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James Thornton Willerson, MD: A Conversation With the Editor1

      Jim Willerson is one of the major forces in cardiovascular disease in the world. After his training in Boston and in Bethesda he returned to his beloved Texas by joining the Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical School in Dallas. Within 1 year he rose from Assistant to Associate Professor of Medicine and 3 years later at age 37 he became Professor of Medicine occupying an endowed chair. A year later he was Director of the Cardiology Division. He remained in Dallas for 18 years, leaving in 1989 to become Chairman of the Department of Internal Medicine at the University of Texas Health Science Center at Houston, Chief of the Medical Services at Herman Hospital and at the Lyndon Baines Johnson General Hospital, Medical Director of the Texas Heart Institute and Chief of Cardiology at the Texas Heart Institute and at St. Luke's Hospital. When he left Dallas his chair in cardiology was renamed the “James T. Willerson, MD., Distinguished Chair in Cardiovascular Diseases.” In 1993 he became Editor in Chief of Circulation. His honors and research contributions have been numerous. His publications in medical journals as of September 1996 number 624 and he is the author or coauthor of 10 books. He has received numerous teaching awards. Many patients are under his personal care. I am grateful that Dr. Willerson was willing to share the interview which follows.
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      References

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        • Willerson JT
        Association of cytomegalovirus with post perfusion syndrome.
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        Amylodosis induced in mice by escherichia coli endotoxin.
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        Primary adyloidosis. Clinical, immunochemical and immunoglobulin metabolism studies in fifteen patients.
        Am J Med. 1969; 47: 259-273
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        Murine amyloid. II. Transfer of an amyloid-accelerating substance.
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        Reserpine in Raynaud's disease and phenomenon. Short term response to intra-arterial injection.
        Ann Intern Med. 1970; 72: 17-27
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        Conjunctival petechiaeafter open heart surgery.
        N Engl J Med. 1971; 284: 539-540
        • Willerson JT
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        Non-invasive assessment of prosthetic mitral paravalvular and intravalvular regurgitation.
        Br Heart J. 1972; 34: 561-568
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        Serum digoxin concentrationsin the human fetus, neonate and infant.
        N Engl J Med. 1972; 287: 1010-1013
        • Willerson JT
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        Improvement in myocardial function and coronary blood flow in ischemic myocardium after mannitol.
        J Clin Invest. 1972; 51: 2989-2998
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        Dissecting aneurysm of the aorta: aortographic features affecting prognosis.
        Radiology. 1972; 105: 567-572
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        Relationship between epicardial ST segment changes and myocardial metabolism during acute coronary insufficiency.
        Circ Res. 1973; 32: 725-730
        • Willerson JT
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        Influence of hyperosmolar agents on hypoxic cat papillary muscle function.
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        Influence of calcium on the inotropic actions of hyperosmotic agents, norepinephrine, paired electrical stimulation and treppe.
        J Clin Invest. 1974; 54: 957-964
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        The neurogenic vasoconstrictor effect of digitalis on coronary vascular resistance.
        J Clin Invest. 1974; 53: 288-296
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        Temporal changes in collateral coronary blood flow in ischemic myocardium during intraaortic balloon pumping.
        Circulation. 1974; 50: 249-254
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        Serum glucagon insulin levels and their relationship to blood glucose values in patients with acute myocardial infarction and acute coronary insufficiency.
        Am J Med. 1974; 57: 747-753
        • Parkey RW
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        • Atkins JM
        • Curry GC
        • Willerson JT
        A new method for radionuclide imaging of acute myocardial infarction in humans.
        Circulation. 1974; 50: 540-546
        • Willerson JT
        • Curry GC
        • Watson JT
        • Leshin SJ
        • Ecker RR
        • Mullins CB
        • Platt MR
        • Sugg WL
        Intraaortic balloon counterpulsation in patients in cardiogenic shock, medically refractory left ventricular failure and/or recurrent ventricular tachycardia.
        Am J Med. 1975; 58: 183-191
        • Willerson JT
        • Watson JT
        • Hutton I
        • Fixler DE
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        • Templeton GH
        The influence of hypertonic mannitol on regional myocardial blood flow during acute and chronic myocardial ischemia in anesthetized and awake intact dogs.
