Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to assess the short-term reproducibility of dipyridamole-echocardiography test (DET) consisting of two-dimensional echo monitoring during dipyridamole infusion (up to 0.84 mg/kg in 10 min). The diagnostic end-point of the test is the detection of new onset or worsening regional asynergy. A group of 87 patients with rest and/or effort angina performed two DETS on two consecutive days. All 60 patients with a positive DET had a positive repeat test, and the 27 negative DETs were also negative on the following day. The timing of the asynergy was also very similar between the two tests, both in patients with angina on effort (r = .93, p less than 0.01) and at rest (r = .92, p less than 0.01). In conclusion, DET has a very high short-term reproducibility regarding the presence and timing of asynergy.
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PMID:Short-term reproducibility of dipyridamole-echocardiography test. 366 15

To investigate the clinical significance of exercise-induced ST segment elevation and ST segment depression after myocardial infarction (MI), we performed 87-lead ECG mapping after previous anterior infarction in 24 patients with isolated left anterior descending coronary artery disease before and 1.5 minutes after treadmill exercise. Thirteen patients showed ST segment elevation only, seven patients showed both ST segment elevation and depression, and four patients showed ST segment depression only. ST segment elevation most frequently occurred in the left anterior chest leads corresponding to the QS area, and ST segment depression developed in the left lower chest and left lower back leads. There was good correlation between the number of lead points showing ST segment elevation (nSTe) after exercise and the number of lead points showing QS waves (nQS) before exercise (r = 0.65). nSTe was also correlated with the asynergy index (r = 0.43). These findings suggest that ST segment elevation is mainly the result of aggravation of wall motion abnormalities of the infarcted myocardium. Body surface distribution of ST segment depression was similar to that in effort angina pectoris without MI. We conclude that exercise-induced ST segment depression in MI mainly reflects the ischemia of the surviving myocardium of small infarcts or the peripheral area of large infarcts.
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PMID:ST segment changes in exercise body surface mapping after myocardial infarction in patients with isolated left anterior descending coronary artery disease. 367 78

Our previous observations showed that left ventricular wall motion abnormality (asynergy) induced by stress was observed in the phase response of radionuclide technique, and the severity and extent of coronary artery disease (CAD) assessed by the Pujadas score (PS) correlated well with the maximal phase delay response (delta MPD) but not with the ejection fraction response (delta EF) in patients with CAD without old myocardial infarction (MI). This study evaluated the usefulness of EF, MPD and the first-third filling fraction (FF, divided by the volume accrued throughout diastole) at rest and during stress, using ergometer and first-pass radionuclide angiocardiography (RNA), to determine the severity of CAD, and to evaluate any abnormalities in the systolic and diastolic coupling in left ventricular function during stress. Seventy-four patients with significant CAD, including 41 with previous transmural MI (MI group) and 33 without MI (angina group) were the subjects of this study. EF at rest and during stress inversely correlated, and MPD on stress linearly correlated with PS in angina group with PS greater than 10, while no such correlations were found in MI group. A normal EF response (delta EF greater than or equal to 5%) was accompanied by a greater-than-normal response in FF (delta FF) in both groups. A lower EF response was accompanied by a smaller delta FF in angina group, but by a larger delta FF in MI group. The difference was statistically significant (p less than 0.03), without significant differences by age, PS, peak heart rate, systolic blood pressure, and ischemia on ECG during stress. Resting EF and FF by the RNA method correlated with those by left ventriculography (LVG), respectively. It was suggested that RNA is an accurate method for determining EF and FF, while phase analysis may provide some additional information different from that provided by LVG. We concluded that EF and MPD during stress are as useful as delta MPD with the exception of a few cases in predicting the severity of CAD, and that scar tissue within the ventricular wall in MI may play an important role in determining the ventricular diastolic mechanical property during stress.
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PMID:[Severity and extent of coronary artery disease and their relationship to left ventricular functional reserve in the chronic disease state]. 372 76

