Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An urgent aorto-coronary bypass operation (AC-bypass) was made in three patients with unstable angina pectoris, suffering from stenosis of the left main trunk (LMT). All patients were admitted with chief complaints of chest discomfort and syncopal attack. Case 1 was a 71 year-old man who suffered with chest discomfort and syncopal attack. He was admitted to our emergency room by ambulance 40 minutes after the syncopal attack, on January 11, 1989. His blood pressure was 140/96; pulse 84 and regular. The electrocardiogram (ECG) showed right bundle branch block, ST elevation in aVR, aVL and ST depression in all other leads. Coronary arteriogram (CAG) was made urgently and showed 80% stenosis in LMT. The emergency AC-bypass operation was successfully carried out about 3 hours and 10 minutes after the onset of symptoms. Case 2 was a 51 year-old man who suffered from precordial oppression and syncopal attack. He was admitted to our emergency room by ambulance about 1 hour after the attack, on January 17, 1989. His blood pressure was 94/74; pulse 120 and irregular. Chest radiography showed a cardiothoracic ratio of 58% and the ECG disclosed atrial fibrillation, ST elevation in aVR and ST depression in I, II, III, aVF, V1-6. The echocardiogram revealed hypokinetic motion in the antero-lateral wall of the left ventricle. CAG was carried out without delay, and showed 70% stenosis with slit in LMT. An emergency AC-bypass operation was successfully carried out about 3 hours and 50 minutes after the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Three operated cases of LMT-lesion with chief complaint of syncopal attack]. 221 92

Heparin, aspirin with dipyridamol or 5% dextrose were administered to 266 patients admitted to the coronary unit with unstable angina. All patients were concurrently treated with isosorbide dinitrate, a beta-blocker and nifedipine. The number of patients who developed an acute myocardial infarction (IM) during the subsequent 72 hours was comparable in all three groups. However, in the heparin treated group only 3.2% patients developed Q IM, as compared with 20% patients treated with aspirin and dipyridamol (p = 0.005) and with 19% in the control group (p = 0.006). The magnitude of the IM was evaluated according to the highest serum value of creatine phosphokinase. In the heparin treated group its value was 810.5 +/- 538 i.u./l which was significantly less than in the aspirin + dipyridamol group where it was 1229 +/- 829 i.u./l (p = 0.048) and in the control group where it was 1417 +/- 919 i.u./l (p = 0.009). The authors defined the group of patients with a high risk of development of IM who had protracted anginous pain longer than 45 mins. with ST segment depression deeper than 1 mm on the ECG on admission. 55% of these patients developed an infarction in the course of the subsequent 72 hours.
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PMID:[Anticoagulantion and antiaggregation therapy in patients with unstableangina pectoris]. 221 58

The incidence and prognostic significance of silent myocardial ischemia were assessed in 175 patients who survived a first acute myocardial infarction (AMI). This was done by means of a 24-hour continuous ECG monitoring which was performed before discharge. Twenty-six out of 175 patients (14.8%) showed one episode or more of S-T segment depression; 19 of these reported no pain at all while the other 7 reported both painful and painless episodes. A total of 65 ischemic episodes were registered; of these 53 (81.5%) were painless and 12 (18.5%) were painful. No difference in the duration of ischemic episodes or in heart rate at the onset of S-T segment depression was detected for painless or painful episodes. The S-T segment depression episodes showed a peak in the morning but were higher in the afternoon and this circadian pattern was statistically significant both with regard to duration (p less than 0.05) and to the number of episodes (p less than 0.05). Cardiac death occurred in 5 of the 26 patients (19.2%) with S-T segment depression during continuous ECG monitoring, and in 5 of the 149 (3.4%) without S-T segment depression (p less than 0.01). In patients with ischemia duration greater than 60 min/24 hours, the mortality rate was higher (p less than 0.05). No cardiac events (unstable angina, non-fatal re-infarction, balloon angioplasty and/or coronary by-pass) occurred in 117 out of 149 patients (78.5%) without ST-segment depression, while these events were observed in 13 out of the 26 patients (50%) with ischemic episodes during Holter monitoring (p less than 0.01). Sensitivity and specificity of S-T segment depression was respectively 29.3 and 89.5% for cardiac death and cardiac events considered together.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The clinical characterization and prognostic significance of episodes of transient myocardial ischemia in patients with a recent myocardial infarct]. 224 97