        J Clin Invest. 1975; 55: 892-902
        • Willerson JT
        • Watson JT
        • Hutton I
        • Templeton GH
        • Fixler DE
        Reduced myocardial reflow and increased coronary vascular resistance following prolonged myocardial ischemia in the dog.
        Circ Res. 1975; 36: 771-781
        • Willerson JT
        • Parkey RW
        • Bonte FJ
        • Meyer SL
        • Atkins JM
        • Stokely EM
        Technetium stannous pyrophosphate myocardial scintigrams in patients with chest pain of varying etiology.
        Circulation. 1975; 51: 1046-1052
        • Willerson JT
        • Parkey RW
        • Bonte FJ
        • Meyer SL
        • Stokely EM
        Acute subendocardial myocardial infarction in patients: its detection by technetium 99m stannous pyrophosphate myocardial scintigrams.
        Circulation. 1975; 51: 436-441
        • Willerson JT
        • Curry GC
        • Atkins JM
        • Horwitz LD
        Influence of hypertonic mannitol on ventricular performance and coronary blood flow in patients.
        Circulation. 1975; 51: 1095-1100
        • Buja LM
        • Parkey RW
        • Dees JH
        • Stokely EM
        • Harris Jr, RA
        • Bonte FJ
        • Willerson JT
        Morphologic correlates of technetium-99m stannous pyrophosphate imaging of acute myocardial infarcts in dogs.
        Circulation. 1975; 52: 596-607
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        • Adcock RC
        • Crie JS
        • Templeton GH
        • Willerson JT
        Negative negative inotropic influence of hyperosmoticolutions on cardiac muscle.
        Am J Physiol. 1975; 229: 1505-1509
        • Stone MJ
        • Willerson JT
        • Gomez-Sanchez C
        • Waterman M
        Radioimmunoassay of myoglobin in human serum. Results in patients with acute myocardial infarction.
        J Clin Invest. 1975; 56: 1334-1339
        • Watson JT
        • Fixler DE
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        • Nall BB
        • Jett GK
        • Willerson JT
        The influence of combined intraaortic balloon counterpulsation and hyperosmotic mannitol on regional myocardial blood flow in ischemic myocardium in the dog.
        Circ Res. 1976; 38: 506-513
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        • Platt MR
        • Rogers DE
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        • Willerson JT
        Similarities in coronary flow between external counterpulsation and intraaortic balloon pumping.
        Am J Physiol. 1976; 230: 1616-1621
        • Buja LM
        • Parkey RW
        • Stokely EM
        • Bonte FJ
        • Willerson JT
        Pathophysiology of technetium-99m stannous pyrophosphate and thallium-201 scintigraphy of acute anterior myocardial infarcts in dogs.
        J Clin Invest. 1975; 57: 1508-1522
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        • Willerson JT
        • Jenning R
        Reduction of experimental myocardial infarct size with hyperosmolar mannitol.
        Proc Soc Exp Biol Med. 1976; 151: 677-683
        • Meyer SL
        • Curry GC
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        • Parkey RW
        • Willerson JT
        Influence of dobutamine on hemodynamics and coronary blood flow inpatients with and without coronary artery disease.
        Am J Cardiol. 1976; 38: 103-108
        • Parkey RW
        • Bonte FJ
        • Stokely EM
        • Lewis SE
        • Graham KD
        • Buja LM
        • Willerson JT
        Acute myocardial infarction imaged with technetium-99m stannous pyrophosphate and thallium-201. A clinical evaluation.
        J Nucl Med. 1976; 17: 771-779
        • Pugh BR
        • Buja LM
        • Parkey RW
        • Poliner LR
        • Bonte FJ
        • Willerson JT
        Cardioversion and its potential role in the production of “false positive” technetium-99m stannous pyrophosphate myocardial scintigrams.
        Circulation. 1976; 54: 399-403
        • Stokely EM
        • Parkey RW
        • Bonte FJ
        • Graham KD
        • Stone MJ
        • Willerson JT.
        Gated blood pool imaging following technetium-99m phosphate scintigraphy.
        Radiology. 1976; 120: 433-434
        • Crie S
        • Wildenthal K
        • Adcock R
        • Templeton GH
        • Willerson JT
        Inhibition of the inotropic effect of hyperosmotic mannitol by lactate in vitro.
        Am J Physiol. 1976; 231: 1209-1213
        • Krishnamurty VSR
        • Adams HR
        • Smitherman TC
        • Templeton GH
        • Willerson JT
        Influence of mannitol on contractile responses of isolated perfused arteries.
