The effect on left ventricular performance of electrical stimulation of the cut central end of the quadriceps nerve was studied in open-chest dogs. Stimulation of the nerve at 2 to 4 times threshold for the flexion reflex, which presumably activated intermediate-sized afferent fibers, caused a decrease in heart rate and arterial pressure. Stimulation at 5 to 25 times threshold, which presumably activated small-sized, high-threshold afferent fibers, increased heart rate, arterial pressure, and cardiac output. When heart rate, arterial pressure, and cardiac output were controlled, activation of high-threshold afferent fibers caused a significant increase in the maximal rate of pressure rise, stroke power, and mean rate of ejection of the left ventricle without an increase in the end-diastolic pressure. These same fibers may in some way be activated during muscular exercise and be partially responsible for the increase in left ventricular contractility that occurs during that time.
A B S T R A C r This study correlated levels of activated fibrinolysis with the presence, extent, and rate of resolution of angiographically documented pulmonary emboli. Pulmonary emboli demonstrable by angiography were associated with detectable fibrin split products in the serum of 24 of 25 patients. In the absence of increased fibrin split products, pulmonary emboli large enough to be demonstrated by angiography were found in only 2 of 25 positive pulmonary angiograms. Spontaneous resolution of pulmonary emboli could not be correlated with the the concentration or persistence of fibrin split products but did correlate well with the presence of a reversible precipitating cause.Thrombophlebitis in the absence of clinical evidence of pulmonary embolism was not associated with increased concentrations of fibrin split products in eight of nine patients. The one patient with increased fibrin split product concentration had evidence on lung scan of silent pulmonary embolism.
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