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

A double-blind cross-over study was performed on 12 men sith stable angina pectoris in order to determine the effect of antilipolytic treatment on exercise tolerance and exercise-induced electrocardiographic changes. The men were exercised to the onset of anginal pain using a reproducible and standardized ergometric load. A nicotinic acid analogue was used to reduce plasma free fatty acids and free glycerol before and during exercise testing and to eliminate their post-exercise rise. This was associated with significant reduction of exercise-induced ST segment depression (p less than 0-005), though there was no significant difference in the duration of exercise before the oneset of pain. A change in the prportions of lipid and carbohydrate for oxidation by the ischaemic myocardium, making relatively more glucose available, is a likely explanation.
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PMID:Antilipolytic therapy in angina pectoris. Reduction of exercise-induced ST segment depression. 79 43

The effects of 20 mg of orally administered isosorbide dinitrate on 10 patients with stable angina pectoris were studied by means of exercise tests. First, the reproducibility of the angina threshold of each patient was controlled; then the effects after 60, 150 and 210 minutes after administration of the drug and of a placebo, given in a random sequence, were studied. No significant changes of the parameters examined were observed after the placebo. A significant increase of duration of exercise and total amount of work performed before appearance of angina were observed after the drug. These changes were maximal in tests made 60 minutes after administration of the drug, declining thereafter; nevertheless, statistically significant differences from placebo were also observed in tests performed after 150 and 210 minutes. The appearance of ischemic ST changes was retarded by the administration of the drug. Disappearance of pain after interruption of exercise was significantly quicker when compared with the observations made after placebo.
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PMID:[Orally administered nitroderivates: efficacy and duration of the effects of isosorbide dinitrate (author's transl)]. 79 8

The sensory function of the upper limbs was examined in 18 subjects who had a myocardial infarction without a well-defined episode of chest pain. The cutaneous pain threshold was significantly higher than in normals. The ischaemia of the upper limbs induced patterns of sensations different from the normals, with onset of pain and of autonomic and coenaesthesic disturbances. These modifications of the sensory function are the same as observed in subjects with a previous painful infarction, but are quite different from those observed in patients with angina pectoris.
Pain 1976 Sep
PMID:Myocardial infarction without pain. A study of the sensory function of the upper limbs. 80 Feb 52

Of 88 consecutive patients aged 20 to 77 years with severe symptomatic aortic valve disease requiring surgery, 51 patients had angina pectoris; of these 51, 41 had predominant aortic stenosis and 10 had severe aortic regurgitation. All patients with angina pectoris underwent coronary angiography; significant coronary arterial disease was encounted in 24 per cent of those with aortic stenosis and 20 per cent of those with aortic regurgitation. By contrast, of 37 patients without angina pectoris 19 underwent coronary arteriography; none showed significant coronary artery disease (P smaller than 0.05). Among patients with angina pectoris, 17 per cent of those with aortic stenosis experienced prolonged, rest or nocturnal pain, compared to 70 per cent of those with aortic regurgitation (P smaller than 0.005). At the time of onset of angina pectoris, there were features of heart failure in 34 per cent of those with aortic stenosis, and in 90 per cent of those with aortic regurgitation (P smaller than 0.005). Nitroglycerin promptly relieved angina pectoris in 56 percent of patients with aortic stenosis and in 50 per cent of those with aortic regurgitation (P smaller than 0.05). Neither the pattern of angina pectoris nor the response to nitroglycerin was dependent upon the coexistence of significant coronary artery disease. In patients with aortic stenosis, there was not significant difference between those with angina pectoris, and those without angina with regard to left ventricular end-diastolic volume, end-diastolic pressure, ejection fraction, peak systolic pressure, wall thickness, cardiac index, or the product of these factors. In patients with aortic regurgitation, cardiac index was significantly lower (P smaller than 0.05), left ventricular end-diastolic volume tended to be larger, and ejection fraction tended to be lower in patients with angina pectoris as opposed to those without angina pectoris.
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PMID:Clinical, haemodynamic, and coronary angiographic correlates of angina pectoris in patients with severe aortic valve disease. 80 13