        Am J Physiol. 1977; 232: H59-H66
        • Gray WR
        • Parkey RW
        • Buja LM
        • Stokely EM
        • McAllister RE
        • Bonte FJ
        • Willerson JT
        Computerized tomography. In vitro evaluation of myocardial infarction.
        Radiology. 1977; 122: 511-513
        • Stone MJ
        • Waterman MR
        • Murray G
        • Harimoto D
        • Platt MR
        • Blomqvist G
        • Willerson JT
        The serum myoglobin level as a diagnostic test in patients with acute myocardial infarction.
        Br Heart J. 1977; 38: 375-380
        • Willerson JT
        • Scales F
        • Mukherjee A
        • Platt MR
        • Templeton GH
        • Fink GC
        • Buja LM
        Abnormal myocardial fluid retention as an early manifestation of ischemic injury.
        Am J Pathol. 1977; 87: 159-188
        • Willerson JT
        • Stone MJ
        • Ting R
        • Mukherjee A
        • Gomez-Sanchez CE
        • Lewis P
        • Hersh LB
        Radioimmunoassay of CPK-B isoenzyme in human sera. Results in patients with acute myocardial infarction.
        Proc Natl Acad Sci. 1977; 74: 1711-1715
        • Lewis M
        • Buja LM
        • Saffer S
        • Mishelevich D
        • Stokely E
        • Lewis S
        • Parkey R
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        • Willerson JT
        Experimental infarct sizing utilizing computer processing and a three-dimensional model.
        Science. 1977; 197: 167-169
        • Buja LM
        • Tofe AJ
        • Kulkarni PV
        • Mukherjee A
        • Parkey RW
        • Francis MD
        • Bonte FJ
        • Willerson JT
        Sites and mechanisms of localization of technetium-99m phosphorus radiopharmaceuticals in acute myocardial infarcts and other tissues.
        J Clin Invest. 1977; 60: 724-740
        • Gilkeson G
        • Stone MJ
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        • Ting R
        • Gomez-Sanchez CE
        • Hull A
        • Willerson JT
        Detection of myoglobin by radiommunoassay in human sera: its usefulness and limitations as an emergency room screening test for acute myocardial infarction.
        Am Heart J. 1978; 95: 70-77
        • Stone MJ
        • Waterman MR
        • Poliner LR
        • Templeton GH
        • Buja LM
        • Willerson JT
        Myoglobinemia is an early and quantitative index of acute myocardial infarction.
        Angiology. 1978; 29: 386-392
        • Buja LM
        • Poliner LR
        • Parkey RW
        • Pulido J
        • Hutcheson D
        • Platt MR
        • Mills L
        • Bonte FJ
        • Willerson JT
        Clinicopathologic study of persistently positive technetium-99m stannous pyrophosphate myocardial scintigrams and myocytolytic degeneration after acute myocardial infarction.
        Circulation. 1977; 56: 1016-1023
        • Bilheimer DW
        • Buja LM
        • Parkey RW
        • Bonte FJ
        • Willerson JT
        Increased fatty acid uptake: a characteristic feature of the peripheral and border zones of experimental myocardial infarcts.
        J Nucl Med. 1978; 19: 276-283
        • Kulkarni PV
        • Parkey RW
        • Buja LM
        • Wilson JE
        • Bonte FJ
        • Willerson JT
        Technetium-labeled heparin: preliminary report of a potential new radio-pharmaceutical for imaging damaged coronary arteries and myocardium.
        J Nucl Med. 1978; 19: 810-815
        • Krishnamurty VSR
        • Adams HR
        • Templeton GH
        • Willerson JT
        Inhibitory effect of hypertonic mannitol on vasoconstrictor and vasodilator responses of isolated arterial smooth muscle.
        Am J Physiol. 1979; 235: 728-735
        • Poliner LR
        • Buja LM
        • Parkey RW
        • Bonte FJ
        • Willerson JT
        Clincopathologic findings in 52 patients studied by technetium-99m stannous pyrophosphate myocardial scintigrams.
        Circulation. 1979; 59: 257-267
        • Jones LR
        • Besch Jr, HR
        • Sutko JL
        • Willerson JT
        Ryanodine-induced stimulation of NET Ca++1 uptake by cardiac sarcoplasmic reticulum vesicles.