The risk of an early submaximum symptom-limited bicycle ergometry [correction of veloergometric] test and its prognostic value up to the end of the first year since the onset of unstable angina pectoris were studied in 258 patients with unstable angina pectoris who had been stabilized by medicamentous treatment. During the bicycle ergometry [correction of veloergometric] test no serious complications were observed. In 22 patients (35.7%) the test was negative and in 166 patients (64.3%) it was positive (angina pectoris and/or horizontal ST depression greater than or equal to 0.1 mV at 80 ms from the point J). In the patients with a positive test the prognosis is statistically worse (death, acute myocardial infarction, aortocoronary bypass, relapse of the unstable angina pectoris and angina pectoris of III and IV functional class according to NYNA/than in the patients with a negative bicycle ergometry [correction of veloergometric] test. The early bicycle ergometry [correction of veloergometric] test is with a high sensitivity (92.6%) and a lower specificity (66.7%) in recognizing the patients with a poor prognosis. The total prognostic accuracy of the test is 80.2%. It classifies the patients with unstable angina pectoris into two groups: with favourable and poor prognosis and helps in the selection of patients for surgical treatment.
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PMID:[The early bicycle ergometry test in drug-stabilized patients with unstable angina pectoris; its risk and benefit]. 228 56

The study was undertaken to examine 221 patients with unstable angina (UA) in the acute period and repeatedly on average of 5.3 years later. Myocardial infarction and sudden coronary death were regarded as unfavorable outcomes of UA. Out of all the patients included into the study, 33 (15%) developed myocardial infarction on days 2-28 of hospital stay, which resulted in death in 7 patients; 6 more patients died suddenly. The hospital mortality rate was 5.8%. Of 175 patients discharged from the unit, 31 developed myocardial infarction in the late period, 1 case ended with a fatal outcome, sudden coronary death was observed in 32 cases. The mortality rates by years were the following: 10.2% within the first year, 17.4% for 3 years, and 28.2% for 5 years. The choice of a complex of initial signs mostly significant for defining the risk for complications with the use of Cox's model of proportional risks indicated that the outcome of UA was affected by the following significant factors: 1) ST segment depression in the leads V4-V6; 2) duration of aggravated condition; 3) duration of coronary heart disease; 4) the number of resting anginal episodes; 5) a patient's fitness on his admission to hospital; 6) a history of arterial hypertension; 7) negative T waves in the leads V4-V5.
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PMID:[Immediate and late prognosis in patients with unstable angina under medical treatment]. 229 Feb 62

The ability of dipyridamole-thallium-201 imaging to predict in-hospital and late cardiac events when performed very early (62 +/- 21 hours, range 23 to 102) after acute myocardial infarction (AMI) was tested in 50 patients. During hospitalization, 1 patient developed recurrent AMI and 8 patients developed recurrent angina after MI associated with ST-segment depression at 60 +/- 42 hours after the dipyridamole-thallium-201 imaging; of these, 6 required urgent coronary revascularization. No patient died in-hospital. There were no serious adverse effects during the dipyridamole protocol. Using stepwise multivariate logistic regression analysis, the best and only statistically significant predictor of in-hospital ischemic cardiac events was the presence of thallium-201 redistribution within the infarct zone (p = 0.0001). Of 20 patients with infarct zone thallium-201 redistribution, 9 (45%) developed in-hospital ischemic cardiac events compared to 0 of 30 patients without infarct zone thallium-201 redistribution (p less than 0.0001). During a follow-up 12 +/- 7 months after discharge, 3 additional patients with infarct zone thallium-201 redistribution developed recurrent AMI or unstable angina, whereas no patient without infarct zone thallium-201 redistribution developed ischemic cardiac events. These data suggest that dipyridamole-thallium-201 imaging performed very early after AMI may identify a subgroup of patients at high risk for in-hospital and late ischemic cardiac events. Such patients may benefit from early cardiac catheterization and revascularization. Patients without infarct zone thallium-201 redistribution appear to be at very low risk for in-hospital and late ischemic cardiac events and may be candidates for early discharge.
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PMID:Ability of dipyridamole-thallium-201 imaging one to four days after acute myocardial infarction to predict in-hospital and late recurrent myocardial ischemic events. 229 84

