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

The effect of beta-blockade by acebutolol on global and regional myocardial perfusion (133Xenon wash-out) was studied in 10 patients with coronary artery disease. Another group of 10 similar patients was used to study the effect of acebutolol on left ventricular cavity size (metal markers--spot film camera). Global perfusion responses roughly paralleled the changes in rate-pressure variable which decreased in 8 patients and increased in 2 who had spontaneous angina pectoris. Regional perfusion decreased more in areas distal to less than 75% stenoses than in those distal to less than 75% stenoses (29 vs 12%; p = 0.10 less than 0.20). Left ventricular asynergy did not modify the response, nor did the presence or absence of collateral vessels. No evidence was found to support the thesis that beta-blockade may evoke a redistribution in perfusion which favours the potentially ischaemic areas of myocardium. Left ventricular cavity size remained unchanged after acebutolol, a cardioselective beta-blocking compound with some degree of agonist activity.
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PMID:Response of left ventricular myocardial perfusion and cavity size to beta-blockade by acebutolol. 2 72

In 34 cases, corresponding to 3,7% of all patients underwent coronary arteriography for evaluation of anginal syndrome in our laboratory, it was observed a congenital coronary anomaly on their angiograms. The purpose of this paper is to verify the frequency of coronary anomalies and to evaluate relations existing between these anomalies and anginal syndrome. Coronary arteriograms, in 22 cases (2,44%), revealed exclusively; the presence of a coronary anomaly without occlusive coronary disease, which might per se justify angina. They were distributed as follows : 5 with coronary fistula, 2 with coronary aneurysms, 2 cases with single ostium and finally, 13 subjects with hypoplasia of one of the three major coronary arteries. One infant, 14 months old, had a hyperplasic left discending artery (LDA) draining in right ventricle cavity. Her ECG revealed signs of right ventricle overload. All the other cases had a typical angina syndrome with positive stress test. Left cineventriculography demonstrated left ventricle asynergy in 16 patients. We concluded that typical angina syndrome in our 22 patients, may be attributable to coronary anomalies observed at their coronary arteriograms.
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PMID:[Congenital coronary artery malformations and associated clinical syndromes (author's transl)]. 23 May 91

Four patients with total occlusion of the left main coronary artery are described. Angina pectoris was severe (NYHA class 3--4) and had lasted 20 months to seven years. Three patients had experienced a myocardial infarction. All displayed large collaterals arising from a nearly normal right coronary artery and feeding both the left anterior descending and the left circumflex arteries. The left ventricular ejection fractions ranged from 20% to 65%, and all patients had varying degrees of left ventricular asynergy. Coronary artery bypass surgery resulted in a marked improvement in three patients; one patient who underwent an aneurysmectomy died two months after the operation. The data show that total occlusion of the left main coronary artery is compatible with survival if adequate collateral supply develops from the right coronary artery. In this rare angiographic subset collateral circulation is clearly functionally significant.
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PMID:Survival with total occlusion of the left main coronary artery. Significance of the collateral circulation. 49 63

A comparison was performed between the echocardiographic (EchoC) indices for the pump and contraction function of left ventricle and the stage of left-ventricle insufficiency, determined according to clinical criteria of 82 patients with ischemic heart disease (IHD)--old myocardial infarction and (or stable angina pectoris without left-ventricle infarction and for stable angina pectoris without left-ventricle aneurysm. With IHD, regardless of the considerable asynergy of left ventricle, some of the functional EchoC-indices were established to preserve their diagnostic values and definitely to differentiate the majority of the cases with, from those without, cardiac insufficiency, objectivizing the determination of initial left-ventricle insufficiency. The most significant diagnostic value of EchoC-assessment of left-ventricle function in IHD has the following complex of EchoC-indices: diastolic extent, left ventricle index resp, expulsion fraction (EF), shortening fraction (FS), average velocity of circumferential fibres (VCF), distance between point E of mitral echogram and interventricular septum (S-E distance), telediastolic interval A-C of mitral echogram and extent, index of left auricle, resp.
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PMID:[Echocardiographic evaluation of left ventricular function in ischemic heart disease (IHD)]. 52 71