        J Pharmacol Exp Ther. 1979; 209: 48-55
        • Rothkopf M
        • Boerner J
        • Stone MJ
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        • Buja LM
        • Parkey RW
        • Willerson JT
        Detection of myocardial infarction extension in patients by CK-B radioimmunoassay.
        Circulation. 1979; 59: 268-274
        • Goodman FR
        • Willerson JT
        • Hester K
        • Weiss G
        Effects of hypertonic mannitol on contractile responses and 45Ca movements in isolated canine arteries.
        J Cardiovasc Pharmacol. 1979; 1: 265-276
        • Rude R
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        • Willerson JT
        Clinical implications of the “doughnut” pattern of uptake in technetium-99m stannous pyrophosphate myocardial scintigrams in patients with acute myocardial infarction.
        Circulation. 1979; 59: 721-730
        • Sutko J
        • Willerson JT
        • Templeton GH
        • Besch Jr, HR
        • Jones LR
        Ryanodine: its alterations of cat papillary muscle contractile state and responsiveness to inotropic interventions and a suggested mechanism of action.
        J Pharmacol Exp Ther. 1979; 290: 37-47
        • Rude RE
        • Rubin HS
        • Stone MJ
        • Lewis S
        • Parkey R
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        • Buja LM
        • Willerson JT
        Radioimmunoassay of serum creatine kinase B isoenzyme: correlation with technetium-99m stannous pyrophosphate myocardial scintigraphy in the diagnosis of acute myocardial infarction.
        Am J Med. 1980; 68: 405-413
        • Mukherjee A
        • Wong TM
        • Buja LM
        • Lefkowitz RJ
        • Willerson JT
        Beta adrenergic and muscarinic cholinergic receptors in canine myocardium. Effects of myocardial ischemia.
        J Clin Invest. 1979; 64: 1423-1428
        • Kulkarni PV
        • Parkey RW
        • Wilson JE
        • Buja LM
        • Bonte FJ
        • Willerson JT
        A modified technetium-99m heparin radiopharmaceutical for scintigraphic recognition of acute experimental myocardial infarcts.
        J Nucl Med. 1980; 21: 117-121
        • Willerson JT
        • Parkey RW
        • Bonte FJ
        • Lewis S
        • Corbett J
        • Buja LM
        Pathophysiologic considerations and clinocopathological correlates of technetium-99m stannous pyrophosphate myocardial scintigraphy.
        Semin Nucl Med. 1980; 10: 54-69
        • Sutko JL
        • Willerson JT
        Ryanodine alteration of the contractile state of rat ventricular myocardium: comparison with dog, cat and rabbit ventricular tissues.
        Circ Res. 1980; 46: 332-343
        • Willerson JT
        • Kulkarni P
        • Stone M
        • Lewis SE
        • Eigenbrodt E
        • Bonte FJ
        • Parkey RW
        • Buja LM
        Localization of an anti-mitochondrial antibody in experimental canine myocardial infarcts.
        Proc Natl Acad Sci. 1980; 77: 6856-6859
        • Buja LM
        • Willerson JT
        Clincopathologic findings in 100 episodes of acute ischemic heart disease (acute myocardial infarction or coronary insufficiency) in 83 patients.
        Am J Cardiol. 1981; 47: 343-356
        • Chien KR
        • Reeves JP
        • Buja LM
        • Bonte FJ
        • Parkey RW
        • Willerson JT
        Phospholipid alterations in canine ischemic myocardium: temporal and topographical correlations with Tc-99m-PPi accumulation and an in vitro sacrolemmal Ca5H permeability defect.
        Circ Res. 1981; 48: 711-719
        • Parkey RW
        • Kulkarni P
        • Lewis S
        • Datz F
        • Gutekunst D
        • Denmar G
        • Buja L
        • Bonte F
        • Willerson JT
        Effect of coronary blood flow and site of injection on Tc99m-PPi detection of early canine myocardial infarcts.
        J Nucl Med. 1981; 22: 133-137
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        • Hirsh PD
        • Hillis LD
        • Campbell WB
        • Firth BG
        • Willerson JT
        Release of prostaglandins and thromboxane into the coronary circulation in patients with ischemic heart disease.
