Mark J Friedman
- Clinical Professor, (Clinical Series Track)
- New York Medical College, New York, New York, United States
- B.A. Psychology, Cum Laude
- Syracuse University, Syracuse, New York, United States
- University Physician’s Healthcare at Kino (2005 - 2008)
- University of Oklahoma College of Medicine (1995 - 2005)
- Springer Clinic, Inc. (1994 - 2005)
- Springer Clinic, Inc. (1994 - 2005)
- Saint Francis Hospital (1986 - 2005)
- University of Oklahoma College of Medicine (1986 - 1995)
- Cardiology of Tulsa, Inc. (1983 - 1994)
- University of Oklahoma College of Medicine (1981 - 1986)
- Cardiology of Tulsa, Inc. (1981 - 1983)
- University of Arizona Health Science Center- Department of Internal Medicine (1979 - 1981)
- University of Arizona- Department of Internal Medicine (1978 - 1979)
- Named to "Best Doctors in America" Central Region
- Fall 1996
- University of Oklahoma College of Medicine-Tulsa
- University of Oklahoma College of Medicine-Tulsa, Spring 1995
- Outstanding Teacher-Subspecialty
- University of Oklahoma College of Medicine-Tulsa, Spring 1990
- Continuing Medical Education Faculty Recognition Award
- Fall 1978
- NIH Sponsored Research Fellowship
- Fall 1978
- The Conrad Engerud Tharaldsen Award of New York Medical College
- New York Medical College, Spring 1971
- The Lange Medical Publishers Award
- Spring 1971
- Alpha Omega Alpha medical honor society
- Fall 1970
- Top Doctors; Tucson
- Castle Connolly, Fall 2019
- Castle Connolly, Fall 2017
- Best procedure teacher and best fellowship mentor
- The Division of Cardiology in the University of Arizona College of Medicine - Tucson, Summer 2019
- Best Clinical Faculty
- Cardiology Fellows; 2017, Spring 2017
- Best Fellowship Mentor
- Cardiology Fellows; 2017, Spring 2017
- Named "Best Doctors in America; 2016
- Fall 2016
- Best Teaching Award
- Cardiology Fellows, Spring 2016
- The Best Mentor Award
- Cardiology Fellows, Spring 2016
- Faculty Mentoring Award
- Cardiology Section, Fall 2015
- Named "Best Doctors in America; 2015
- Fall 2015
- Named to "Best Doctors in America"
- Fall 2014
- Fall 2013
- Fall 2012
- Fall 2011
- Fall 2010
- Fall 2009
Licensure & Certification
- Arizona Medical Board, New York Medical College (1975)
No activities entered.
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- Avery, R., Ebong, I., Skaria, R., Day, K., Miller, C., Juneman, E., Oliva, I., Friedman, M., Maltais, S., & Khalpey, Z. (2019). Preoperative Risk Stratification of Right Ventricular Function Utilizing Cardiac Magnetic Resonance Imaging Compared With Echocardiographic and Hemodynamic Parameters. ASAIO journal (American Society for Artificial Internal Organs : 1992).More infoAccurate right ventricle functional analysis prior to mechanical circulatory support continues to be valuable for preoperative stratification of patients at risk for developing right ventricular (RV) failure. While cardiac magnetic resonance imaging (CMR) remains the gold standard, CMR is limited by availability and patient-specific contraindications. Further investigation of other imaging modalities would be beneficial as it may serve as a surrogate to identifying RV systolic dysfunction. A single-center, retrospective study including 29 patients with advanced heart failure was performed. All patients underwent ventricular functional analysis with both CMR and echocardiography, and 19 patients underwent right heart catheterization. Predictability with multimodal assessment of RV function was determined using logistic regression methods. Of the 29 participants, 10 had severe RV dysfunction. Tricuspid annular plane of systolic excursion was a modest predictor of RV dysfunction with odd ratio (OR) of 0.07 (0.01-0.72) and c-statistic of 0.79. Invasive hemodynamic measurement of cardiac index by thermodilution method was also predictive of RV dysfunction but failed to reach statistical significance (OR of 0.03,
- Khalpey, Z., Kazui, T., Ferng, A. S., Connell, A., Tran, P. L., Meyer, M., Rawashdeh, B., Smith, R. G., Sweitzer, N. K., Friedman, M., Lick, S., Slepian, M. J., & Copeland, J. G. (2019). First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart. ASAIO journal (American Society for Artificial Internal Organs : 1992), 62(5), e43-5.More infoThe 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.