Hemodynamic and angiographic data obtained during pain from four patients with Prinzmetal's variant angina are reported. The left ventricular pressure-time index did not increase before or during attacks of angina in three of the four patients; left ventricular systolic performance was impaired during pain in all three. In one of these three patients left ventricular pressure-volume data obtained during angina suggested a reduction in diastolic compliance; in another, pain and S-T segment elevation were present during coronary arterial spasm. The fourth patient had an increase in both arterial blood pressure and heart rate before an attack; in this patient coronary arterial spasm could not be demonstrated during the period of pain and S-T elevation. The data presented suggest that hemodynamic factors that increase the myocardial oxygen requirements are absent and that coronary arterial spasm is present in some, but not all, patients with variant angina.
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PMID:Prinzmetal's variant angina: hemodynamic and angiographic observations during pain. 80 9

In 34 patients with coronary atherosclerosis a pacing test was performed with measurement of the lactate, glucose, potassium and inorganic phosphate coronary arterio-venous differences. Eighteen of these 34 patients felt no pain during the pacing test. In this group of asymptomatic patients, there was no significant change of the lactate, glucose, potassium and inorganic phosphate myocardial extraction. In the 16 patients who felt an anginal pain during the pacing test, there was a significant myocardial production of lactate, but the myocardial loss of potassium and inorganic phosphate was not continuously statistically significant. Myocardial extraction of glucose during the pacing-induced angina did not increase. Although, in some patients, both the potassium and the inorganic phosphate might be used to assess a condition of myocardial ischaemia, the lactate remains the best metabolic criterion for pacing-induced ischaemia.
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PMID:[Values of glucose, potassium and inorganic phosphate as metabolic indicators of myocardial ischemia in humans]. 80 87

Seventeen patients received placebo medication during a 12-week run-in period, followed by four double-blind study periods of six weeks each, during which time placebo, 80 mg, 160 mg and 320 mg propranolol dosages were administered. Examination of the frequency of angina episodes and nonprophylactic nitroglycerin consumption revealed significant beneficial clinical responses for both the 160 and 320 mg dosages. Exercise testing also demonstrated increased exercise tolerance (320 mg dose) with a shift of the exercise end point from pain to fatigue in seven of 17 patients. The interrelationships between propranolol daily dosage, clinical response assessed by percent reduction in anginal episodes, beta-adrenergic blockade measured by percent reduction in exercise heart rate and serum levels were examined. In general, serum levels of 30 ng/ml, when drawn 90 to 180 minutes following the last oral dose, were required to achieve a 25% or greater reduction in angina frequency. Serum levels above 30 ng/ml were similarly correlated with a 20% or greater reduction in exercise heart rate at equivalent levels of exercise. Detailed examination of different patterns of clinical response with respect to beta-blockade, serum levels and oral doses are presented.
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PMID:Dose response effectiveness of propranolol for the treatment of angina pectoris. 80 75

In 10 patients without and 20 patients with various degrees of angiographically proven CAD 93 pacing runs were studied. Changes of PAm, of ECG, and of anginal pain serving as parameters of myocardial ischemia were correlated to the rate-pressure-product. In patients without CAD no correlations could be ascertained. In each patient with CAD determination of ischemia was achieved reproducibly. Ischemia threshold is represented by a sharp increase of PAm. Ischemia threshold seems a parameter to be preferred as compared to pain threshold. The extent of CAD (angiographically estimated) correlates well with the pacing test especially when collaterals are taken into account. After NG no substantial improvement of ischemia can be detected: Ischemia threshold before and after NG was reached at same rate pressure in each case. We conclude the atrial pacing test to be an excellent test for the provocation of myocardial ischemia. The test is also useful for estimation of the extent of CAD.
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PMID:Pacing-induced myocardial ischemia in spite of nitroglycerin. Correlations regarding the extent of coronary artery disease. 80 82

