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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study was carried out using 616 participants in a randomized clinical trial at the Harvard MRFIT (Multiple Risk Factor Intervention Trial) Clinical Center, to test if there were differences in the psychological dimensions of anxiety, depression, and functional heart symptoms in groups given different levels of treatment in a CHD (Coronary Heart Disease) Intervention Program. A theoretical framework was given to justify a number of hypotheses as to the induction of adverse psychological effects. At the end of two years in the MRFIT Program there were no significant differences between the special intervention group (SI) and the usual care group (UC) in the selected psychological variables.
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PMID:The psychological effects of differential treatment of a high risk sample in a randomized clinical trial. 48 65

Data were obtained from 13 sprint (age range 41-58) and 13 distance (age range 4-78) Masters track athletes. The mean VO2max value for the distance runners was 54.4 +/- 3 ml kg min compared with 47.2 +/- 2 ml kg min for the sprinters. The highest VO2max (71.0 ml kg min) was obtained on a 45-year-old distance runner while the lowest (27.3 ml kg min) was obtained on the oldest (78 years) distance runner. VO2max decreased by 34.5% from age 40 to 70 in the distance runner in spite of continued training that ranged from 40 to 120 miles/week. Maximum ventilation rates were 122.5 +/- 6.8 and 116.8 +/- 7.0 1 min for the sprint and distance runners, respectively. Percentage of body fat was 16.5 +/- 0.5 for the sprinters and 18.0 +/- 1.1 for the distance runners. Serum cholesterol values were 218.7 +/- 8.7 and 203.0 +/- 13.8 ml/dl, while triglyceride values were 101.5 +/- 8.2 and 84.1 +/- 9.3 mg/dl for the sprint and distance groups, respectively. These data indicate that, VO2max decreases significantly with aging despite the continuation of long distance training. Percent body fat and serum lipid levels were significantly lower in these athletes compared to those for sedentary adults, suggesting a protective effect against coronary heart disease. Only one subject had S-T segment depression during the exercise test.
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PMID:Physiological characteristics of sprint and endurance Masters runners. 49 75

Patients with chronotropic incompetence, defined as a failure of the heart rate response to exercise to rise to within two standard deviations of the expected increase with exercise, where studied and compared to patients with known coronary disease by angiogram with and without ST segment depression. 72% of the patients with chronotropic incompetence but without ST depression had significant coronary heart disease. The demonstration of chronotropic incompetence in exercise testing has important predictive implications and should be looked upon as carefully as ST segment changes. There was no evidence of SA node ischemia in these patients. Intrinsic heart rate measurements done in this study suggest autonomic dysfunction as a possible pathophysiologic mechanism for chronotropic incompetence. The heart rate response to exercise may be a useful predictor of the presence and severity of coronary disease. Therefore, a predicted heart rate response with standard deviation for age and sex should be included as part of the stress test protocol.
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PMID:Chronotropic incompetence in exercise testing. 49 1

In 15 patients with angiographically proven coronary heart disease and reproducible exercise induced ischemic ST-segment depression the antianginal effect of Perhexilinmaleat was tested in a cross-over randomized double-blind trial. The patients were treated 4 weeks with a placebo, 2 weeks with 200 mg and 2 weeks with 400 mg/day Perhexilinmaleat. The exercise-induced ischemic ST-segment depression was significantly reduced (p less than 0.001) by Perhexilinmaleat. This calcium-antagonist drug also prolonged the PQ-interval and reduced the heart rate during exercise. Some liver specific enzymes were slightly elevated. These and other side effects more often occurred at the higher dose of 400 mg/day.
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PMID:[Influence of perhexilinmaleat on the exercise electrocardiogram (author's transl)]. 54 2

A screening examination including an electrocardiogram (limb leads only) coded by the Minnesota Code, using rigorous quality control was done on 18 403 male civil servants aged 40 to 64. The association of the findings with coronary heart disease has been tested in relation to age trends, symptomatic history, and coronary heart disease mortality rates in the ensuing five years. The results were positive for Q waves, left axis deviation, ST depression, and T wave changes (including minor T wave items as an isolated finding), ventricular conduction defects, and atrial fibrillation; but they were generally unimpressive for increased R amplitude and for lengthening or shortening of the PR interval, QT interval duration, premature beats, and extremes of heart rate. The prognosis of specific electrocardiographic findings discovered at screening is quite different from when they arise in clinical practice. Among the 6 per cent of men in this study with patterns suggesting ischaemia, the subsequent coronary heart disease mortality was little more than 1 per cent per year; and among those who were symptom free it was even less.
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PMID:Prevalence and prognosis of electrocardiographic findings in middle-aged men. 65 38

