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Query: EC:2.7.10.1 (
ERK
)
95,504
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Conduction defect are known to delay and fragment the ecg signal and may be expected to cause changes on the signal-averaged ecg that mimic ventricular late potentials. The aim of our study was to asses whether signal-averaged ECG (SAE) identify patients (pts) with sustained ventricular tachycardia (VT) after
myocardial infarction
(MI) who display right or left bundle branch block (RBBB or LBBB). We studied 23 pts with RBBB and 25 pts with LBBB.
SEA
was recorded with bidirectional filters at 25-250 HZ and 40-250 Hz using Simson method. The total filtered QRS duration (QRSd), root mean square voltage in the terminal 40ms of the QRS (RMS40) and low amplitude signal duration less than 40uV (LAS40)) were measured. Signal-averaged parameters with a filter at 25-250 Hz were: [table: see text] Signal-averaged parameters with a filter at 40-259 Hz were: [table: see text] In conclusion SAE parameters do not allow separation of pts with sustained VT from pts with RBBB or LBBB after MI. These data indicate that conduction defects have effects on signal-averaged ecg parameters and may result in masking of ventricular late potentials.
...
PMID:[A method of averaged ECG signal does not identify patients with ventricular tachycardia in disorders of intraventricular conduction]. 158 19
In isoprenaline-induced
myocardial infarction
in rabbits, the circulating neutrophils (neu) were in an activated state. tanshinone (tan, ig) suppressed the neu functions (acid-phosphatase release, adhesiveness, and phagocytosis) dose-dependently and reduced myocardial necrosis concomitantly. There was a positive correlation between neu functions and myocardial necrosis. In addition, tan caused an obvious decrease in content of lipoperoxide malondialdehyde in serum and myocardium, an increase in superoxide dismutase activity, an inhibition of leukocytic infiltration, and a production of prostaglandin E2 in myocardium. These effects were also related closely to the suppression of neu functions. Anti-inflammatory drug dexamethasone was used as control and had similar effects on
Neu
functions and
myocardial infarction
. It is suggested that the prophylactic effects of tan on
myocardial infarction
may result from the inhibition of circulating neu functions.
...
PMID:[Relationship between inhibitory action of tanshinone on neutrophil function and its prophylactic effects on myocardial infarction]. 178 Dec 93
The objective of this study was to predict the prognosis of patients who become symptomatic after having undergone coronary artery bypass grafting (CABG) using clinical and exercise test responses. A retrospective analysis was performed of all veterans referred for clinical indications to a Veterans Administration Medical Center for a treadmill test after having undergone CABG. Of 2,044 patients who were exercise tested from April 1984 to May 1987, 296 had previously undergone CABG. Clinical data considered included age, sex, medication and symptom status, history of
myocardial infarction
, type of
myocardial infarction
and time from CABG. The exercise test responses considered were
MET
level, maximal heart rate, maximal systolic blood pressure, chest pain pattern and ST-segment response. During a 2-year follow-up after exercise testing, there were 15 deaths, 11 nonfatal myocardial infarctions, 6 repeat CABGs and 3 percutaneous transluminal coronary angioplasties. Although
MET
level and maximal heart rate were significantly related to prognosis and no patient who exceeded 8 METs died, the predictive power of these exercise test responses was low and ST-segment depression was not predictive at all. The inability of the exercise electrocardiogram to predict cardiac events in patients after CABG requires the use of other methods of testing to identify those who need invasive studies and intervention.
...