- Tanaka, T. D., Sawano, M., Ramani, R., Friedman, M., & Kohsaka, S. (2018). Acute heart failure management in the USA and Japan: overview of practice patterns and review of evidence. ESC heart failure, 5(5), 931-947.More infoGlobally, acute heart failure (AHF) remains an ongoing public health issue with its prevalence and mortality increasing in the east and the west. Effective treatment strategies to stabilize AHF are important to alleviate clinical symptoms and to improve clinical outcomes. However, despite the progress in the management of stable and chronic heart failure, no single agent has been proven to play a definitive role in the management of AHF. As a consequence, contemporary treatment strategies for patients with AHF vary greatly by region. This manuscript reviews the medical treatment options for AHF, with an emphasis on the differences between the treatment strategies in the USA and Japan. This information would provide a framework for clinicians to evaluate and manage patients with AHF and highlight the remaining questions to improve clinical outcomes.
- Marsh, K. M., Ferng, A. S., Pilikian, T., Desai, A. A., Avery, R., Friedman, M., Oliva, I., Jokerst, C., Schipper, D., & Khalpey, Z. (2017). Anti-inflammatory properties of amniotic membrane patch following pericardiectomy for constrictive pericarditis. Journal of cardiothoracic surgery, 12(1), 6.More infoSince constrictive pericarditis is most often idiopathic and the pathophysiology remains largely unknown, both the diagnosis and the treatment can be challenging. However, by definition, inflammatory processes are central to this disease process. Amniotic membrane patches have been shown to possess anti-inflammatory properties and are believed to be immune privileged. Due to these properties, amniotic membrane patches were applied intraoperatively in a complicated patient presenting with constrictive pericarditis.
- Friedman, M. J., Ewy, G. A., Jones, S. E., Cruze, D., & Moon, T. E. (2016). 1-year followup of cardiac status after adriamycin therapy. Cancer treatment reports, 63(11-12), 1809-16.More infoTo study the natural history of the alterations in cardiac function produced by Adriamycin therapy, serial M-mode echocardiograms, electrocardiograms, and systolic time intervals were obtained in 15 patients prior to Adriamycin therapy and at 3-month intervals during and 1 year after cessation of therapy. The echocardiographic E-point septal separation increased from a median 0 dose value of 0.40 cm to 0.70 cm (P less than 0.003) at the time of the maximum dose of Adriamycin. The electrocardiographic frontal plane voltage decreased 13% (P less than 0.008) and the pre-ejection period/left ventricular ejection time ratio increased from a median value of 0.37 to 0.40 (P less than 0.01) during this same period. During the first year after Adriamycin was discontinued, no significant change was noted in any of these values. Thus, as a group, the slight deterioration of ventricular function that occurred during Adriamycin therapy remained unimproved during the 1-year followup period.
- Kazui, T., Nicole, S., Friedman, M., Kim, S. S., Lick, S., & Khalpey, Z. I. (2016). A modified Park's stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report.. Journal of Cardiothoracic Surgery, 11(1), 161.
- Kazui, T., Sydow, N., Friedman, M., Kim, S., Lick, S., & Khalpey, Z. (2016). A modified Park's stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report. Journal of cardiothoracic surgery, 11(1), 161.More infoAortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI.
- Lin, I., Sung, J., Sanchez, R. J., Mallya, U. G., Friedman, M., Panaccio, M., Koren, A., Neumann, P., & Menzin, J. (2016). Patterns of Statin Use in a Real-World Population of Patients at High Cardiovascular Risk. Journal of managed care & specialty pharmacy, 22(6), 685-98.More infoWidespread use of statins has improved hypercholesterolemia management, yet a significant proportion of patients remain at risk for cardiovascular (CV) events. Analyses of treatment patterns reveal inadequate intensity and duration of statin therapy among patients with hypercholesterolemia, and little is known about real-world statin use, specifically in subgroups of patients at high risk for CV events.
