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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To value stress tolerance and stress myocardial perfusion before and after a week of oral therapy with gallopamil 150 mg daily, we studied 10 patients suffering from stable effort angina. We performed bicycle exercise stress testing and thallium scintigraphy (Tl) with planar technique in 3 projections (anterior-posterior and oblique left anterior at 45 and 70 degrees) according to the current standards. We valued systolic and diastolic blood pressure (SBP-DBP), heart rate (HR) and HR-SBP product at rest, at symptoms stress-induced and at the end of the procedure. Moreover we valued work threshold of chest discomfort and ischemia, the maximal work capacity and the perfusion defects according to a Tl score obtained dividing the 3 projections in 5 segments and fixing a value according to the observed perfusion from 0 = normal perfusion to 3 absent perfusion. We observed a significant reduction of basal HR (77 vs 71, p = 0.05), SBP (147 +/- 15 vs 131 +/- 15 mmHg, p = 0.001), DBP (91 +/- 6 vs 83 +/- 6 mmHg, p = 0.002). Work threshold of chest discomfort and ischemia significantly arose (8 +/- 3 vs 11 +/- 4 min., p = 0.002; 6 +/- 3 vs 10 +/- 4 min., p = 0.001). The HR-SBP product at the maximal work capacity and the Tl score significant decreased (31650 +/- 6239 vs 29406 +/- 5418, p = 0.003; 8 +/- 2 vs 5 +/- 1, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The effect of gallopamil on myocardial perfusion in angina of effort]. 163 Jun 81

One hundred and twenty-two patients suffering from slight or moderate essential arterial hypertension with a previous history of myocardial infarction were selected for inclusion in this study. Patients were divided into two groups of 61 according to the type of anti-hypertensive therapy received. Patients in group 1 received nifedipine (30 mg p.d.), while patients in group 2 were treated using other anti-hypertensive therapy (diuretics, alpha-methyldopa, clonidine, indapamide). At the end of the follow-up period, which lasted 5 years, a statistically significant improvement in the following factors was observed in group 1 in comparison to the control group: (a) an improved response of both SBP (p less than 0.001) and DBP (p less than 0.001) levels to anti-hypertensive therapy; (b) a more significant diminution in the thickness of the interventricular septum (p less than 0.001) and the posterior wall of the left ventricle (p less than 0.001) assessed using ultrasonography; (c) a reduced number of cases of post-infarction angina (p less than 0.05); (d) fewer cases of recurrent infarction (p less than 0.05); (e) fewer deaths as a result of re-infarction (p less than 0.01). These results confirm that the vascular and cardioprotective effects of nifedipine give a good long-term outcome in hypertensive patients with a previous history of myocardial infarction.
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PMID:[The role of therapy with a Ca++ antagonists (nifedipine) in the long-term prognosis of hypertensive patients with previous myocardial infarction]. 209 51

One hundred and twenty-two patients suffering from slight or moderate essential arterial hypertension with a previous history of myocardial infarction were selected for inclusion in this study. Patients were divided into two groups of 61 according to the type of anti-hypertensive therapy received. Patients in Group 1 received nifedipine (30 mg p.d.), while patients in Group 2 were treated using other anti-hypertensive therapy (diuretics, alpha-methyldopa, clonidine, indapamide). At the end of the follow-up period, which lasted 5 years, a statistically significant improvement in the following factors was observed in Group 1 in comparison to the control group: (a) an improved response of both SBP (p less than 0.001) and DBP (p less than 0.001) levels to anti-hypertensive therapy; (b) a more significant diminution in the thickness of the interventricular septum (p less than 0.001) and the posterior wall of the left ventricle (p less than 0.001) assessed using ultrasonography; (c) a reduced number of cases of post-infarction angina (p less than 0.05); (d) fewer cases of recurrent infarction (p less than 0.05); (e) fewer deaths as a result of re-infarction (p less than 0.01). These results confirm that the vascular and cardioprotective effects of nifedipine give a good long-term outcome in hypertensive patients with a previous history of myocardial infarction.
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PMID:Role of Ca++ antagonists (nifedipine) in the long-term prognosis of hypertensive patients with previous history of myocardial infarction. 226 1