PMID:Use of the exercise test to predict prognosis after coronary artery bypass grafting. 278 26
The uses of the exercise test continue to grow and diversify. Familiarity with the mechanics, logistics, and interpretation of these tests leads to their optimal use. The application of exercise testing for competitive or recreational sports, cardiovascular fitness exercise training, and cardiac rehabilitation is the focus of this review. Many test protocols are available, but treadmill testing is the most widely used. The inclusion of thallium scintigraphy in the exercise protocol requires additional time and expense and is best reserved for those in whom the exercise electrocardiographic response cannot be adequately interpreted. Exercise testing is a relatively safe procedure, providing that adequate screening of individuals for unstable cardiac or medical conditions has been performed. The test must be administered by experienced personnel in a setting where the necessary emergency resuscitative equipment is available. Adequate interpretation of the exercise test requires knowledge of the individual being tested and of the reason the test is being performed. Complete analysis of the exercise test includes electrocardiographic response (ST segment changes and rhythm disturbances), hemodynamic response (heart rate and blood pressure before, during, and after exercise), and functional capacity (exercise duration, symptoms, conversion to
MET
's). When exercise tests are employed to establish a diagnosis of coronary artery disease, an assessment of the pretest likelihood (prevalence) of disease is essential in deriving a reasonable assessment of the probability of disease after the test has been performed and reviewed. This information is particularly important when screening asymptomatic subjects for underlying coronary disease before they engage in an exercise program. Exercise testing of individuals with known cardiac disease prior to engaging in competitive or recreational sports can yield much useful information. In addition to a knowledge of the underlying cardiac condition, the type and intensity of the sport being performed must be taken into account when exercise testing is performed for athletic screening. Individuals with congenital or acquired valvular heart disease, coronary artery disease, and rhythm disturbances should undergo an exercise test as part of the pretraining evaluation. Patients with ischemic heart disease, especially those who have had a recent
myocardial infarction
or have undergone coronary artery bypass surgery, require counseling regarding their ability to perform certain activities of daily living and to return to work. Exercise testing can be a useful tool in establishing activity guidelines for these individuals.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Exercise testing for sports and the exercise prescription. 355 96
A branching treadmill protocol was designed to measure functional capacity in patients with low work capacity and varying ability to walk at speeds used in traditional protocols. A comfortable walking pace is first selected (2.0 to 3.5 mph, 0.25 mph increments) and the workload is then increased every 2 minutes in 1
MET
increments (a multiple of the resting oxygen uptake [1
MET
= 3.5 ml O2/kg/min]) by adjusting grade. Nine trained (maximal
MET
= 7.6 +/- 1.6, mean +/- standard deviation) male subjects (age 59 +/- 7 years) with previous
myocardial infarction
and 9 trained (maximal
MET
= 11.7 +/- 2.5) male control subjects (age 56 +/- 8 years) completed submaximal and maximal workloads without handrail support. The measured oxygen consumption, volume of oxygen in ml/kg/min (VO2), was compared with the predicted VO2 cost of treadmill walking calculated from speed and grade. A linear regression analysis of predicted versus measured VO2 was performed. There were no significant differences between
myocardial infarction
and control regression lines. Therefore, a simplified prediction equation for estimated VO2 in
myocardial infarction
and control subjects is proposed. Overall VO2 prediction = 1.61 + 0.99 x. The main advantage of the branching protocol format is the selection of a stable, brisk walking pace compatible with age and gait, which may improve mechanical efficiency through impedance matching. The protocol is adaptable enough in design so that most patients can complete the exercise test without use of handrails, which is essential for an accurate estimate of VO2 from treadmill speed and grade.
...
PMID:Usefulness of a branching treadmill protocol for evaluation of cardiac functional capacity. 368 88
Although exact definitions of exercise requirements for primary and secondary prevention of coronary disease cannot be stated with certainty on the basis of currently available information, we can make some general conclusions. The characteristics associated with lowered risk from coronary disease in apparently normal populations are: 8
MET
-hours of activity during leisure time or job: walking briskly during leisure time (1 hour = 1
MET
-hour) walking at job (same as above) jogging during leisure time (30 minutes of activity = 1
MET
-hour) walking to and from work (same as walking above) performing very heavy work in occupational pursuits (few jobs today have those energy requirements) regularly climbing 5 flights or more of stairs (10 steps per flight) regularly walking 5 city blocks per day (12 blocks per mile) regularly engaging in strenuous sports (basketball, running, mountaineering, skiing, swimming, or tennis) accumulating activities that use 2000 or more kcal per week Conclusions concerning the prevention of reinfarction in patients who are recovering from a first
heart attack
include: Exercise is helpful in hastening the recovery process after
myocardial infarction
and should be started early in the recovery period. Exercise helps to reduce mortality when used in conjunction with a multifactorial program.
...
PMID:The role of exercise in the primary and secondary prevention of atherosclerotic coronary artery disease. 391 44
To evaluate phase II intensive monitored cardiac rehabilitation using a 6-level, 6-session protocol, 31 patients were placed in a progressive 6-level exercise protocol with careful supervision and assessment of heart rate, rhythm, blood pressure and perceived exertion. Duration after the cardiac event ranged from 12 days to 8 years (median 10 months). Each exercise prescription was based on exercise testing with oxygen consumption determinations. Exercise activities were individually prescribed according to percentages of maximal
MET
level achieved on the exercise test. Each exercise session incorporated calisthenics, treadmill exercise, and bicycle and arm ergometry with progressively greater workloads on the various stations. All patients completed the 6 levels within 6 sessions of approximately 1 hour each, and achieved their designated 50 to 75% target heart rate with perceived exertion level 13 or less. There were no critical cardiac events, i.e., high-grade ventricular arrhythmias or
myocardial infarction
. All completed the 6-level protocol and progressed to a nonmonitored exercise program with no difficulty. The results of this short-term method of telemetry-monitored rehabilitation suggest benefits of proper exercise instruction, successful achievement of the 50 to 75% exercise target heart rate, detection of minor new arrhythmias and alterations of blood pressure response, adequate use of the perceived exertion scale, and a safe and effective transition to subsequent exercise programs.