- Friedman, M. J., Ewy, G. A., Jones, S. E., Cruze, D., & Moon, T. E. (2015). 1-year followup of cardiac status after adriamycin therapy. Cancer treatment reports, 63(11-12), 1809-16.More infoTo study the natural history of the alterations in cardiac function produced by Adriamycin therapy, serial M-mode echocardiograms, electrocardiograms, and systolic time intervals were obtained in 15 patients prior to Adriamycin therapy and at 3-month intervals during and 1 year after cessation of therapy. The echocardiographic E-point septal separation increased from a median 0 dose value of 0.40 cm to 0.70 cm (P less than 0.003) at the time of the maximum dose of Adriamycin. The electrocardiographic frontal plane voltage decreased 13% (P less than 0.008) and the pre-ejection period/left ventricular ejection time ratio increased from a median value of 0.37 to 0.40 (P less than 0.01) during this same period. During the first year after Adriamycin was discontinued, no significant change was noted in any of these values. Thus, as a group, the slight deterioration of ventricular function that occurred during Adriamycin therapy remained unimproved during the 1-year followup period.
- Khalpey, Z., Kazui, T., Ferng, A. S., Connell, A., Tran, P. L., Meyer, M., Rawashdeh, B., Smith, R. G., Sweitzer, N. K., Friedman, M., Lick, S., Slepian, M. J., & Copeland, J. G. (2015). First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart. ASAIO journal (American Society for Artificial Internal Organs : 1992), 62(5), e43-5.More infoThe 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.
- Copeland, H., Gustafson, M., Coelho-Anderson, R., Mineburg, N., Friedman, M., & Copeland, J. G. (2014). Fourth time cardiac retransplantation. World journal for pediatric & congenital heart surgery, 5(1), 88-90.More infoBeginning at age 11 years, our patient has had four heart transplants. Now, 26 years later at age 37, he is fully active. This case is presented to document a unique experience and to consider the difficult decision-making process and ethical issues of multiple cardiac retransplantation.
- Suryanarayana, P. G., Copeland, H., Friedman, M., & Copeland, J. G. (2014). Cardiac transplantation in African Americans: a single-center experience. Clinical cardiology, 37(6), 331-6.More infoIn view of limited data on the subject of graft and patient survival differences between African American (AA) and non-AA heart transplant recipients, we reviewed our experience.
- Copeland, H., Gustafson, M., Coelho-Anderson, R., Mineburg, N., Friedman, M., & Copeland, J. G. (2012). Third- and fourth-time cardiac retransplantation: an option in selected patients. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 31(3), 336-7.
- Copeland, J. G., Copeland, H., Gustafson, M., Mineburg, N., Covington, D., Smith, R. G., & Friedman, M. (2012). Experience with more than 100 total artificial heart implants. The Journal of thoracic and cardiovascular surgery, 143(3), 727-34.More infoThe SynCardia Total Artificial Heart (SynCardia Systems Inc, Tucson, Ariz) has been used as a bridge to cardiac transplantation in 930 patients worldwide and in 101 patients in our program. Our experience with SynCardia Total Artificial Heart implantation documents its indications, safety, and efficacy.
- Friedman, M. J., Kalbfleisch, J. M., Robins, L., McEntee, C. W., Brewer, D. L., Slagle, R. C., O'Meara, B., Hall, R., Conrad, L. L., & Hawkins, H. M. (1985). The management of patients with acute myocardial infarction after successful reperfusion with streptokinase. Cardiology clinics, 3(1), 85-91.More infoIntracoronary streptokinase administration has been an effective procedure for establishing reperfusion of an evolving myocardial infarction by lysing the thrombus that is usually responsible for the infarction. After reperfusion is accomplished, appropriate management of the patient must be planned to provide the best chance for assuring continued vessel patency, and appropriate management of the patient's residual coronary artery disease also must be considered. In selected patients, percutaneous transluminal coronary angioplasty of the residual coronary lesion has been performed successfully immediately following reperfusion with streptokinase. Early coronary artery bypass graft surgery has been performed with good results in other patients. The appropriate management of the patient with acute myocardial infarction is still evolving, and only with additional study and experience will the "best" approach in the management of these patients be defined.
- FRIEDMAN, M. J., TEMKIN, L. P., GOLDMAN, S., & OVITT, T. W. (1983). EFFECTS OF PROPRANOLOL ON RESTING AND POST-EXTRASYSTOLIC POTENTIATED LEFT-VENTRICULAR FUNCTION IN PATIENTS WITH CORONARY-ARTERY DISEASE. AMERICAN HEART JOURNAL, 105(1), 81-89.
