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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors provide the results of a comparative study of exercise tolerance (bicycle ergometry test) in 64 patients with coronary heart disease (CHD) and in 68 patients with associated CHD and cerebral atherosclerosis. During the latter syndrome the working capacity was lowered as a result of less economical work of the circulatory apparatus. In particular, physical loading in such patients was accompanied by marked increment of the heart rate and blood pressure elevation. Increased heart oxygen requirement in the second group patients during exercise was accompanied by more frequent ischemic alterations in the myocardium attended by ST segment depression on the ECG. It is concluded that concomitant cerebral atherosclerosis aggravates the basic pathogenetic mechanisms of CHD, namely the disagreement between myocardium oxygen requirement and supply.
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PMID:[Physical exertion tolerance in patients with ischemic heart disease associated with cerebral arteriosclerosis]. 652 8

Under conditions of experimentally induced psychic stress, the changes were studied in the activity of the sympatheticoadrenal system and the thrombocytic-vascular and the plasmic links of the hemostatic system. Ninety-seven men aged 35-61 years and suffering from coronary heart disease without hypertension and circulation insufficiency were studied. The diagnosis of coronary atherosclerosis was confirmed by selestive coronary angiography. Hypercatecholaminemia and a hypercoagulatory state were elicited prior to the investigation. According to the adaptive-protective activation of the anticoagulation system, in particular heparin activation, the patients were divided into two groups: a favourable one, characterized by the adequate protective activation of the anticlotting system, and an unfavourable one, characterized by the depression of the anticoagulation system and the depletion of the sympatheticoadrenal system.
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PMID:[Effect of emotional stress on the system of hemostasis in patients with coronary arteriosclerosis]. 671 78

This report concerns possible adverse health effects and benefits that might result from consumption of large amounts of choline, lecithin, or phosphatidylcholine. Indications from preliminary investigations that administration of choline or lecithin might alleviate some neurological disturbances, prevent hypercholesteremia and atherosclerosis, and restore memory and cognition have resulted in much research and public interest. Symptoms of tardive dyskinesia and Alzheimer's disease have been ameliorated in some patients and varied responses have been observed in the treatment of Gilles de la Tourette's disease, Friedreich's ataxia, levodopa-induced dyskinesia, mania, Huntington's disease, and myasthenic syndrome. Further clinical trials, especially in conjunction with cholinergic drugs, are considered worthwhile but will require sufficient amounts of pure phosphatidylcholine. The public has access to large amounts of commercial lecithin. Because high intakes of lecithin or choline produce acute gastrointestinal distress, sweating, salivation, and anorexia, it is improbable that individuals will incur lasting health hazards from self-administration of either compound. Development of depression or supersensitivity of dopamine receptors and disturbance of the cholinergic-dopaminergic-serotinergic balance is a concern with prolonged, repeated intakes of large amounts of lecithin.
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PMID:Effects of consumption of choline and lecithin on neurological and cardiovascular systems. 675 53

Effects of diltiazem, a recently introduced calcium antagonist, on exercise performance were studied in nine coronary disease patients with effort angina. The duration of exercise before the onset of angina and the time to the onset of ischemic ST depression 2 hours after 90 mg of oral diltiazem were compared with those 2 hours after oral placebo and a few minutes after 0.3 mg of sublingual nitroglycerin. Diltiazem prolonged the duration of exercise in all nine patients (average 2.5 minutes, p less than 0.001) and delayed the onset of ischemic ST depression (average 2.4 minutes, p less than 0.001). The increment of the duration of exercise and the time to the onset of ischemic ST depression following 90 mg of oral diltiazem were almost equivalent to that following sublingual nitroglycerin. These results in fixed coronary atherosclerosis indicate the clinical antianginal efficacy of diltiazem which persists for at least 2 hours after oral administration.
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PMID:Increased exercise tolerance after oral diltiazem, a calcium antagonist, in angina pectoris. 678 21

