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

The relationship between regional myocardial blood flow and the results of exercise tests were evaluated in 54 patients, 40 of whom had angiographically demonstrated coronary artery disease (CAD) and 14 had normal angiograms. After 20 patients had 2-step tests, 20 had bicycle ergometry, and 14 had treadmill tests, regional myocardial specific blood flow (RMBF) at rest was determined by selective injections of xenon-133 into the left coronary artery and quadrantic washout measured with an Anger camera. RMBF (ml/min/100 gm, mean +/- SE) was significantly lower in patients with coronary artery disease (72 +/- 3) than in normals (91 +/- 7, p less than .05) but RMBF in 12 CAD patients with negative exercise tests (75 +/- 6) was similar to regional myocardial blood flow in 28 coronary artery disease patients with positive exercise tests (71 +/- 4). Degree of ST depression did not influence results. Although measurement of RMBF and exercise testing are both useful procedures in the evaluation of patients with CAD, the data in the present study indicate the RMBF measurements at rest cannot predict the result of the postexercise ECG and vice versa.
 ...
PMID:Comparison between regional myocardial blood flow measurements and results of exercise tests. 60 2

A follow-up study of 1,402 patients with a positive maximal treadmill stress test was made to evaluate the significance of angina during the test. Life tables were constructed and evaluated for significance of age, sex and work load at onset of angina. Coronary events (myocardial infarction, progression of angina and coronary death) were twice as frequent in subjects with angina and S-T segment depression as in those without angina. The increased incidence in 4 years held for all coronary events and was still doubled at 7 years for progression of angina and coronary death. The incidence of coronary events was more than twice as great when the angina was induced by a light work load (4 metabolic equivalents = METS) as when it was induced by a heavy work load (8 to 9 METS). Men aged 41 to 50 years having angina during exercise testing had a 3-fold greater incidence of coronary events and a 4-fold greater incidence of myocardial infarction compared with their counterparts who had S-T segment depression alone. In this study, angina during exercise testing identified 85% of true positive tests for coronary artery disease, whereas S-T depression alone identified only 64% of such tests. Thus, angina during exercise testing increases the sensitivity of the test and identifies cohorts of subjects at high risk for subsequent coronary events.
 ...
PMID:Significance of chest pain during treadmill exercise: correlation with coronary events. 62 16

First heart sound (S1) energy spectra in isovolumic systole, hemodynamics, and angiographic left ventricular wall motion (LVWM) at rest and with atrial pacing were compared in 27 patients who underwent diagnostic cardiac catheterization and angiography because of chest pain. Eighteen patients were found to have coronary artery disease (CAD) and nine patients, normal coronary arteries. Eleven of the 18 CAD patients (61%) had a mean reduction in the spectral energy of S1 of 6.5 +/- 1.4 (SEM) dB below control (-52%), during interruption of ischemic stress of rapid atrial pacing, compared to only one of nine patients without CAD (P less than 0.05). Only five CAD patients (28%) had an abnormal rise (greater than or equal to 5 mm) in left ventricular end-diastolic pressure (LVEDP) either during or upon interruption of pacing, and six (33%) had ischemic ST-segment depression greater than or equal to mv in the ECG. Similarly two patients free of CAD (22%) had an abnormal increase in LVEDP, and none had ECG evidence of ischemia. Seventeen CAD patients (94%) had segmental LVWM abnormalities at rest or with interruption of pacing, while three patients with normal coronary arteries (33%) had abnormal angiographic LVWM (P less than 0.01). Thus, reduction is S1 spectral energy is a common accompaniment of myocardial ischemia. In the present study, it was more frequently observed than abnormalities in either the ECG or LVEDP, but was not was consistently seen as segmental left ventricular wall motion abnormalities.
 ...
PMID:Spectral energy of the first heart sound in acute myocardial ischemia. A correlation with electrocardiographic, hemodynamic, and wall motion abnormalities. 62 70

