive insulin, blunted insulin response to glucose loading, decreased K-glucose, hyperbeta- and hyperprebeta-lipoproteinemia progressing, in some animals, to overt diabetes mellitus has been observed in monkeys. The syndrome develops spontaneously in “middle-age” animals, or earlier in animals with obesity resulting from hypothalamic lesions.

Pulmonary stenosis with left to right intracardiac shunts

Abstract 1.l. Data obtained in six patients with pulmonary stenosis and left to right intracardiac shunts of blood are presented. In four patients there were coexisting ventricular septal defects, and in two patients atrial septal defects were demonstrated. 2.2. The factors governing the direction of the intracardiac shunts in such patients include the degree of pulmonary stenosis, the degree of compensation of the right ventricle and, in those with associated ventricular septal defects, the degree of dextroposition of the aorta. 3.3. In the four patients with pulmonary stenosis and left-to-right intraventricular shunts, a possible relationship to the tetralogy of Fallot has been considered. 4.4. A predominant left-to-right intracardiac shunt in the presence of pulmonary stenosis should be evaluated as a possible contraindication to valvulotomy.

Left heart radiopotassium dilution curves in patients with rheumatic mitral valvular disease.

Left heart radiopotassium-dilution curves were carried out in 9 patients with rheumatic mitral valvular disease. From the curves, blood flow, circulation times, and left heart and aortic volumes were calculated. When this technic is used along with left heart pressure measurements, it appears to have a satisfactory reliability in demonstrating abnormalities of flow, volume, and mitral valve function. In theory, its proper application permits complete quantitation of these parameters.

Serum glycoproteins in hyperlipoproteinemic patients with and without clinical vascular disease.

Abstract Total serum protein-bound carbohydrate levels were determined in 126 patients with either hyperbetalipoproteinemia or hyperprebetalipoproteinemia or with both. Forty-one % of these had clinically manifested vascular disease. Twenty-six normals were similarly studied. Serum glycoproteins were then analyzed in 11 normal controls, II hyperlipoproteinemic patients, and 11 hyperlipoproteinemic patients with vascular disease. Elevations of protein-bound carbohydrate were found in patients with and without vascular disease, when compared to healthy, normolipemic controls. Specific elevation of four glycoproteins: α 1 -acid glycoprotein, ceruloplasmin, haptoglobin, and hemopexin were found to account for this rise in serum carbohydrate. The profile of response observed in these patients differs from those described previously for other disease states.

Electrocardiogram, Myocardial Oxygen and Contraction in Scar and Collaterally Supplied Muscle After Experimental Coronary Ligation

Studies of myocardial electrocardiograms, oxygen, and cinematographic muscle contraction were carried out in dogs during coronary branch ligation and after 2 to 12 weeks recovery. Scars were found in 12 of 13 animals. Five were transmural at some point and seven entirely subendocardial. Myocardial electrocardiographic abnormalities were found in every animal with a scar. Epicardial electrocardiographic abnormalities (localized Q waves or low R waves) were roughly conterminous with the surface projection of the entire extent of all transmural scars and of six out of seven subendocardial scars. Precordial leads were abnormal in only three animals, all with transmural scars. Responses to oxygen inhalation, hypoxia, and levarterenol for these animals were within the range of normal variation, but there was a tendency to develop ventricular fibrillation, unrelated to the amount of scar. Study of the acute ischemic dysfunction consequent to coronary ligation is not of great value for the interpretation of the situation at re-exploration two or more weeks later. The behavior of recovered collaterally supplied muscle, assessable by the techniques employed in these studies (provided that epicardial thickening has been avoided by minimizing exposure and trauma at the time of ligation), has relevance to many human coronary disease situations in which regional circulation is carried on by intramyocardial or small caliber vessels.

Study of Nailfold Capillaries in Hypertriglyceridemia (Types III and IV Hyperlipoproteinemia)

Reflected light nailfold capillaroscopy was used to discover micro-angiopathy in atherosclerotic patients with hypertriglyceridemia (types III and IV hyperlipoproteinemia). In comparison with healthy normolipemic controls, 51 of a series of 64 patients were found to have beds of dilated, congested, elongated, and tortuous capillary venular limbs and loops; and 29 of these with capillary abnormalities were found to have either fresh or old hemorrhages. Serial studies revealed that capillary hemorrhages tended to subside shortly after the hyperlipoproteinemia was controlled by a low carbohydrate diet, while the morphologic abnormalities showed little or no change for 8 to 21 months.