- Fisher, D. C., Sahn, D. J., Friedman, M. J., Larson, D., Valdes-Cruz, L. M., Horowitz, S., Goldberg, S. J., & Allen, H. D. (1983). The effect of variations of pulsed Doppler sampling site on calculation of cardiac output: an experimental study in open-chest dogs. Circulation, 67(2), 370-6.More infoWe measured aortic flow by two-dimensional Doppler echocardiography in an open-chest dog model to examine how variations in Doppler sample volume length and position influence aortic hemodynamic flow calculations. Fourteen dogs underwent right-heart bypass, in which venous return from the venae cavae drained by gravity to a reservoir. A variable-speed roller pump returned the blood to the pulmonary artery, fixing left-sided cardiac input and output. Echo Doppler measurements were performed using a 3.5 MHz transducer placed directly on the aortic arch to determine internal aortic cross-sectional area. The transducer was then directed to image the aortic arch for Doppler velocity measurements and the various sampling sites were investigated. Doppler cardiac output could then be determined for each of the various sample volumes over a range of known roller pump settings. Doppler velocity was analyzed using fast Fourier transform spectral analysis. Mean velocity over the cardiac cycle was obtained by planimetry of the area under the Doppler velocity curve with a minicomputer. Doppler-derived determinations of cardiac output achieved a correlation of r = 0.98-0.99 to values obtained by the roller pump over a range of cardiac outputs from 0.75-5 l/min. The standard error of the estimate was 0.21/min. In this laminar flow model, there was no difference between the predictive accuracy of any of the sampling sites over the range of roller pump flows. Our study shows that Doppler velocity measurements can be used to quantify aortic flow over a clinically useful range and that variations of sample length and position did not produce significant differences in calculated flows.
- Fisher, D. C., Sahn, D. J., Friedman, M. J., Larson, D., Valdes-Cruz, L. M., Horowitz, S., Goldberg, S. J., & Allen, H. D. (1983). The mitral valve orifice method for noninvasive two-dimensional echo Doppler determinations of cardiac output. Circulation, 67(4), 872-7.More infoWe developed and validated a mitral valve orifice method for Doppler cardiac output determination. In 15 open-chest dogs, cardiac output was controlled and measured by a roller pump interposed between the right atrium and pulmonary artery as a right-heart bypass. Left heart flows were measured in the open-chest dog model by Doppler measurements at the mitral valve orifice and compared not only to volume flow measured by the roller pump, but to electromagnetic flow meters as well. The maximum mitral valve orifice area was measured off short-axis two-dimensional echocardiographic views by planimetry. The maximal orifice was then adjusted for its diastolic variation in size by calculating a ratio of mean-to-maximal mitral valve separation on a derived M-mode echocardiogram. Flow was sampled parallel to mitral valve inflow in a four-chamber plane. The multiplication of mean flow throughout the cardiac cycle by the mean mitral valve area after correction for diastolic size variation yielded a cardiac output determination that could be compared to the roller pump measurement. Fifty-two cardiac output determinations over roller pump values of 1-5 l/min yielded a high correlation between roller pump flows and Doppler (r = 0.97 +/- 0.23 l/min). Our study shows that the mitral valve orifice provides an accurate site for Doppler cardiac output measurements.