Atrial filling fraction obtained by left ventricular echocardiogram (AFF by LV echo) is considered to be a reliable measure of AFF of LV. However, in patients with LV asynergy, AFF by LV echo cannot be evaluated correctly by this method. To obtain AFF, we devised a new echocardiographic index of AFF, obtained from the aortic-left atrial echogram (AFF by Ao echo), and examined the significance of this index in 9 normal subjects (Normals) and 49 patients with various heart diseases. The correlation between AFF by Ao echo and left ventricular end-diastolic pressure (LVEDP) also was examined. In an additional 20 patients with acute myocardial infarction (acute MI), the relationship between AFF by Ao echo and pulmonary arterial end-diastolic pressure (PAEDP) was studied for several days following the onset of MI. Results were as follows: In Normal patients and patients without asynergy, a significant correlation was seen between AFF by LV echo and AFF by Ao echo (r = 0.710, p less than 0.001). The value of AFF by Ao echo was always greater than that by LV echo. AFF by Ao echo in patients with hypertensive heart disease (HHD), angina pectoris (AP) and old myocardial infarction (old MI) was significantly higher than that in Normal patients. A significant curvilinear correlation was seen between AFF by Ao echo and LVEDP (r = 0.673, p less than 0.005). In patients with acute MI, AFF by Ao echo correlated well with PAEDP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Atrial filling fraction obtained by aortic root echocardiogram in man. 373 55

A frequent clinical problem is documentation of the elusive entity of "electrocardiographically silent" effort myocardial ischemia. In this study, 83 patients with angina on effort and either negative or nondiagnostic exercise stress test results underwent a dipyridamole-echocardiography (echo) test, a feasible and useful tool for detection of coronary artery disease (CAD). The dipyridamole-echo test (2-dimensional echocardiographic monitoring combined with intravenous dipyridamole infusion at a maximal dosage of 0.84 mg/kg over 10 minutes) and coronary arteriography were performed in all patients. Positivity of dipyridamole-echo test was based on the detection of regional transient asynergy of contraction. At coronary arteriography, 50 of the 83 patients had significant (more than 70% diameter reduction) CAD: 27 had 1-vessel, 17 had 2-vessel and 6 had 3-vessel CAD. Interpretable echocardiograms were recorded in all the patients studied. The dipyridamole-echo test results were positive in 27 of the 50 patients (54%) with CAD. No patient without CAD had a positive test result. In conclusion, the dipyridamole-echo test frequently unmasks electrocardiographically silent effort myocardial ischemia by providing objective mechanical evidence of the ischemic event.
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PMID:Role of dipyridamole-echocardiography test in electrocardiographically silent effort myocardial ischemia. 373 11

A frequent clinical problem is to document the elusive entity of electrocardiographically silent myocardial ischemia. Since echocardiography offers a practical tool to detect reversible mechanical changes due to ischemia, 32 patients with angina on effort, and coronary artery disease, and 15 patients with angina at rest were studied. In all 47 patients electrocardiographic changes during effort or rest pain were inconclusive. Combined 12 lead electrocardiographic and 2-Dimensional echocardiographic monitoring were performed: during ergonovine testing in the 15 patients with angina at rest; during dipyridamole testing in the 32 patients with effort angina and a non diagnostic stress test. Interpretable echocardiograms were obtained in all the patients studied. Positivity of both the Ergonovine-Echocardiographic test and the Dipyridamole-Echocardiographic test was based upon the detection of regional transient asynergy. Of the 15 patients who had chest pain at rest in the absence of diagnostic electrocardiographic changes, Ergonovine-Echocardiographic test was positive in 6 (40%). Of the 32 patients who had chest pain in absence of diagnostic electrocardiographic changes during exercise stress testing, the Dipyridamole-Echocardiographic test was positive in 18 (56%). Echocardiographic monitoring in combination with provocative testing (ergonovine and dipyridamole) may be a practical, non invasive, inexpensive tool which is feasible in all patients with good basal echocardiograms and is able to unmask electrocardiographically silent myocardial ischemia by providing objective mechanical evidence of the ischemic event.
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PMID:Echocardiographic documentation of myocardial ischemia in presence of angina pectoris without ST-T changes. 375 1

Thirty-nine patients with early post-infarction angina (all with significant, angiographically assessed coronary artery disease and a baseline asynergy on 2-D echo), performed a dipyridamole-echocardiography test (DET: 2-D echo monitoring with dipyridamole infusion, 0.14 mg kg-1 min-1 for 4 min). Twenty-nine patients had a positive DET (sensitivity = 74%). Two mechanical patterns of DET-positivity could be identified: a worsening of the asynergy in that same region showing a baseline asynergy (11 patients); a 'de novo' asynergy in a region remote from the one showing a baseline asynergy (18 patients); The prevalence of single-vessel disease was significantly higher in patients with type 1 positivity pattern (6 single-, three double- and two triple-vessel disease), while patients with type 2 positivity always showed a multivessel coronary involvement (8 double-, 10 triple-vessel disease). In 4 of the 10 patients with 3-vessel disease and type 2 asynergy, such asynergy developed in a territory different from the one supplied by the more stenotic non-infarct-related vessel. In conclusion, DET represents a safe and feasible tool effectively to localize ischaemia, relative to the infarcted region, and to evaluate the haemodynamic significance of coronary lesions in patients with post-infarction angina.
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PMID:Early post-infarction angina: usefulness of dipyridamole-echocardiography test. 381 31