Echocardiography was performed in 25 consecutive patients with angina pectoris and angiographically demonstrable coronary artery disease. Left ventricular echograms detected late or pansystolic mitral valve bowing suggesting of mitral valve proplapse in 6/25 (24%). Left ventricular angiography showed prolapse of the posterior mitral leaflet in 15/25 (60%), including 5 detected by echocardiography. Significant triple vessel coronary disease was present in 11 of 15 patients with prolapsed mitralvalve. In each of the latter a greater than 90 per cent obstructive lesion was noted in at least one coronary artery: right coronary artery, 9 subjects (82%); left circumflex coronary artery, 5 patients (33%); and left anterior descending coronary artery, 4 patients (27%). Of 15 subjects with angiographic evidence of mitral valve prolapse, 13 had left ventricular asynergy-inferior or inferoposterior in 8 subjects (62%) and anterior or anteroapical in 5 subjects (38%). Eleven subjects had vectorcardiographic evidence of transmural myocardial infarction-inferior or inferoposterior in 9 (82%) and anteroseptal in 2 (18%). A single subject with mitral valve prolapse had mild mitral regurgitation. It is concluded that: (1) coexisting prolapse of the posterior mitral valve leaflet and coronary artery disease is usually associated with triple vessel obstructive lesions, (2) severe right coronary disease, inferior left ventricular wall asynergy, and inferior myocardial infarction are important angiographic and vectorcardiographic correlates, and (3) echocardiography will detect such mitral valve prolapse in only one-third of affected cases.
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PMID:Mitral valve prolapse in patients with coronary artery disease. Echocardiographic-angiographic correlation. 83 37

The indices of contractility of the left ventricular myocardium were studied by means of ventriculography and catheterization in 84 patients with ischemic heart disease according to the extent of damage to the coronary arteries and the course of the disease. Changes in the coronary arteries were encountered twice as frequently among patients with postinfarction cardiosclerosis as among patients with angina pectoris and no history of infarction. The main cause of disorders of myocardial contractility in patients with ischemic heart disease is post-infarction cardiosclerosis (56% of cases). Signs of impaired functional capacity of the left ventricle appeared in segmental asynergy involving 20 to 25% of its circumference. Changes in the indices of contractility were revealed in 13% of patients with angina pectoris.
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PMID:[Myocardial contraction in ischemic heart disease]. 92 72

Evaluation of the results of surgery for coronary artery disease requires a knowledge of the clinical course of patients not having this mode of treatment. To obtain such information we performed a retrospective analysis of the fate of 266 patients with arteriographically documented significant stenosis following from one to ten years. For the entire group the five year survival was 73%. Subdivided into single, double or triple vessel disease categories the percent five year survival rates were respectively 92, 65 and 55. A history of angina pectoris or myocardial infarction prior to angiography did not affect survival. However, hypertension, congestive heart failure, abnormal hemodynamics or left ventricular asynergy were all associated with a diminished five year survival, the values being respectively 61%, 38%, 62% and 58%. These results should be of VALUE IN ASSESSING THE PROGNOSIS OF NONSURGICALLY TREATED PATIENTS WITH CORONARY ARTERY DISEASE.
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PMID:Prognosis in coronary artery disease. Angiographic, hemodynamic, and clinical factors. 110 13