A randomized, placebo-controlled, double-blind crossover investigation in 12 patients with non-asthmatic chronic obstructive lung disease and co-existing stable angina pectoris was done to compare two beta 1-selective adrenoceptor blocking agents, atenolol 100 mg and bisoprolol 20 mg. Systolic and diastolic blood pressures (SBP, DBP), heart rate (HR) as well as airway resistance (AWR, and less frequently forced expiratory volume in 1 s (FEV1) and intrathoracic gas volume (ITGV) were measured in the sitting position before and at various times up to 24 h after drug intake. During the first 4 h both beta-blockers produced a significant reduction in HR in comparison to placebo (p less than 0.01). Atenolol 100 mg significantly increased AWR relative to placebo and bisoprolol (p less than 0.05). After 24 h, a significant reduction in HR (p less than 0.01) could only be demonstrated after bisoprolol, whereas atenolol alone led to a significant elevation in AWR relative to placebo and bisoprolol (p less than 0.05) at that time. It is concluded that bisoprolol appears to have a high degree of beta 1-selectivity, thus providing a wide split between beta 1- and beta 2-adrenoceptor blockade. Bisoprolol in its therapeutic dose range is expected to be relatively safe as regards bronchoconstriction in patients suffering both from hypertension and/or angina pectoris and chronic obstructive lung disease.
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PMID:Effects of single oral doses of bisoprolol and atenolol on airway function in nonasthmatic chronic obstructive lung disease and angina pectoris. 287 33

The symptomatic benefits of combining beta-adrenoceptor blockers and nitrates in angina pectoris are well recognised. Their actions on cardiac haemodynamics and volumes when combined have been poorly characterized. Accordingly this study investigated a new cardioselective beta-adrenoceptor blocking agent celiprolol and buccal nitroglycerine in 24 patients with angiographically documented coronary artery disease. Following a control period, with confirmed stable haemodynamics, three groups (n = 8/group) of prospectively matched patients, were studied following intravenous celiprolol (8 mg), buccal nitrate (10 mg) or their combination. Haemodynamics and left ventricular ejection fraction (nuclear probe) were determined following each intervention. The actions of each regimen on the haemodynamics of exercise-induced angina were compared by exercise testing in the control state and following each regimen. At rest, celiprolol did not alter haemodynamic parameters. Nitrate therapy reduced left ventricular filling pressure (pulmonary artery occluded pressure--PAOP) and volumes; the ejection fraction and heart rate increased. Combination therapy resulted in a highly significant reduction in left ventricular preload and afterload (PAOP and mean arterial blood pressure) at an increased left ventricular ejection fraction and reduced cardiac volumes; there was a trend to reduce cardiac double product (HR X SBP). During exercise celiprolol reduced systolic blood pressure, heart rate and cardiac index; systemic vascular resistance index increased. Nitrate therapy reduced blood pressure and PAOP, and increased ejection fraction. Combination therapy reduced all components of the triple product (heart rate, systolic blood pressure and PAOP) without affecting the other haemodynamic or radionuclide parameters. These data suggest improvements in cardiac function from the combination of celiprolol and nitrate therapy which were not achieved by either agent when used as monotherapy; they afford an interesting insight into the manner in which such widely utilised therapeutic modalities interact in coronary artery disease.
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PMID:A rest and exercise haemodynamic evaluation of a new cardio-selective beta-adrenoceptor blocker celiprolol alone and in combination with nitroglycerine in ischaemic heart disease. 288 72

A double-blind, crossover, randomized placebo controlled study involving 15 patients with effort stable angina, was carried out to assess atenolol (A) 100 mg during an 8-week period. Thereafter, atenolol antianginal efficacy was evaluated in a 6-month follow-up open non-comparative study. No antianginal drugs other than A were administered except for isosorbide dinitrate 5 mg when necessary. At the end of the 2-week wash-out period, and at the end of each 2-week period during the crossover phase of the study, and every 12 weeks during the 6-month follow-up, an ergometric test was performed and the following parameters were evaluated: HR, SBP, DP, Total Work Load (TWL) and S-T changes. The Barlett's test was performed to assess variance homogeneity, while the Tukey Hd test was used to evaluate the parameters during the treatments. During atenolol, the reduction in SBP was close to statistical significance, HR and S-T were significantly reduced (p less than or equal to 0.05) whereas TWL was significantly increased (p less than or equal to 0.05). During long-term atenolol treatment, all cardiovascular parameters clearly improved in comparison to the placebo period, confirming the antianginal efficacy of atenolol, even in the long-term treatment.
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PMID:Efficacy of atenolol in the short and long-term treatment of patients with effort stable angina. 292 Nov

The present work was performed in order to assess the differences in electrocardiographic and hemodynamic responses to supine and upright dynamic exercise of patients with coronary artery disease. Changes in heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, rate-pressure product (RPP) and ST segment depression during supine and upright bicycle stress test were compared in twenty patients suffering from stable effort angina and without previous myocardial infarction. In the supine posture lower values of HR were observed at rest, during stress test and during three minutes of the recovery period. Conversely, in all patients both SBP and DBP were higher during the stress test in the supine position decubitus. No significant changes in RPP was observed between the two different postures. Finally, ST segment didn't show differences at rest between the upright and supine position. All the patients had a lower ischemic threshold during exercise in the supine position than in the upright one. In fact an ST segment depression greater than 1 mm was observed during stress test in the supine position at lower work-load levels and at lesser HR values. Consequently for given HR, SBP and DBP ST segment, depression was greater in the supine rather than in the upright position.
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PMID:[Influence of posture on exercise-induced electrocardiographic and hemodynamic changes in patients with stable effort angina pectoris]. 324 16

