Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:4.1.1.6 (CAD)
 4,420 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The change in left ventricular volume during a representative cardiac cycle was assessed in 19 patients with CAD and 8 control subjects before and after 10 mg isosorbiddinitrate sublingually. 15mCi99mTc-HSA were administered intravenously. After the tracer had equilibrated, the precordial changes of activity were measured with a gamma-camera connected to a computer. In order to determine the overall left-ventricular function from volume curves, the ejection fraction, the maximal systolic ejection rate and the maximal diastolic filling rate of the left ventricle were measured. For the assessment of regional wall motion abnormalities the volume changes were observed in a cinemode on a colour video display. In addition the relative changes of regional EF, regional stroke volume and the timing of endsystole were recorded as a functional scintigram. The results showed very clear differences between control subjects and patients with CAD. Furthermore differences existed between patients with hypokinesia and those with akinesia or aneurysm. The results emphasize that quantitative gated nuclear cardiography not only provides information concerning the left ventricular function but also allows the assessment of local wall motion as to reversible or irreversible asynergy.
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PMID:[Quantitative gated nuclear cardiography in coronary artery disease after administration of isosorbiddinitrate (author's transl)]. 54 1

In order to evaluate the effects of rapid digitalization on LV volumes, ejection fraction, and asynergy, 21 patients without heart failure were studied with a combination of hemodynamic and angiographic techniques before and after administration of intravenous ouabain (0.007 mg./Kg.). Seven patients had no CAD and served as normal (control) subjects (Group I), while 14 patients had extensive coronary disease (Group II). All pre-ouabain parameters were within the normal limits in Group I. After ouabain infusion, all indices of LV contractility: dP/dt, VCF, and ejection fraction rose significantly in the normal group, while LV filling pressure and end-diastolic volume remained unchanged. The baseline hemodynamic and volumetric values for Group II patients corresponded closely to their normal (Group I) counterparts, and exhibited similar changes after ouabain administration. Eight patients in Group II also had regional disorders of LV contractility, delineated by 23 abnormal hemiaxes of shortening. After ouabain, 15 out of 23 asynergic segments (65 per cent) improved, seven remained unchanged, and one worsened. It is therefore concluded that rapid digitalization not only enhances LV performance in normal subjects and in patients with CAD, but can also markedly reduce the extent of LV asynergy.
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PMID:Effects of rapid digitalization on total and regional myocardial performance in patients with coronary artery disease. 68 6

To assess the relation between the extent of myocardial necrosis and the presence of myocardium at risk in myocardial infarction without Q waves (NQMI) we studied by echocardiography the prevalence of jeopardized myocardium in a group of NQMI stratified on the basis of left ventricular wall motion (akinesis, hypokinesis, normal kinesis). We have studied 60 consecutive patients with non-Q myocardial infarction. Patients were examined by 2D echo at rest (V-VI day from the acute episode) and during symptoms limited bicycle ergometric test (ExT) (XX-XXX day). Regional left ventricular wall motion was evaluated as normal or asynergic (severe hypokinetic, akinetic) and the ExT was considered positive in case of new asynergic areas or ECG criteria. 2D echo at rest was technically satisfactory in 56 patients, 19 showed almost an akinetic segment (Aci) 17 had hypokinetic areas (Ipo) and 20 had normal left ventricle kinesis (Norc). Wall motion abnormalities were localized more frequently in the apex and lateral areas. During exercise 2D echo was performed in 46 patients (82%) with 23 positive tests (50%). Stratifying the population on the basis of left ventricle wall motion we observed a major number of positive tests in the group of patients with normal wall motion in comparison with those with asynergic areas at rest (Norc 66.6%, Ipo 35.7%, Aci 42.6% p less than 0.05 Nore vs Ipo and Nore vs Aci) despite the same CAD extension. These data show the heterogeneity of the NQMI that likely includes patients with transmural (asynergy group) and subendocardial MI (normal kinesis group), the latter with a higher degree of myocardium at risk.
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PMID:[Stratification of risk in infarcts without Q wave: role of echocardiography at rest and during exertion]. 224 30

Using multigated radionuclide ventriculography (RNV), the left ventricular (LV) phase histogram (PH) was used to quantitate LV synchrony at rest and at submaximal and maximal supine exercise in 10 normal and 10 coronary (CAD) patients. Each LV PH was obtained by masking the phase image with an LV region, generated semiautomatically and modified if necessary to minimize ambiguity of LV delineation. The shape and spread of each histogram was characterized by its standard deviation (SD) and skewness (SK). Normals had a tight resting PH with slight negative skewness (SD = 9.06 +/- 0.22 (mean +/- SEM; SK = -0.53 +/- 0.05). CAD patients had a wider resting PH with a larger SD and a significantly more positive skewness reflecting greater contractile asynchrony (SD = 16.53 +/- 2.26; SK = 0.35 +/- 0.22). With exercise the PH distribution for the normals remained tight (SD = 8.1 +/- 0.24) while SK changed little (SK = -0.29 +/- 0.04). In contradistinction, with exercise CAD patients markedly increased the spread of their LV PH (SD = 27.42 +/- 3.77) and increased the number of late pixels (SK = 0.75 +/- 0.15). It is concluded that quantitative PH analysis is a useful adjunct for the analysis of regional asynergy during resting or exercise radionuclide left ventriculography.
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PMID:Quantitative phase analysis of exercise radionuclide left ventriculography in normals and patients with coronary artery disease. 683 32

Transesophageal atrial stimulation (TRAS) was combined with 2-dimensional echocardiography in 69 consecutive patients on days 3 to 5 (mean 3.3) of their first, uncomplicated myocardial infarction, to determine if inducible remote asynergy (i.e., not directly adjacent to the infarcted area and supposedly related to another vascular territory) provides information regarding (1) extent of coronary artery disease, and (2) future ischemic events. Uncomplicated, adequate stress studies were performed in 59 of 69 patients (86%); all these patients had regional asynergy at rest. Remote asynergy at rest was present in 7 patients and during TRAS in 26 patients. Coronary angiography was performed within 2 to 3 weeks after the acute phase. Multivessel disease was present in 23 of these patients and absent in 3. Of the 33 patients without remote asynergy during TRAS, 5 had multivessel disease. Sensitivity of remote asynergy during TRAS for detecting multivessel CAD was 82%, specificity 90%, and predictive accuracy 86%. New ischemic events, defined as recurrent infarction, cardiac death, or revascularization within 12 to 18 months (mean 12.6) occurred in 24 patients (41%); remote asynergy during TRAS was present in 16 of these patients (67%). It is concluded that TRAS combined with 2-dimensional echocardiography can safely be performed in the early days of acute myocardial infarction; remote asynergy during TRAS reliably identifies patients with multivessel disease and future ischemic events.
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PMID:Usefulness of combined two-dimensional echocardiography and transesophageal atrial stimulation early after acute myocardial infarction. 748 93