...
PMID:Phase II intensive monitored cardiac rehabilitation for coronary artery disease and coronary risk factors--a six-session protocol. 396 60
Data from the preceding low-level exercise test studies have been compiled and are presented in Table II. The table is arranged according to groups of prognostic indicators for future coronary events or indicators for those patients with multivessel coronary artery disease. In summary, current studies demonstrate safety and predictive value in predischarge low-level exercise testing in patients after
myocardial infarction
. If the test reveals a positive S-T segment change or angina or both, the predictive value for future cardiac events is significant. In addition, a limited duration on the exercise test, a flat or falling blood pressure response, and the presence or absence of premature ventricular depolarizations add to this predictive value. A more sophisticated technique that employs radionuclide ventriculography may add to the sensitivity and specificity of these various tests but should be used selectively. Post-
myocardial infarction
patients who perform low-level exercise testing prior to discharge and demonstrate no exercise-induced abnormality from baseline may also harbor multivessel coronary disease, and this group of patients needs to be carefully followed. Testing at 3 weeks and 6 weeks after infarction may be beneficial in revealing additional clinical data. Less data are currently available on predischarge low-level exercise testing in patients with myocardial revascularization. However, these limited data support both feasibility and safety of low-level exercise testing in myocardial revascularization patients before discharge. Prognostic data with regard to low-level exercise testing for this group of patients should be forthcoming. Data from low-level exercise testing need to be incorporated during the in-hospital phase to eliminate unnecessary testing as the patient proceeds home and/or to medically supervised exercise programs. Proper therapeutic modalities based on these data should be included. In accord with this, it is imperative that the cardiac rehabilitation team or exercise testing laboratory correspond directly with the private physician regarding all clinical data and recommendations for discharge activity. Follow-up exercise testing for patients after
myocardial infarction
and coronary bypass surgery utilizes end points similar to those of predischarge low-level testing and therefore will not be discussed in detail. In general the patient should be able to achieve a higher heart rate or
MET
level in follow-up testing.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Exercise testing for patients after myocardial infarction and coronary bypass surgery: emphasis on predischarge phase. 660 42
During the ten year period (1981-1990) of detection of Pseudomonas aeruginosa susceptibility towards anti-Pseudomonas antibiotics a decrease in susceptibility towards GEN took place, namely from 91.7% to 80.0%. Susceptibility towards STR, COL and POL has not altered. During the course of five years we recorded a remarkable augmentation in resistance towards the group of 10 new antibiotics
NET
-by 24.3%, TIC-by 20.6% and AZL-by 18.5%. The most effective antibiotics of this group were CIP (100%),
AMI
(98.6%), OFL (99.3%), and CTZ (100%). Eight combinations of antibiotics were tested on 100 strains and CTX+GEN was proved to be the most effective combination-synergistic effect on 92.0 strains. The comparison of the effect of CTX+GEN combination on 12 strains implies identical results gained by both, the plate dilution method and the method of detection of lethal effect rate. For the purpose of routinized examinations the dilution micromethod is the most suitable. (Tab. 4, Ref. 19.).
...
PMID:[The effect of antibiotics and their combinations on Pseudomonas aeruginosa in vitro]. 800 78
To determine the exercise workload, ECG, and thallium-201 image parameters that are most closely associated with a poor prognosis from ischemic heart disease, the test results of 268 patients were reviewed. Only patients with unequivocal thallium-201 redistribution were selected. A multivariate analysis was performed to find the variables that were most strongly associated with the outcomes of coronary revascularization,
myocardial infarction
, and cardiac death during a follow-up period of 25 +/- 19 months. Patients who underwent early elective revascularization had poorer exercise tolerance and more thallium image abnormalities than those with no events. In the remaining patients
myocardial infarction
was most closely related to the extent and severity of thallium ischemia (p = 0.0086), whereas cardiac death was associated with abnormal thallium lung uptake (p = 0.0082) and an inability to exercise to 9.6
MET
(p = 0.0144). Thus unlike
myocardial infarction
, cardiac death is best predicted by variables that reflect poor left ventricular function rather than those that indicate ischemia.
...
PMID:Variables associated with a poor prognosis in patients with an ischemic thallium-201 exercise test. 842 25
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