In 29 patients, the site and extent of coronary artery obstruction were related to the position and area of abnormally contracting segments of the left ventricle, both in patients with a history of angina without myocardial infarction (group I) and in patients with prior documented myocardial infarction (group II). The degree of coronary artery obstructive disease was estimated in the standard manner and also by a coronary artery index which considered not only the degree of obstruction but also the total length of the obstructed segment. A kinetic or dyskinetic segments were present in 22 of the 29 patients. An abnormally contracting segment was present in 12 or 18 patients without prior myocardial infarction in comparison with 10 of the 11 patients with prior infarction. Complete obstruction of a coronary vessel and resultant dyskinesia were more frequent in the right coronary artery than in either the left anterior descending or the circumflex artery. There was a significant correlation between total per cent of vessel obstruction and degree of ventricular asynergy in both groups; consideration of length of obstructed segment did not improve this correlation.
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PMID:Left ventricular dyskinesia in infarction and angina. 113 45

Selective coronarography, left ventricular cineangiography were performed three to six months after acute myocardial infarction in 45 patients. Simultaneously, stroke volume (SV), enddiastolic (EDV) and endsystolic volume (ESV), ejection fraction (EF) and left ventricular enddiastolic pressure (LVEDP) were determined. LVEDP was measured at rest and after static (handgrip) exercise. According to the type of the LV abnormality patients were divided in three groups: 1. without LV abnormality (5 patients) 2. asynergy (15 pts) and 3. aneurysm (25 pts). The data were reviewed separately in patients where abnormalities of LV were associated with angina pectoris. The degree of coronary obstruction and the type of LV abnormality did not disclose any correlation. LVEDP at rest was in normal limits in patients in group 1 and 2, elevated in patients with aneurysm. (LVEDP: 15, 15 and 25 mmHg resp.) After handgrip exercise LVEDP increased in each group: 21, 22, 32 mm Hg. SV: decreased significantly in LV aneurysm (53 ml/beat). EDV was 50 ml in patients with asynergy and 118 ml in those with aneurysm. ESV was in normal limits when asynergy was present, 35 ml in patients without abnormality and 118 ml in LV aneurysm. EF was 0.66 and 0.65 in group 1 and 2, in group 3 (aneurysm) this value was 0.49 (significantly lower). The extent of shortening of the longitudinal and transverse diameters were significantly diminished in each group. When angina was associated with LV asynergy a higher SV was observed, when angina was associated with aneurysm, SV and EF were decreased. The conclusion from these data can be drown that the compromised LV after prior AMI works with a different mechanism, according the type (and degree) of abnormality.
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PMID:Abnormalities of left ventricular function associated with prior acute myocardial infarction. 123 42

A dipyridamole-echocardiographic test (DET) was carried out to find out how safe and useful it was in predicting clinical outcome and in identifying patients at risk. The test was performed in 107 asymptomatic patients early (5 to 8 days) after a first acute uncomplicated myocardial infarction managed with thrombolytic therapy. All patients were followed up for a mean of 15 months and 94 underwent coronary angiography. The test was considered positive if transient asynergy of contraction was newly detected either in the infarct and adjacent areas or in the remote zones; two subsets were studied, according to the dose of dipyridamole (0.56 or 0.84 mg.kg-1) needed to induce ischaemia. The test was accomplished satisfactorily in 96% of patients. Intra-inter-observer agreements were 88% and 91% respectively. The test also proved safe at the high infusion dose. During the follow-up period, two patients died, one experienced re-infarction and 12 (12%) developed recurrence of angina. DET was abnormal in 32 patients (adjacent and remote asynergy in 28 and four patients respectively): 18 had a critical and two a non-critical stenosis in the infarct-related vessel, and nine had an occluded artery with collateral distal flow. Multivessel disease was present in 11 patients considered positive, four in the remote and seven in the adjacent zones. However, 20 patients with negative DET results had multivessel disease. Of the positive DET patients, seven had angina. There were eight total events in the 71 negative DET patients, five of whom had multivessel disease. Abnormality was more pronounced in positive DET patients, but did not influence the outcome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Usefulness of dipyridamole-echocardiographic test to identify jeopardized myocardium after thrombolysis. Limited clinical predictivity of dipyridamole-echocardiographic test in convalescing acute myocardial infarction: correlation with coronary angiography. 139 7


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