        N Engl J Med. 1981; 304: 685-691
        • Roan PG
        • Buja LM
        • Saffer S
        • Hagler H
        • Duke B
        • Hillis LD
        • Willerson JT
        Effects of systemic hypertension on ischemic and non-ischemic regional left ventricular function is awake, unsedated dogs after experimental coronary occulsion.
        Circulation. 1982; 65: 115-125
        • Mukherjee A
        • McCoy KE
        • Duke RJ
        • Hogan M
        • Hagler H
        • Buja LM
        • Willerson JT
        Relationship between beta adrenergic receptor numbers and physiologic responses during experimental canine myocardial ischemia.
        Circ Res. 1982; 50: 735-741
        • Bush LR
        • Samowitz W
        • Buja LM
        • Rude RE
        • Willerson JT
        Recovery of left ventricular segmental function after long-term reperfusion following temporary coronary occulsion in conscious dogs: comparison of 2- and 4-hour occlusions.
        Circ Res. 1983; 53: 248-263
        • Bush LR
        • Campbell WB
        • Tilton GD
        • Buja LM
        • Willerson JT
        Effects of the selective thromboxane synthetase inhibitor dazoxiben on variations in cyclic blood flow in stenosed canine coronary arteries.
        Circulation. 1984; 69: 1161-1170
        • Chien KR
        • Han A
        • Sen A
        • Buja LM
        • Willerson JT
        Accumulation of unesterified arachidonic acid-in ischemic canine myocardium: relationship to a phosphatidyl-choline deacylation-reacylation cycle and the depletion of membrane phospholipids.
        Circ Res. 1984; 54: 313-322
        • Bush LR
        • Campbell WB
        • Kern K
        • Tilton GD
        • Apprill P
        • Ashton J
        • Schmitz J
        • Buja LM
        • Willerson JT
        The effects of alpha2 adrenergic and serotonergic receptor blockade on platelet aggregation in stenosed canine coronary arteries.
        Circ Res. 1984; 55: 642-652
        • Willerson JT
        • Campbell WB
        • Winniford MD
        • Schmitz J
        • Apprill P
        • Firth B
        • Ashton J
        • Smitherman T
        • Bush L
        • Buja LM
        Conversion from chronic to acute coronary artery disease: speculation regarding mechanisms [editorial].
        Am J Cardiol. 1984; 54: 1231-1236
        • Corbett J
        • Lewis SE
        • Wolfe CL
        • Rellas JS
        • Lewis M
        • Parkey RW
        • Sokolov JJ
        • Rude RE
        • Buja LM
        • Willerson JT
        Measurement of myocardial infarct size in patients by technetium pyrophosphate single photon tomography.
        Am J Cardiol. 1984; 54: 1231-1236
        • Chien KR
        • Sen A
        • Reynolds R
        • Chang A
        • Kim Y
        • Gunn MD
        • Buja LM
        • Willerson JT
        Release of arachidonate from membrane phospholipids in cultured myocardial cells during ATP depletion: correlation with the progression of cell injury.
        J Clin Invest. 1985; 78: 1770-1780
        • Wolfe CL
        • Lewis SE
        • Corbett JR
        • Buja LM
        • Willerson JT
        Measurement of infarction fraction using single photon emission computed tomography.
        J Am Coll Cardiol. 1985; 6: 145-151
        • Wheelan K
        • Wolfe C
        • Corbett J
        • Rude R
        • Winnifrd M
        • Parkey RW
        • Buja LM
        • Willerson JT
        Early positive technetium-99m stannous pyrophosphate images as a marker of reperfusion in patients receiving thrombolytic therapy for acute myocardial infarction.
        Am J Cardiol. 1985; 56: 252-256
        • Buja LM
        • Willerson JT
        Infarct size. Can it be measured or modified in humans?.
        Prog Cardiovasc Dis. 1987; XXIX: 271-289
        • Apprill P
        • Schmitz JM
        • Campbell WB
        • Tilton G
        • Ashton J
        • Raheja S
        • Buja LM
        • Willerson JT
        Cyclic blood flow variations induced by platelet activating factor instenosed canine coronary arteries despite inhibition of thromboxane synthetase, serotonin receptors, and alpha-adrenergic receptors.
        Circulation. 1985; 72: 397-405
        • Schmitz JM
        • Apprill PG
        • Buja LM
        • Willerson JT
        • Campbell WB
        Vascular prostaglandin and thromboxane production in a canine model of myocardial ischemia.