Fifty-five patients with effort angina pectoris and technically satisfactory baseline echocardiograms performed a supine exercise-echocardiography test (EET) and a high-dose dipyridamole-echocardiography test (DET, up to 0.84 mg/kg of intravenous dipyridamole in 10 minutes). All underwent coronary arteriography, which showed that at least 1 major artery had more than 70% stenosis in 34 patients. For each patient, the same physician performed both tests, with the same echocardiographic equipment. Detection of new onset or worsening regional asynergy was the only criterion of positivity for both tests. DET yielded interpretable studies in all 55 patients (100%); EET yielded only 40 such studies (73%) (p less than 0.01). In the 40 patients in whom both tests were interpretable, DET showed, compared with EET, a similar sensitivity (72% vs 76%) and specificity (100% vs 87%) (difference not significant for both) for detecting angiographically assessed coronary artery disease. In the 16 patients in whom both DET and EET yielded positive responses for ischemia, the same myocardial region showed reversible asynergy. Thus, independent of all factors that can affect the performance of each test (operator, patient and instrumentation), DET was significantly more feasible than EET, with comparable sensitivity and specificity. Dipyridamole provokes asynergy in the same regions that show ischemia during exercise.
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PMID:Comparison of the high-dose dipyridamole-echocardiography test and exercise two-dimensional echocardiography for diagnosis of coronary artery disease. 382 91

During Ergonovine-test a patient with Prinzmetal angina presented (in I, aVL, V3-V6) ST downsloping which, after a temporary phase of alternative normalization (AST) beat to beat in V5, progressed to ST upsloping with typical angina. The M-mode echo-study first discovered, before than ecg, septal impairment (hypokinesia which increased to akinesia in the AST phase) and also asynergy of posterior wall of left ventricle. After intravenous nitrate echo-alterations reversed more rapidly than ecg one (transitional phase of ST decrease). The authors relate the AST to temporary alternative pseudonormalization caused by a phase of electrical instability during progressive vasospastic ischemia involving first the endocardial layers and after the epicardium of a single myocardiocoronary district. Probably also other partially opposite ischaemic districts, as suggested from echo data of posterior wall asynergy took a part in these events. This rare ST-alternans type as new pseudonormalization phenomenon and the usefulness of echo-study during ischaemic attacks are stressed.
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PMID:[Clinical, electrocardiographic and echocardiographic findings in a case of vasospastic angina with alternating pseudonormalization of the ST segment]. 383 2

To determine the clinical significance of transient remote asynergy after the first acute myocardial infarction (AMI), 2-dimensional echocardiography was performed at rest and directly after dynamic exercise in 49 consecutive patients within 3 weeks of AMI. In 43 patients (88%), technically adequate 2-dimensional echocardiographic examinations were obtained. Asynergy was found in all patients at rest. Immediately after exercise, new areas of asynergy, not adjacent to the infarcted area (i.e., transient remote asynergy), were present in 18 patients. Of these patients, 17 had multivessel coronary artery disease (CAD), compared with 5 of 25 patients without transient remote asynergy. Sensitivity of transient remote asynergy for detecting multivessel CAD was 77% and specificity was 95%. Left ventricular ejection fraction at rest and after exercise was measured in 39 patients (90%) and could only identify patients with 3-vessel CAD. New ischemic events, defined as reinfarction or recurrent angina pectoris, within a mean of 12 weeks (range 8 to 16) after discharge, occurred in 16 patients. Transient remote asynergy was present in 12 of these patients (75%). It is concluded that exercise-induced transient remote asynergy early after AMI can identify patients with multivessel CAD and a subgroup of patients prone to early new ischemic events. Left ventricular ejection fraction, however, is not only more laborious but also of lesser value in identifying patients with multivessel CAD.
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PMID:Usefulness of two-dimensional exercise echocardiography shortly after myocardial infarction. 394 82


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