Short-term efficacy of diltiazem in prolonging exercise end points in patients with chronic stable atherosclerosis-associated angina has been demonstrated. The safety and efficacy of diltiazem were examined in a placebo-controlled exercise study over 4 months (eight patients) and subsequently at 12 to 16 months (six patients). Three end points were evaluated: (1) time to onset of angina or fatigue if angina were eliminated; (2) time to 1 mm S-T segment depression or termination of exercise if S-T depression were eliminated; and (3) time to termination of exercise (2+ angina or fatigue). All end points were significantly prolonged over the medium-term 4 month study and decreased again significantly with return to placebo. Maximal effect occurred at 3 months with the first end point increasing from a mean +/- standard error of the mean of 7.2 +/- 1.2 to 10.2 +/- 0.9 minutes (p less than 0.01), the second end point from 8.0 +/- 0.9 to 10.3 +/- 1.0 minutes (p less than 0.01), and the third end point from 9.6 +/- 1.3 to 11.9 +/- 0.8 minutes (p less than 0.05). At 12 to 16 months efficacy was again present. Comparisons for 3 month peak effect with 12 to 16 month long-term effect and subsequent final placebo period were, respectively: first end point, 10.5 +/- 1.3, 9.4 +/- 1.0 and 6.6 +/- 1.7 minutes; second end point, 11.0 +/- 1.3, 10.2 +/- 1.2 and 6.3 +/- 0.7 minutes; and third end point, 12.1 +/- 1.0, 11.0 +/- 1.0 and 9.2 +/- 1.5 minutes. No significant adverse effects of hematologic abnormalities were noted.
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PMID:Long-term efficacy of diltiazem in chronic stable angina associated with atherosclerosis: effect on treadmill exercise. 680 Feb 53

The study includes 119 patients with minor ischemic cerebrovascular lesions before the age of 55 during 1976-78. Atherosclerotic signs were found in 65% at aortocranial angiography and/or exercise test (ST depression). Abnormalities in hemostasis (defective fibrinolytic response in 50%, high Factor VIII activity in 45% of those investigated, and high Factor VIII related antigen (VIII R:Ag) in 20%) could not be explained by accumulation of atherosclerotic risk factors as most often no significant independent correlations were found at stepwise multiple regression. Significant correlations with aortocranial atherosclerosis was found for age, VIII R:Ag and blood pressure reaction at exercise test. Only E-SR showed significant correlation to ST depression at exercise test. These results indicate different determinants and risk indicators for atherosclerosis with different locations. An early evaluation of the longitudinal study (mean 42 months' follow up) showed that 16 patients had suffered new occlusive vascular incidents. The malign prognostic subgroup (cerebral or myocardial infarction or death; n = 10) showed significantly higher levels of VIII R:Ag (p less than 0.005) and triglycerides (p less than 0.05) than the benign group (new TIA, n = 6). This indicates that VIII R:Ag may be a useful marker for development of atherosclerosis and predictor for the outcome of ICD.
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PMID:A study of hemostasis in ischemic cerebrovascular disease. V. A multivariate evaluation of risk indicators and predictors. Early results of a longitudinal study. 681 52

Hypertension in the black African differs in some respects from white Europeans: complications due to accelerated atherosclerosis are rare and treatment with beta-blockers alone is ineffective. It is not known if baroreceptor function is depressed in African hypertensives to the same extent as it is in whites. Therefore, we have assessed baroreceptor reflex sensitivity (BRS) by the phenylephrine method in 19 African hypertensive patients living in the Gambia, West Africa. The results were compared to predicted BRS values for white patients of the same age and blood pressure calculated from a regression equation derived from 61 hypertensive patients studied in Oxford. It was found that baroreceptor reflex sensitivity was reduced in the African hypertensives and the log mean BRS was similar to the predicted value for Europeans of the same age and level of blood pressure (0.473 +/- 0.24 msec/mmHg and 0.489 +/- 0.21 msec/mmHg respectively). The resting mean arterial pressure in the African patients varied from 117 to 194 mmHg. The results indicated that African hypertensives have a depression of baroreflex sensitivity which is similar to European hypertensive patients.
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PMID:Baroreceptor function in the hypertensive black African. 683 10