        Circ Res. 1985; 57: 223-231
        • Rehr RB
        • Peshock RM
        • Malloy CR
        • Keller AM
        • Parkey RW
        • Buja LM
        • Nunnally RL
        • Willerson JT
        Improved in vivo magnetic resonance imaging of acute myocardial infarction after intravenous paramagnetic contrast agent administration.
        Am J Cardiol. 1986; 57: 864-868
        • Golino P
        • Ashton JH
        • Benedict CR
        • Fitzgerald C
        • Raheja S
        • Taylor A
        • Campbell W
        • Buja LM
        • Willerson JT
        Serotonin as a mediator cyclic flow variations in stenosed canine coronary arteries.
        Circulation. 1986; 73: 572-578
        • Willerson JT
        • Hillis LD
        • Winniford M
        • Buja LM
        Speculation regarding mechanisms responsbile for acute ischemic heart disease syndromes.
        J Am Cardiol. 1986; 8: 245-250
        • Peshock RM
        • Malloy CR
        • Buja LM
        • Nunnally RL
        • Parkey RW
        • Willerson JT
        Magnetic resonance imaging of acute myocardial infarction: gadolinimum diethylene-triamine pentaacetic acid as a marker of reperfusion.
        Circulation. 1986; 74: 1434-1440
        • Jansen DE
        • Corbett JR
        • Buja LM
        • Hansen C
        • Ugolini V
        • Parkey RW
        • Willerson JT
        Quantification of myocardial injury produced by temporary coronary artery occlusion and reflow with technetium-99m-pyrophosphate.
        Circulation. 1987; 75: 611-617
        • Ashton JH
        • Ogletree ML
        • Michel IM
        • Taylor AL
        • Raheja S
        • Schmitz J
        • Buja LM
        • Campbell WB
        • Willerson JT
        Cooperative medication by serotonin S2 and thrombozane A2/ prostaglandin H2 receptor activation of cyclic flow variations in dogs with severe coronary artery stenoses.
        Circulation. 1987; 76: 952-959
        • Golino P
        • Ashton JH
        • Glas-Greenwalt P
        • McNatt J
        • Buja LM
        • Willerson JT
        Coronary thrombolysis: mediation of reocclusion by thromboxane A2 and serotonin after thrombolysis with tissue-type plasminogen activator in a canine preparation of coronary thrombosis.
        Circulation. 1988; 77: 678-684
        • Willerson JT
        • Golino P
        • Eidt J
        • Campbell WB
        • Buja LM
        Specific platelet mediators and unstable coronary artery lesions. Experimental evidence and potential clinical implications.
        Circulation. 1989; 80: 198-205
        • Eidt JF
        • Allison P
        • Noble S
        • Ashton J
        • Golino P
        • McNatt J
        • Buja LM
        • Willerson JT
        Thrombin is an important mediator of cyclic coronary blood flow variations due to platelet aggregation in stenosed canine coronary arteries.
        in: FM Abboud FM Fallon HJ Wilson JD Rosenberg LE Schrier RW Transactions of the Association of American Physicians. Waverly Press, 1989: 125-136
        • van den Berg EK
        • Schmitz JM
        • Benedict CR
        • Malloy CR
        • Willerson JT
        • Dehmer GJ
        Transcardiac serotonin concentration is increased in selected patients with limiting angina and complex coronary lesion morphology.
        Circulation. 1989; 49: 116-124
        • Golino P
        • Ashton JH
        • Buja LM
        • Taylor AL
        • McNatt J
        • Rosolowsky M
        • Campbell WB
        • Willerson JT
        Local platelet activation causes vasoconstriction of large epicardial canine coronary arteries in vivo: thromboxane A5 and serotonin as possible mediators.
        Circulation. 1989; 79: 154-166
        • Ashton JH
        • Golino P
        • McNatt JM
        • Buja LM
        • Willerson JT
        Serotnin S2 receptor blockade (LY53857) combined with thromboxane A2/prostaglandin H2 receptor blockade (SQ29,548) provide protection against epinephrine-induced intermitten thrombosis in severely narrowed canine coronary arteries.
        J Am Coll Cardiol. 1989; 13: 755-763
        • Golino P
        • Ashton JH
        • McNatt J
        • Glas-Greenwalt P
        • O'Brien RA
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