Myocardial perfusion imaging with thallium-201 and electrocardiography with the subject at rest and undergoing submaximal treadmill exercise were performed in 19 men and 3 women. Selective coronary arteriography and left ventriculography showed that 7 had normal coronary arteries and 15 had coronary artery disease.The 11 persons with electrocardiographic evidence of an old myocardial infarct (q waves) had a perfusion defect at rest in the area of the infarct and a segmental abnormality of wall motion apparent on the left ventriculogram corresponding to the perfusion defect.MYOCARDIAL PERFUSION IMAGING AND ELECTROCARDIOGRAPHY WERE EQUALLY SENSITIVE IN DETECTING CORONARY ARTERY DISEASE IN EXERCISING INDIVIDUALS: perfusion defects were noted in 7 of the 15 persons with coronary artery disease, and diagnostic ST-segment depression was present in 8 of the 15. Combination of the results of the two tests with exercise permitted the identification of 11 of the 15 persons and improved the sensitivity. Combination of the results of rest and exercise imaging and electrocardiography permitted the identification of 94% of the patients with coronary artery disease.Myocardial perfusion imaging with (201)TI in the subject at rest is a sensitive indicator of previous myocardial infarction. Imaging after the subject has exercised is a useful adjunct to conventional exercise electrocardiography, especially in those whose exercise electrocardiogram is non-interpretable.
 ...
PMID:Myocardial perfusion imaging with thallium-201: correlation with coronary arteriography and electrocardiography. 63 Apr 87

In 12 patients with coronary artery disease and typical exercise-induced angina pectoris hemodynamic and ECG studies were performed at rest and during ergometer load in supine position. During the attacks of angina there was a significant ST-depression in all cases accompanied by elevated pulmonary capillary wedge pressures (PCP) and pulmonary artery mean pressures (PAM). Intravenous administration of 40 mg furosemide showed consistent hemodynamic changes. Cardiac output (CO) dropped significantly by 15.9 per cent at rest (p is less than 0.001) and by 6.9 per cent during exercise (p is less than 0.005). The PCP during exercise following furosemide decreased from 32.9 mmHg to 11.8 mm Hg (p is less than 0.001) and was paralleled by a significant decrease of PAM, indicating reduction of ischemia-related hemodynamic impairment. Furthermore, there was a striking improvement of Ecg findings during ergometer load in 9 of 12 patients as well as a relief of anginal pain in 11 of 12 patients. The present demonstration of antianginal properties of furosemide may be explained by the reduction of ventricular volumes and pressures, resulting in a decrease of myocardial wall stress. These effects are suggested to be related to the peripheral venodilator capacity of furosemide in conjunction with its diuretic properties. Thus, in patients with left ventricular dysfunction secondary to ischemia, intravenous furosemide may have salutary effects on myocardial oxygen requirements resembling the action of nitroglycerin, but without its oxygen-wasting effects on tachycardia.
 ...
PMID:[Effects of furosemide on hemodynamic, electrocardiographic, and symptomatic responses to exercise in patients with angina pectoris (author's transl)]. 63 18

Although many patients with coronary artery disease (CAD) have a positive exercise test without pain, the frequency and significance of this "silent" ischemia is unclear. Therefore, we studied 122 consecutive clinically stable patients with angiographically defined CAD (greater than 75 per cent luminal stenosis) and a positive exercise test. Seventy-eight patients had pain or anginal equivalent during or after a positive exercise test; 44 did not, including 32 (26 per cent) with no symptoms at all. Patients were evaluated as to age, sex, prior myocardial infarction, congestive failure, hypertension, diabetes mellitus, and digoxin or propranolol therapy--in addition to anginal symptoms before, during, or after the exercise itself. Extent of CAD, presence of collaterals, and left ventricular ejection fraction were also determined. All exercise tests were evaluated for evidence of ST-T abnormalities or prior infarction on the control ECG as well as peak heart rate during exercise and post-exercise degree of ST segment depression. There were no significant differences between patients with and without exercise-induced pain in regard to any of the clinical and angiographic features noted above, demonstrating that "silent" myocardial ischemia during or after exercise testing is not uncommon and is not readily attributable to any obvious clinical or catheterization findings. Further studies are necessary to determine if patients with evidence of "silent" myocardial ischemia are especially prone to sudden death.
 ...
PMID:"Silent" myocardial ischemia during and after exercise testing in patients with coronary artery disease. 63 80