Four clusters of psychosocial risk factors for coronary heart disease (CHD) are reviewed. Socio-economic disadvantage acts through a number of influences to increase CHD risk. In advanced industrialized nations those in the lower social strata now have much higher CHD risk than persons in middle and upper social classes. Sustained disturbing emotions represent a second cluster. Anxiety, depression and other indices of neuroticism have frequently been found in association with angina pectoris and cardiac death, though not with myocardial infarction (MI). However, sleep disturbances are associated with angina, cardiac death and MI. The Type A behaviour pattern results from an interaction between a self-activating individual and an environment which rewards hurried and competitive activity. Despite a small number of negative findings, the Type A pattern has been shown in cross-sectional, retrospective and prospective studies by many research teams to be associated with a variety of manifestations of CHD. A fourth, and more recently recognized cluster of psychosocial risk factors, may be grouped together under the general heading of "overload". Many investigations have now shown, for example, that excessive workload is a powerful predictor of CHD risk. It is suggested that all four clusters share the common property of exposing the individual, either chronically, or in frequently recurring episodes, to excessive psychological demands. They appear to exert their pathogenic influence through long-term mechanisms such as atherosclerosis or plaque formation, rather than by precipitating sudden coronary events.
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PMID:Psychosocial risk factors for coronary heart disease. 698 1

Total insulin-like activity (ILA) was evaluated by biological testing blood serum on the basis of stimulation of glycogen synthesis in rat diaphragm in vivo. Glucose loading was followed by an increase in ILA and radioimmune insulin (RII) levels both in patients with breast fibroadenomatosis and healthy controls. However, the patients revealed an increased RII response matched by absence of ILA response, while the basal ILA was three times that in healthy controls. An elevated basal level of ILA was also observed in patients with coronary atherosclerosis and mental depression. Enhanced hyperinsulinism due to RII complementary factors, capable of insulin-like activity, may prove to be a factor in specific age-associated pathology (cancer, atherosclerosis, mental depression).
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PMID:[Summary insulin-like activity of the blood serum in breast cancer and in specific age-related pathology]. 704 36

Mucocutaneous lymph node syndrome (MCLS) in the young has been known to have coronary aneurysms, and then it has been recently suspected as a cause of premature atherosclerosis and cardiomyopathy. Thirty-three schoolchildren who suffered from MCLS were studied to evaluate cardiac involvements and left ventricular function using two-dimensional (2-D) echocardiograms and submaximal stress test. Fifteen normal schoolchildren were studied as normal control. All these MCLS children were asymptomatic and had no significant findings in routine chest X-ray and electrocardiographic examinations. According to submaximal stress test, 8 cases showed a J type ST depression of only 0.5--1.0 mm, and there were no positive cases. Using 2-D echocardiograms, the left coronary artery was detected in 85% and the right coronary in 27%. One case showed an aneurysm of the left coronary artery. However, none of them showed abnormal left ventricular wall motion or the wall motion abnormality compatible with cardiomyopathy. There were no significant differences between MCLS and normal control in ejection fraction, mean VCF, diastolic descent rate of the anterior mitral valve, D/S ratio of the left ventricular wall, and Weissler's index (PEP/ET). These findings suggested that 1) most of MCLS schoolchildren do not have obvious cardiac involvement and their left ventricular function is within normal limits, 2) because of its low sensitivity, submaximal stress test is not so useful in screening coronary lesions, and 3) the 2-D echocardiogram works not only in detecting coronary aneurysms but also in evaluating left ventricular function.
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PMID:[Noninvasive evaluation of cardiac involvements and left ventricular function in schoolchildren with the history of mucocutaneous lymph node syndrome]. 711 88


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