- Friedman, M. J., Temkin, L. P., Goldman, S., & Ovitt, T. W. (1983). Effects of propranolol on resting and postextrasystolic potentiated left ventricular function in patients with coronary artery disease. American heart journal, 105(1), 81-9.More infoThe effect of propranolol on global and segmental left ventricular function at rest and after postextrasystolic potentiation was studied in 12 patients with chest pain. Heart rate was controlled with atrial pacing, and left ventricular cineangiograms were performed before and after 0.15 mg/kg of propranolol. During each ventriculogram a premature ventricular stimulus was introduced by means of a programmed stimulator. Propranolol decreased global left ventricular ejection fraction from 64 +/- 4.5 to 58 +/- 4.6 (p less than 0.03). Postextrasystolic potentiated global ejection fraction was not affected by propranolol (78 +/- 3.5 vs 73.6 +/- 3.4; p = NS). The area ejection fraction of the anteroapical region was decreased after propranolol (64 +/- 4.8 vs 52 +/- 6.5; p less than 0.01); however, the postextrasystolic potentiated area ejection fraction was not affected by propranolol (78 +/- 2.6 vs 71 +/- 4.6; p = NS). Frame by frame analysis of the ventriculograms demonstrated that propranolol depressed global and segmental left ventricular function by affecting the second one-third ejection fraction without influencing the first or third one-third ejection fraction. Propranolol has a small depressant effect on global and segmental left ventricular function in patients with coronary artery disease. Postextrasystolic potentiated global and segmental left ventricular function and early systolic ejection phase indices are not altered by propranolol and therefore may be useful in assessing left ventricular function in patients with coronary artery disease who are taking propranolol.
- Goldman, S., Henry, R., Ovitt, T., Friedman, M. J., Rosenfeld, A., & Daly, M. (1983). Regional myocardial perfusion at rest and during intracoronary papaverine in patients with coronary artery disease. American heart journal, 105(3), 372-9.More infoRegional myocardial perfusion was measured in 32 patients with the xenon-133 washout technique at rest and after 5 mg of intracoronary papaverine. Areas of decreased perfusion and/or decreased vasodilation were identified visually from computer-generated functional images. The locations of arteries and stenoses, obtained from identically positioned cineangiograms, were overlaid on the functional images. Perfusion rates for 62 myocardial regions were calculated and correlated with the percentage of stenosis. There was no association between degree of stenosis and perfusion at rest. Regional myocardial perfusion increased after papaverine in regions supplied by coronary arteries without stenoses (0% to 25%), 88.6 +/- 4.7 ml/min/100 gm. This increase was significantly greater (p less than 0.001) than the increase in regions supplied by 51% to 75% stenoses (23.7 +/- 6.3 ml/min/100 gm), or 76% to 99% stenoses (12.9 +/- 6.3 ml/min/100 gm), or 100% stenoses (2.5 +/- 3.8 ml/min/100 gm). Thus there was an inverse relationship between the increase in myocardial perfusion stimulated by papaverine and the degree of coronary artery stenosis measured angiographically. In regions supplied by two stenoses in series, vasodilation produced less of an increase than a single stenosis of a similar degree.
- Friedman, M. J., Carlson, K., Marcus, F. I., & Woolfenden, J. M. (1982). Clinical correlations in patients with acute myocardial infarction and left ventricular thrombus detected by two-dimensional echocardiography. The American journal of medicine, 72(6), 894-8.More infoEleven of forty-nine patients with acute myocardial infarction had left ventricular thrombus identified by two-dimensional echocardiography. The patients with thrombi had a greater incidence of transmural infarction, high-grade ventricular ectopy on ambulatory monitoring and lower radionuclide ejection fractions than the patients without thrombi. Most of the patients were receiving full-dose heparin and/or warfarin anticoagulation from the time of admission to the hospital. Thus the thrombi either developed prior to hospital admission or developed during anticoagulation therapy. Two patients with thrombi had peripheral emboli complicating their infarction. One of these patients was undergoing anticoagulation at the time of his embolus.
- Friedman, M. J., Okada, R. D., Ewy, G. A., & Hellman, D. J. (1982). Left ventricular systolic and diastolic function in hyperthyroidism. American heart journal, 104(6), 1303-8.More infoIn order to assess the effect of hyperthyroidism on systolic and diastolic function of the left ventricle, M-mode echocardiograms and systolic time intervals were obtained in 13 patients while they were clinically hyperthyroid and again when they were euthyroid following radioactive iodine therapy. Echocardiographic tracings of the septum and left ventricular posterior wall were digitized and analyzed to provide the maximum velocity of shortening and maximum velocity of lengthening. These velocities were normalized for left ventricular diastolic dimension. The left ventricular minor axis fractional shortening and the normalized maximum velocity of shortening were both increased during the hyperthyroid state. The normalized maximum velocity of lengthening, a measure of diastolic left ventricular function, was also increased during the hyperthyroid state when compared to the euthyroid state. The preejection period index and the preejection period/left ventricular ejection time ratio were lower when the patients were hyperthyroid than when they were euthyroid. These data confirm the increased inotropic state and demonstrated increased diastolic relaxation velocities of the hyperthyroid left ventricle.