In 15 patients with coronary heart disease and typical ST-segment depression during and/or after increasing physical effort in supine cycloergometry the normalizing effect of different dosages of Molsidomine on the electrocardiogram under effort was investigated in 74 exercise tolerance tests. Already after application of 0,5 mg Molsidomine there was observed a significant positive effect in comparison to an identical workload without drug. The normalizing effect was further increased by raising the dosage ot 1 mg or 2 mg respectively. To the administration of 3 mg only 1 out of 10 patients in the trial responded with an additional normalizing effect on the ECG since the rest of the patients showed already normal ECGs on 2 mg. This dose relationship also was observed in the pressure-rate-product. There was a dose-dependent decrease from which we can conclude a relief of the working myocardium. Under effort without drug 13 of 15 patients complained about stenocardia. Under the same effort and under Molsidomine however there were no more of these complaints. Because of these results it is recommended to use 2 mg of Molsidomine as a dosage in daily routine. It is needed 2 or 3 times dialy since in previous investigations there was shown a long-lasting effect over more than 5 hours. 3 out of 15 patients showed side effects which were only weak headache or weak congestion in the head.
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PMID:[The normalizing effect of ECG in exercise tolerance tests under molsidomine in different dosages (author's transl]. 67 55

The action of the contrast material over the various contractility indices was assessed five minutes after left ventriculography. There was an increase of the contractility index in normal subjects. On the contrary, in coronary patients, the contractility function remained unchanged or was depressed, related to the presence or not, of signs of cardiac failure. Depression of the various indices was noted in subjects with primary cardiomyopathy. After recalling the mechanism of action of the contrast products on the cardiovascular haemodynamic parameters, the following practical conclusions were drawn in relation with a series of 65 cases of coronary heart disease: the late diastolic left ventricular pressure remained lower than 20 mmHg after ventriculography in the subjects with a normal ejection fraction; it incraeased between 20 and 30 mmHg in most of the subjects with an ejection fraction ranging from 0.4 and 0.6, finally it was constantly found above 35 mmHg in the subjects with severely disturbed ventricular contraction with an ejection fraction lower than 0.4. These results underline the interest of this simple test, easy to perform, consisting in measuring the left ventricular late diastolic pressure before and 5 minutes after left ventriculography.
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PMID:[Modifications of contractility after left ventriculography. A new test in evaluation of myocardial function]. 80 84

Despite widespread clinical application of propranolol (P) in angina pectoris, convincing evidence of its efficacy has been incomplete, thereby resulting in continued controversy. Its antianginal effectivess was investigated in 20 patients with documented coronary heart disease in a 44-wk study incorporating a prolonged 12-wk lead-in period, individualization of P dosage in a 6-wk dose-finding period, and a 24-wk doule-blind crossover phase. On double-blind placebo, patients had 10.5 +/- 2.1 anginal attacks and consumed 12.8 +/- 3.0 nitroglycerin tablets (NTG) each week compared to 6.6 +/- 1.5 anginal episodes (- 37%, p less than 0.001) and 8.0 +/- 1.7 NTG (-38%, p less than 0.001) when on P. No patient experienced more angina with P than with placebo. In addition, time to onset of chest pain during treadmill exercise was prolonged by P from 190 +/- 16 to 248 +/- 22 sec (+31%, p less than 0.02) and ST depression was reduced from 1.7 +/- 0.21 to 0.99 +/- 0.18 mm (-42%, p less than 0.05). There was correlation (r = 0.64 p less than 0.01) between per cent declines in anginal frequency and resting double product with P. Thus, propranolol favorably altered several indices of myocardial ischemia in severe coronary heart disease. This investigation clearly documents the clinical efficacy of optimal beta adrenergic blockade in coronary disease and provides objective justification for the judicious application of propranolol in treatment of angina pectoris.
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PMID:Efficacy of beta adrenergic blockade in coronary heart disease: propranolol in angina pectoris. 81 Feb 95

The long-term efficacy of lidoflazine was investigated in 40 patients with a longer history of angina pectoris and well-documented ischemic heart disease over a whole range of 18 months in double-blind technique. Significant improvement occurs to frequency and severity of angina pectoris, related to reduction in consumption of nitro-compounds and in the extent of ST-segmental depression under resting and cycloergometric test conditions. Increase in cardiac work capacity is evident. There are no changes in heart rate, blood pressure and AV-interval in the ECG. The mode of action of lidoflazine may be an increase in the formation of coronary collaterals, whereas its acute vasodilating properties, experimentally verified in the dog, does not play any important part in the treatment of human coronary insufficiency. The introduction of lidoflazine in the treatment of coronary heart disease appears to be justified as an additive medication.
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PMID:[Efficacy of lidoflazine in angina pectoris. A long-term double-blind study]. 81 96

Hemodynamic and electrocardiographic analysis during rapid right atrial stimulation was performed before and one, two, and four hours after oral application of longacting nitroglycerin (5 mg) and isosorbide dinitrate (20 mg) in 11 and 9 patients, respectively with coronary heart disease. Atrial stimulation without nitrate induced significant ischemic ST segment depression. Cardiac output showed a small decrease and the mean arterial, pulmonary artery, and pulmonary wedge pressure increased. Isosorbide dinitrate reduced the ischemic reaction by 40% from the first to the fourth hour after application. Cardiac output, stroke volume, aterial, pulmonary artery, and pulmonary wedge pressure also decreased continuously. Nitroglycerin caused a similar reduction of ischemic ST segment depression for two hours. Systolic, diastolic, and mean arterial pressure decreased significantly. Cardiac output, stroke volume, and pulmonary artery pressure remained unchanged. It was concluded that the applied dose of isosorbide dinitrate showed a more extensive longacting effect.
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PMID:[Hemodynamic and electrocardiographic prolonged nitrate effect during frequency load in coronary disease]. 82 Jan 4


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