The haemodynamic dose-response effects of intravenous penbutolol, a newer beta-adrenoceptor antagonist with intrinsic sympathomimetic activity but without cardioselectivity, were evaluated in 10 patients with angiographically documented coronary artery disease. Following four logarithmetically cumulative i.v. boluses (0.5-4 mg dosage range) there was a log linear increase in plasma penbutolol concentration; the levels achieved (51 +/- 8 to 219 +/- 19 ng/ml) were in the therapeutic range (12 to 250 ng/ml). Penbutolol resulted in a linear decrease in heart rate (maximum delta HR - 4 beats/min; P less than 0.01); there was a small increase in pulmonary artery occluded pressure which reached its maximum at the lower doses (maximum delta PAOP + 1 mm Hg; P less than 0.01). The resting cardiac output, blood pressure and calculated systemic vascular resistance were unchanged. During 4 min steady-state supine bicycle exercise there was attenuation of exercise cardiac output (delta C.I. - 0.6 1 min-1 m-2; P less than 0.01) and systolic pressor response (delta SBP - 13 mm Hg; P less than 0.01) compared with control observations without change in other measured or derived variables. The haemodynamic profile of penbutolol compared favourably with other beta-adrenoceptor antagonists previously evaluated under similar conditions in patients with ischaemic heart disease. Over the i.v. dose-range evaluated penbutolol attenuated exercise-induced angina with a relatively modest depression of cardiac performance; the small change induced in resting haemodynamic variables may, in part, have been contributed to by the intrinsic sympathomimetic activity of penbutolol.
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PMID:Haemodynamic dose-response effects of i.v. penbutolol in angina pectoris. 631 39

Twenty cases with effort angina underwent exercise training for a mean follow-up period of 38 weeks. Various parameters were investigated to clarify whether or not such parameters can be used to predict an increase in exercise tolerance of patients with effort angina. The increase of exercise tolerance after training was found to be related to a reduction of the myocardial oxygen demand at a given external work load. The maximal heart rate (max HR) the maximal systolic blood pressure (max SBP) and the maximal rate-pressure product (max RPP) could not predict the post-training increase in exercise tolerance. Before training, the maximal oxygen intake (VO2max) was found to be lower, and the HR/VO2max and the SBP/VO2max were higher in the group (11 patients) which showed a good response to the exercise program (effective group) than those in the group (9 patients) which did not (unchanged group). Before training, the HR/VO2max and the SBP/VO2max in the effective group were also higher than those of 96 healthy adults. On the other hand, the HR/VO2max and the SBP/VO2max in the unchanged group were not different from those of the healthy adults throughout the training. It is useful to compare the values of the HR/VO2max and the SBP/VO2max of patients with effort angina to those of healthy adults for the prediction of post-training increase in exercise tolerance.
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PMID:Exercise parameters for the prediction of post-training increase in exercise tolerance in patient with stable angina pectoris. 685 25

The purpose of this investigation was to examine the psychophysiologic responses of Type A and Type B individuals, among persons with and without coronary heart disease (CHD). Subjects were 58 adult male volunteers; 24 had a history of myocardial infarction or clinically diagnosed angina pectoris (CHD) and 34 had been designated free of coronary disease following recent cardiologic examination (non-CHD). All subjects had normotensive resting blood pressures; among CHD patients, no subject was currently on beta-adrenergic blocking medication. Measures of heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) were obtained during a baseline period and while subjects performed a series of difficult and frustrating cognitive tasks. Each subject was also administered the Structured Interview for Type A--Type B assessment (SI) and the Jenkins Activity Survey (JAS). Results indicated that, independent of the A/B typology, CHD patients experienced significantly greater DBP elevations during the experimental tasks than did non-CHD controls. Type A subjects (as determined by the SI) exhibited greater task-related increases in SBP and DBP than did Type Bs, but changes in HR did not differ between these two groups. Type A--Type B assessments based on the JAS were unrelated to subjects SBP, DBP, or HR responses, and neither SI- nor JAS-defined Type As differed reliably from Type Bs on measures of task performance. Overall, these results are consistent with the hypothesis that heightened cardiovascular reactivity under stress may mediate relationships between behavioral factors and CHD.
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PMID:Coronary-prone behavior pattern and cardiovascular response in persons with and without coronary heart disease. 717 93


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