Amounts of coronary arterial narrowing by atherosclerotic plaques in clinically isolated, chronic, pure aortic regurgitation: analysis of 37 necropsy patients older than 30 years

Measuring plasma fibrinogen to predict stroke and myocardial infarction

Epidemiological observations indicate that high plasma fibrinogen levels are strongly correlated with the frequency of two major thrombotic complications of atherosclerosis, stroke and myocardial infarction. Thrombosis is increasingly recognized as a central mechanism in stroke and myocardial infarction, and fibrinogen is involved in events thought to play a major role in thrombosis. Therefore, elucidation of the relationship between fibrinogen and thrombosis may strengthen the predictive value of this protein and suggest new treatment to prevent stroke and myocardial infarction. The current data relating fibrinogen to thrombosis are not easy to reconcile with the available epidemiological observations. In addition, advances in understanding the atherogenic potential of several risk factors for coronary heart disease have used information on the measurement of the risk factors in population-based studies. Thus, measuring plasma fibrinogen to predict stroke and myocardial infarction may be important in gaining insight into the thrombogenic potential of this protein and in inspiring new strategies against the thrombotic complications of atherosclerosis.

Electrocardiographic observations in clinically isolated, pure, chronic, severe aortic regurgitation: analysis of 30 necropsy patients aged 19 to 65 years

Certain electrocardiographic findings are described in 30 necropsy patients with clinically isolated pure, chronic, severe aortic regurgitation. They were 19 to 65 years old (mean 45). The hearts of the 22 men ranged in weight from 430 to 1,110 g (mean 717) and of the 8 women, from 375 to 950 g (mean 638). Four had grossly visible left ventricular (LV) scars. All but 1 patient was in sinus rhythm. The PR interval was greater than 0.20 second in 8 patients (28%) and the QRS duration was greater than or equal to 0.12 second in 6 patients (20%). Only 5 patients (17%) had 1 or more ventricular premature complexes recorded on the resting electrocardiogram analyzed. The mean QRS amplitude for each of the 12 leads averaged 23 mm. The highest mean QRS voltage occurred in leads V2 and V3 (each 38 mm), and the lowest in lead aVR (11 mm). The mean QRS voltage in V5 was higher than in V6 (33 vs 28 mm) and in 22 patients (73%) the QRS voltage in V5 was higher than in V6. The sum of the S wave in V1 plus the larger of the R wave in V5 or V6 (Sokolow-Lyon index) averaged 51 mm and in only 22 patients (73%) was it greater than 35 mm. The Romhilt-Estes voltage criteria for LV hypertrophy was fulfilled even less frequently, despite the severe degrees of LV hypertrophy in the patients studied.(ABSTRACT TRUNCATED AT 250 WORDS)