With the use of a three-phase experimental design, the efficacy of oral nitroglycerin has been evaluated in a total of 53 patients with documented angina pectoris due to coronary artery disease. The study were a double-blind, randomized, and cross-over comparison of controlled-release nitroglycerin (2.6 mg. tablets administered three times daily) and an indistinguishable placebo. Sixteen patients recorded anginal symptoms by the diary method over a 6 month trial of randomly sequenced 1 month periods of drug or placebo. In 15 patients, ST segments were monitored with a Holter dynamic electrocardiograph for periods of 10 to 12 hours under normal life style and evaluated by matching activities during periods of drug and placebo. In 22 patients, a multistage treadmill exercise test was conducted to an endpoint of anginal pain. The three phases of the investigation were run in succession; each phase was completed before the next one was begun. Oral nitroglycerin reduced the incidence and severity of anginal attacks by 47.2 and 49.4 per cent, respectively, and decreased the number of sublingual nitroglycerin tablets used by 51.1 per cent in comparison to placebo (p less than 0.001). Eleven of 16 patients (69 per cent) decreased their need for sublingual nitroglycerin by over 50 per cent. Based on a polynomial trend analysis over a period of 8 weeks, no tolerance to the therapeutic effects of the drug was found. With DCG monitoring, drug decreased the ST segment depression from 1.76 mm. on placebo to 1.12 mm, with a significant difference of 0.64 mm. (p less than 0.001). ST segment depression was decreased more than 0.5 mm. by drug in comparison to placebo in 10 of 15 patients (66 per cent). Larger depressions of the ST segment noted with placebo at heart rates greater than 80 beats per minute were prevented by administration of the drug. During treadmill exercise, drug delayed the onset of pain by 83 seconds (64 per cent) over placebo (p less than 0.001) and decreased the duration of pain by 70 seconds (49 per cent) in comparison to placebo (p less than 0.001). Drug did not affect heart rate or systolic blood pressure at rest or after exercise, as well as rate-pressure product for production of angina following exercise (p less than 0.05). There was no side effects reported caused by the drug. The data demonstrate that oral nitroglycerin, given as controlled-release tablets, was absorbed from the gastrointestinal tract in quantities sufficient to provide statistically significant clinical improvement of angina pectoris.
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PMID:Oral nitroglycerin as a prophylactic antianginal drug: clinical, physiologic, and statistical evidence of efficacy based on a three-phase experimental design. 81 Nov 2

A myocardial revascularisation procedure was carried out on 68 patients with obstructive atheroma of the coronary arteries associated with severe angina pectoris. In 58 cases a total of 97 vein grafts were used, and in 10 cases the internal mammary artery was anastomosed to the anterior descending artery (using a vein graft in 5 of them). Before operation the patients had selective coronary arteriography, and a maximal exercise test using a bicycle ergometer. Three months postoperatively the patency of the coronary by-pass was checked, and a further exercise test completed. In the exercise test the criteria were the appearance of angina pectoris, improved performance (measured by the duration of exercise, the maximal power, and the heart rate at the end of exercise), and improved ECG findings. These criteria were correlated by the patency of the graft or grafts as noted at arteriography. There was no pain on exercise in 55 patients (81 per cent), the performance improved in 37 (54 per cent), and the ECG findings improved in 50 (72 per cent). At angiography, 34 patients (50 per cent) had a completely patent by-pass (group I), 31 patients (45.5 per cent) had at least one patent graft (group II), and 3 patients (4.4 per cent) had no patent graft (group III). Group I corresponds to 31 good or very good results and to 3 states on non improvement; group II contains 22 good results and 9 states of non improvement; group III corresponds to 3 states of non improvement. Exercise demonstrates the results of myocardial revascularisation surgery; the correlations between these results and those of graft patency justify its use in surveillance of coronary patients who have been operated. Exercise tests show that the best results are obtained in patients with severe functional disturbances and whose ventricular cinetics have remained sufficient.
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PMID:[Evaluation of the results of myocardial revascularization surgery by exercise tests under electrocardiographic control. Correlations with control coronography]. 81 70


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