Two patients known to have coronary artery disease died suddenly outdoors while active. Neither had symptoms or signs of acute myocardial infarction. They were being monitored by continuous tape recording of the electrocardiogram at the time of death. In one patient the cause of death was cardiac arrest, preceded by bigeminy and multiform ventricular ectopic beats, in the other ventricular fibrillation preceded by atrial fibrillation, multiform ventricular ectopic beats, and ST depression. These observations are added to the limited reported cases in which the mechanism leading to sudden death outside the hospital is recorded.
 ...
PMID:Two monitored cases of sudden death outside hospital. 65 36

To aid in the study of coronary artery disease, 57 patients with complete left bundle branch block underwent clinical evaluation, treadmill exercise testing and cardiac catheterization. The patients were classified into two groups according to coronary angiographic findings: 30 patients with significant stenosis (70 percent or greater luminal narrowing) of at least one major vessel and 27 with no significant coronary artery disease. There was no difference in age, presenting symptoms or previous medical treatment between the two groups. There were more men in the group with coronary artery disease. Exercise-induced S-T changes were similar in the two groups; the sensitivity and specificity of these changes for the diagnosis of coronary artery disease were unacceptable irrespective of the criterion chosen. With additional S-T depression of either 1 or 2 mm below the baseline value, the predictive accuracy was only 53 percent. Combined exertional chest pain and 1 mm S-T depression increased the predictive accuracy of exercise testing to 71 percent. These data indicate that exercise-induced electrocardiographic changes do not facilitate detection of coronary artery disease in patients with complete left bundle branch block.
 ...
PMID:Is the treadmill exercise test useful for evaluating coronary artery disease in patients with complete left bundle branch block? 67 34

To determine the value of a multivariate approach for the analysis of the treadmill exercise tolerance test (ETT), 237 patients referred for evaluation of chest pain who underwent a standard Bruce protocol ETT and coronary arteriography were studied. Predictive value of a positive ETT was 0.78 (43/55) using 1.0--1.9 mm ST segment depression criterion, 0.97 (59/61) using greater than or equal to 2.0 mm ST segment depression. When the 1.0--1.9 mm ST criterion was combined with peak systolic blood pressure-heart rate product (double product) less than or smaller than 23,000, exercise duration less than 6 minutes, and ST depression for greater than 3 minutes into recovery, predictive value improved to 0.89 in 18 patients with any two of the above. Predictive value for multivessel disease was also improved using non-ST criteria. Predictive value of a negative ETT for absence of coronary artery disease was 0.60 (29/48), and was 0.86 (12/14) if double product was greater than or equal to 30,000. Presence of chest pain during ETT did not improve predictive value of any type of test. Digitalis ingestion in 33 patients was not associated with decreased predictive value of a positive test. These data suggest that the predictive value of both positive and negative ETT in a symptomatic population can be improved with a multivariate approach.
 ...
PMID:A multivariate approach for interpreting treadmill exercise tests in coronary artery disease. 67 42

The response to electrocardiographically monitored submaximal exercise stress testing has been studied in 44 patients with mitral leaflet prolapse (MLP). With exercise, ventricular premature contractions occurred in 7, ventricular tachycardia in 1, and atrial fibrillation in 1. Exercise was terminated short of target heart rate in 18 patients, because of chest pain (5), fatigue (7), ventricular arrhythmia (4), dizziness (1) or ST segment depression (1). 23 patients developed postexercise ST segment abnormalities, of whom 5 had 'ischemic' patterns and arteriographically proven coronary artery disease (CAD); among the 18 others, the ST segments were depressed and minimally downsloping in 2, slowly ascending from depressed J point in 3, horizontal for greater than or equal to 80 msec with J depression of less than 1 mm in 12, and cupped in 1. The incidence of arrhythmias provoked by submaximal exercise stress testing in patients with MLP was lower than suggested in previous reports. In all 5 cases where MLP and CAD coexisted, the classical 'ischemic' electrocardiographic response to exercise was not obscured. Even in the absence of CAD, postexercise ST segment abnormalities were common with MLP (18/39 = 46%) and differed from the progressively resolving ST segment deviation characteristic of CAD with angina. Exercise testing can safely be recommended, subject to standard contraindications, in patients with MLP and yields useful information.
 ...
PMID:The electrocardiographic response to exercise in 44 patients with leaflet prolapse. 71 Apr 93


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>