A retrospective 5 year follow-up study was performed in 140 patients with unequivocal ischemia during exercise radionuclide angiography (greater than or equal to 10% decrease in left ventricular ejection fraction or greater than or equal to 5% decrease in ejection fraction together with a distinct regional wall motion abnormality). In 84 patients (60%), ischemia during radionuclide angiography was silent (silent ischemia group), whereas 56 patients experienced angina during the test (symptomatic group). Work load and antianginal medication were similar in both groups. Critical cardiac events (unstable angina, myocardial infarction, cardiac death) occurred in 27% of patients in the silent ischemia group and 16% of those in the symptomatic group (p = NS); however, myocardial infarction or death was more frequent in patients with silent ischemia (22% versus 9%; p less than 0.05). If there was additional exercise-induced ST segment depression, the rate of critical events was further increased (p less than 0.05). The difference in critical cardiac events seemed to be influenced by the higher incidence of revascularization procedures in symptomatic patients, whereas medical therapy had no similar effect. Thus, these findings suggest that patients with documented severe ischemia should undergo left heart catheterization and revascularization irrespective of symptoms to improve their prognosis.
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PMID:Long-term follow-up of patients with silent ischemia during exercise radionuclide angiography. 231 52

The electrocardiogram is the graphic representation against time of the difference in potential between points of the body caused by the current field of the heart. To examine the origin of this current field, a method of transforming body surface electrocardiographic data to the epicardial surface has been developed. The computed epicardial current density distributions in 219 patients with acute inferior myocardial infarction showed that, in 89% of patients, the current flow out of the heart during the ST segment came from two regions, not only from the infarction region but also from a region over the great vessels. This findings suggests that current flows from the ischemic region, through the low-resistance pathway provided by the intracavity blood, out the great vessels, and back to the epicardium. A similar pathway has been hypothesized when ischemia caused endocardial ST elevation, such as during a stress test or with unstable angina. To test this hypothesis, a group of patients with ST depression on the 12-lead electrocardiogram, not associated with ST elevation, was examined with body surface mapping. Ninety-four percent of patients had epicardial current density distributions that showed a region of current flow out of the heart and over the great vessels that was consistent with this hypothesis. This could explain the poor localization of coronary artery disease by electrocardiographic techniques when there is ST depression on the body surface.
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PMID:Importance of the great vessels in the genesis of the electrocardiogram. 186 Jan 91

Patients with 3-vessel coronary artery disease (CAD) and normal left ventricular (LV) function have a worse prognosis if they manifest ischemia during exercise testing. The present study determines if exercise radionuclide angiography can aid in the risk stratification of patients with 1- or 2-vessel CAD and impaired LV function (ejection fraction less than 50%). Sixty-five consecutive patients with these findings were followed for a median duration of 24 months (range 12 to 49). Eleven of the 65 patients (17%) had severely ischemic exercise radionuclide angiograms, defined as: a decrease in ejection fraction with exercise; greater than or equal to 1.0 mm of ST-segment depression; and peak exercise workload less than or equal to 600 kg-m/min. During follow-up 11 patients had initial significant cardiac events: 4 cardiac deaths, 1 cardiac arrest, 4 myocardial infarctions and 2 bypass or angioplasty procedures for unstable angina greater than or equal to 3 months after the exercise study. Four of 11 patients (36%) with severely ischemic exercise radionuclide angiograms had events, compared to 7 of 54 patients (13%) without ischemic radionuclide angiograms. Event-free survival at 18 months was 73% for patients with severe exercise ischemia versus 92% for those without ischemia (p less than 0.05). Univariate analysis showed that severe ischemia on radionuclide angiography was the only variable of several tested that significantly predicted future cardiac events (chi-square = 8.16, p less than 0.005). Among patients with 1- or 2-vessel CAD and impaired resting LV function, severe ischemia on exercise radionuclide angiography identifies a subgroup at high risk for future cardiac events.
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PMID:Risk stratification of single or double vessel coronary artery disease and impaired left ventricular function using exercise radionuclide angiography. 234 19

To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans. 239 93


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