- Friedman, M. J., Roeske, W. R., Sahn, D. J., Larson, D., & Goldberg, S. J. (1982). Accuracy of M mode echocardiographic measurements of the left ventricle. The American journal of cardiology, 49(4), 716-23.
- Friedman, M. J., Sahn, D. J., Goldman, S., Eisner, D. R., Gittinger, N. C., Lederman, F. L., Puckette, C. M., & Tiemann, J. J. (1982). High predictive accuracy for detection of left main coronary artery disease by antilog signal processing of two-dimensional echocardiographic images. American heart journal, 103(2), 194-201.More infoTwo-dimensional echocardiography has been used to image the left main coronary artery. We have successfully imaged the left main coronary artery in 16 of 19 patients with left main coronary artery disease (LMCAD) and in 14 of 18 control patients using a dynamically focused 3-1/2 MHz experimental phased array sector scanner. Images were displayed with standard logarithmic compression grey scale allocation and with a modified antilog curve which enhances high intensity echoes. All of the 16 patients with LMCAD were identified from the antilog processed image. Only 1 of the 18 control patients had a false positive study. Modified antilog processed images provide high sensitivity (100%) and specificity (93%) for detecting LMCAD. This noninvasive technique could be used to screen patients for the presence or absence of LMCAD.
- Goldman, S., Henry, R., Friedman, M. J., Ovitt, T., Rosenfeld, A., Salomon, N., & Copeland, J. (1982). Increased regional myocardial perfusion after intracoronary papaverine in patients after coronary artery bypass grafting. The Journal of thoracic and cardiovascular surgery, 83(4), 563-8.More infoThe objective of coronary artery bypass grafting (CABG) is to increase blood flow to ischemic areas of the myocardium. To determine if this was achieved, anterior wall myocardial perfusion was measured at rest and during intracoronary papaverine (5 mg), with the use of xenon-133 washout in 35 patients. Twelve control patients had no significant diameter narrowing (0% to 25%) of the left anterior descending coronary artery (LAD), 13 patients had greater than 50% narrowing of the LAD, and 10 patients had greater than 50% narrowing of the LAD with patent saphenous vein bypass grafts to the LAD. There was no significant difference in age. LVEDP, and global ejection fraction among the patients. There was no significant difference in anterior wall myocardial perfusion at rest between control subjects (61.0 +/- 3.7 ml/min/100 gm) and non-CABG LAD patients (60.2 +/- 5.4 ml/min/100 gm), or CABG LAD patients (63.4 +/- 4.8 ml/min/100 gm). After coronary arteriolar vasodilatation with papaverine, anterior wall perfusion increased in the CABG patients to 140.6 +/- 6.8 ml/min/100 gm. This was significantly greater (p less than 0.001) than the increase in the non-CABG LAD patients (72.8 +/- 8.1 ml/min/100 gm) but not different from the increase in the control subjects (145.3 +/- 8.4 ml/min/100 gm). In three cases, the same patients were studied before and after CABG with identical results. These data indicate that in patients with coronary disease, increases in myocardial perfusion are limited by the resistance of the proximal stenosis independent of vasodilatation distal to the stenosis. After successful CABG, the patent vein graft restores control of myocardial perfusion to the arteriolar bed.
- Sahn, D. J., Goldberg, S. J., Allen, H. D., Valdes-Cruz, L. M., Canale, J. M., Lange, L., & Friedman, M. J. (1982). A new technique for noninvasive evaluation of femoral arterial and venous anatomy before and after percutaneous cardiac catheterization in children and infants. The American journal of cardiology, 49(2), 349-55.More infoA new ultrasonic method was applied to image the femoral artery and vein in children for evaluation of short- and long-term effects of cardiac catheterization with femoral percutaneous cannulation. Sixty-six children and infants (aged 5 days to 20 years) were studied with a 9 megahertz electronically focused real time scanner. Adequate studies were obtained in 46 patients before catheterization, in 26 of 30 short-term follow-up studies and in 14 long-term follow-up studies. Femoral arterial size could be quantitatively measured at the inguinal ligament and a correlation existed between imaged femoral arterial diameter and body weight (r = +0.82) or body surface area (r = +0.80). Short-term follow-up ultrasonic imaging studies allowed diagnosis of spasm and other complications of percutaneous femoral arterial puncture. Long-term follow-up studies were performed 4 months to 3 years after catheterization in 14 patients who had no complications recorded at the time of catheterization. These revealed significant differences between vessels on the catheterized and uncatheterized (control) sides in only 3 of the 14. High resolution ultrasonic imaging can provide anatomic and functional information about femoral arteries and veins and appears to be of assistance in planning cardiac catheterization and in studying the short- and long-term effects of percutaneous femoral cannulation.
