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)

Practical and noninvasive means are needed for evaluating efficacy of coronary bypass surgery (CBS) in improving blood flow (CBF) to ischemic myocardium in coronary patients. Revascularization was assessed in 15 patients by pre- and post-CBS rest and exercise rubidium-81 myocardial images with a scintillation camera equipped with pinhole collimator and high-energy shield. Ischemic areas were detected by decreased 81Rb activity after exercise compared to rest. Before CBS all patients had exercise angina (EA), positive treadmill ECG (TECG), and abnormal exercise 81Rb scans. After CBS all 15 patients had increased physical activity before angina or completion of treadmill exercise with increased heart rate-blood pressure product (HRBP) (+ 63 +/- 3.2 X 10(2) bpm - mm Hg) in 14 of 15 patients indicating increased CBF; four had positive TECG, and five had EA. The increased HRBP in 14 patients was associated with improved post-CBS exercise 81Rb scans: six had normal patterns while nine were improved with less ischemic patterns. Further, lack of angina and increased exercise tolerance correlated closely with increased 81Rb myocardial perfusion. Thus pre- and postoperative rest and exercise 81Rb scintigraphy gives an accurate, noninvasive, objective approach for evaluation of CBF following CBS and demonstrates the usefulness of this revascularization procedure in coronary patients.
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PMID:Determination of improved myocardial perfusion after aortocoronary bypass surgery by exercise rubidium-81 scintigraphy. 108 43

To assess the protective effects of L-carnitine (LC) infusion on ischemic heart disease, 30 patients who had angina and ischemic ECG changes during exercise were evaluated by bicycle ergometry. They were categorized in LC and non-treatment (NT) groups. There were no significant differences in age and sex between the 2 groups. Before exercise, 15 patients (9 males and 6 females) received 60 mg/kg LC and the results including hemodynamics, coronary circulation, and cardiac metabolism at rest and during exercise were compared with those of the NT group studied in the same protocol (50 watts x to cycle, 15 min). At the end of 30 min LC drip infusion, the arterial carnitine content (LC (a)) reached 1,980 +/- 257.3 microM and then was maintained at 1,212.7 +/- 136.2 microM during exercise. There was no correlation of LC (a) with the coronary arterio-venous difference nor with myocardial uptake of LC. Although there was no significant difference in coronary blood flow (CBF: mliters/100 g/min) between the LC and NT groups at rest (LC: 92.1 +/- 29.0 vs NT: 88.0 +/- 26.5), CBF during exercise increased significantly in the LC group compared with the NT group (LC: 230.4 +/- 113.8 vs NT: 139.1 +/- 52.7; p < 0.05). In the NT group, there was no significant change in coronary arterio-venous oxygen difference ((a-cs) O2: vol %) during exercise, but in the LC group (a-cs) O2 increased significantly from 10.2 +/- 1.3 to 11.5 +/- 1.9 (p < 0.01). Furthermore, although there was no significant difference in myocardial oxygen consumption (MVO2: mliters/100 g/min) at rest between the 2 groups (LC: 9.30 +/- 2.96 vs NT: 9.71 +/- 3.09), it increased significantly in the LC group compared with the NT group during exercise (LC: 25.11 +/- 9.98 vs NT: 15.55 +/- 6.09). MVO2/LVWI (LVWI = left ventricular work index) and MVO2MT (MT = myocardial tension) did not significantly differ at rest between the 2 groups. However, these 2 indices decreased significantly during exercise (p < 0.05) in the NT group, and remained unchanged in the LC group, showing a significant difference between the 2 groups (both p < 0.05). In myocardial energy substrates, the myocardial uptake ((a-cs) x CBF) of free fatty acid (FFA: muEq/100 g/min) increased significantly in the LC group compared with that of the NT group (LC: 10.16 +/- 13.26-->31.88 +/- 27.58* vs NT: 16.02 +/- 27.92-->18.11 +/- 31.00;* = p < 0.05, LC vs NT).
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PMID:[Effect of L-carnitine in patients with ischemic heart disease]. 184 35

In clinical and experimental studies we assessed images of digital subtraction coronary angiography (DSA) for evaluating regional myocardial perfusion. Myocardial perfusion was assessed by injecting contrast medium into the coronary artery, and by imaging the regional myocardium using DSA. On the time-density curve obtained from the myocardial region of interest, we calculated the time to peak concentration (TPC) and the exponential washout rate (T). TPC and T were measured in five patients with stable effort angina pectoris (AP) and left anterior descending (LAD) lesions before and after percutaneous transluminal coronary angioplasty (PTCA). The values of 1/T increased significantly from 0.09 +/- 0.02 l/sec to 0.21 +/- 0.04 l/sec (p less than 0.01) after PTCA, but l/TPC did not change. No significant difference in ejection fractions was observed between the patients with AP and the normal subjects (n = 7), while the regional percent area shrinkage in the anterolateral and apical regions supplied by the LAD was significantly decreased in the patients with AP compared with those of normal subjects (anterolateral: 39.8 +/- 8.8% vs 51.3 +/- 6.8%, apical: 36.6 +/- 8.4% vs 52.4 +/- 13.4%, both p less than 0.01). In 10 anesthetized dogs with varying degrees of reduction in the left circumflex coronary artery (LCX) blood flow (CBF: categories of stenosis (S1-S5), we compared 1/TPC and 1/T with regional myocardial function (systolic wall thickening: %WTh). With varying LCX stenosis, there were no significant changes in heart rate and mean aortic pressure and significant linear correlations were observed between %WTh and 1/TPC (r = 0.51), between %WTh and 1/T (r = 0.55). At S1 (CBF: 100-90% of the control), neither %WTh nor 1/TPC differed from that of the controls, but 1/T was significantly decreased (80% of the controls, p less than 0.01). From S3 (CBF: 79-60%) to S5 (CBF: 39-0%), %WTh, 1/TPC and 1/T were significantly decreased from those of the control levels (all p less than 0.01). However, at S5 (CBF: 39-0%) the values of 1/TPC (71% of controls) and 1/T (33%) did not differ from those at S4; whereas, %WTh was markedly reduced and the systolic thinning of the ventricular wall occurred at S5. Therefore, in critical coronary stenosis, 1/T was more sensitive than 1/TPC or wall dynamics for assessing myocardial ischemia. Both 1/TPC and 1/T, as well as %WTh, were useful for assessing moderate myocardial ischemia; however, these DSA indices had considerable limitations for evaluating the severity of myocardial ischemia when CBF was markedly reduced.
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PMID:[Comparison of myocardial perfusion assessments by digital subtraction angiography with those of left ventricular wall dynamics]. 213 31