- Schroeder, J. S., Feldman, R. L., Giles, T. D., Friedman, M. J., DeMaria, A. N., Kinney, E. L., Mallon, S. M., Pit, B., Meyer, R., Basta, L. L., Curry, R. C., Groves, B. M., & MacAlpin, R. N. (1982). Multiclinic controlled trial of diltiazem for Prinzmetal's angina. The American journal of medicine, 72(2), 227-32.More infoTo assess the efficacy of a new calcium entry blocker, diltiazem (Cardizem), for prophylaxis of Prinzmetal's angina, 48 patients were studied in randomized, multiple crossover multiclinic study (2 weeks single-blind, 8 weeks double-blind). Diltiazem dosage in one crossover phase was 120 mg per day; in the other, 240 mg per day. Therapeutic response was measured by patients' diary records of angina frequency and nitroglycerin tablet consumption. Treatment with 120 mg of diltiazem per day reduced angina by 41 percent from the entry placebo period and 20 percent from the paired placebo period (p less than 0.005). Treatment with 240 mg of diltiazem per day reduced angina frequency by 68 percent from the entry placebo period and 43 percent from the paired placebo period (p less than 0.01). There were similar reductions in nitroglycerin consumption. Adverse experiences that may have been related to the medication were noted in only 5 percent of patients. There were no alterations in blood pressure or heart rate. The PR interval increased 3 percent at the 240 mg dosage level. We conclude that diltiazem is an effective and safe agent for control of symptoms of Prinzmetal's angina.
- FRIEDMAN, M. J., TEMKIN, L. P., GOLDMAN, S., & OVITT, T. (1980). EFFECT OF PROPRANOLOL ON REST AND POST EXTRASYSTOLIC POTENTIATED LEFT-VENTRICULAR FUNCTION IN MAN. CLINICAL RESEARCH, 28(1), A6-A6.
- Friedman, M. J., Sahn, D. J., Burris, H. A., Allen, H. D., & Goldberg, S. J. (1979). Computerized echocardiographic analysis to detect abnormal systolic and diastolic left venticular function in children with aortic stenosis. The American journal of cardiology, 44(3), 478-86.
- Friedman, M. J., Sahn, D., & Huber, K. (1979). The Utility of Two-Dimensional Echocardiography and B-Mode Ultrasonography in the Evaluation of Loculated Pericardial Effusion. Circulation 60, 1644-9.
- Ewy, G. A., Jones, S. E., Friedman, M. J., Gaines, J., & Cruze, D. (1978). Noninvasive cardiac evaluation of patients receiving adriamycin. Cancer treatment reports, 62(6), 915-22.
- Friedman, M. J., Okada, R. D., & Goldman, S. (1978). Advances in cardiovascular nuclear medicine. Arizona medicine, 35(5), 331-5.
- Friedman, M. J., Temkin, L., Ovitt, T., Rosenfeld, A., Copeland, J., & Marcus, F. (1978). Benefits of Bypass Surgery. Medical Times, 24-33.
- Tanaka, T., Friedman, M. J., Okada, R. D., Buckels, L. J., & Marcus, F. I. (1978). Diagnostic value of exercise-induced S-T segment depression in patients with right bundle branch block. The American journal of cardiology, 41(4), 670-3.
- Janardhanan, R., Lotun, K., Khalpey, Z. I., Smith, M. C., Rutter, T., Nemanova, D., & Friedman, M. (2013, June). MITRAL VALVE OBSTRUCTION: ACCURATE DIAGNOSIS BY 3D-TRANSESOPHAGEAL ECHOCARDIOGRAPHY. AMERICAN SOCIETY OF ECHOCARDIOGRAPHY. Minneapolis, MN.