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

Two multivariate methods, a logistic regression-derived algorithm and a Bayesian independence-assuming method (CADENZA), were compared concerning their abilities to estimate posttest probability of coronary disease in patients with suspected coronary disease. All patients underwent exercise testing within 3 months prior to coronary angiography. Coronary disease was defined as the presence of one or more vessels with greater than or equal to 50% luminal diameter narrowing. A group of 300 patients (disease prevalence = 37%) was used to derive the algorithm. Another group of 950 patients was used to validate the algorithm and compare it to CADENZA. Seven variables (age, sex, symptoms, diabetes, mm ST depression, ST slope, and peak heart rate) were used to generate posttest probabilities for each method. The receiver operating characteristic curve area for the logistic regression method (0.81 +/- 0.01) was significantly higher than CADENZA (0.75 +/- 0.01; p less than 0.05). There was, however, no difference in the calibration of the two methods. When given equivalent variable information, the logistic regression algorithm had better discrimination than CADENZA for estimating the probability of coronary disease following exercise electrocardiography.
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PMID:Comparison of logistic regression and Bayesian-based algorithms to estimate posttest probability in patients with suspected coronary artery disease undergoing exercise ECG. 152 2

The aim of this study was to investigate the value of continuous ECG monitoring in early diagnosis of coronary heart disease. 312 patients (59 women, 253 men, aged 20-60 years) with chest pain since 3-6 months were studied. All patients underwent clinical examination, serum lipid determination, exercise ECG test, ambulatory ECG monitoring and coronary angiography. 194 patients had normal or nonsignificant irregularities of coronary arteries, in 118 patients significant atherosclerotic stenoses were found. Sensitivity and specificity of ECG monitoring were: 46 and 54% respectively. Significantly higher frequency of changes and longer duration of depression or elevation of ST segment in patients with significant coronary artery stenosis was found. ST segment changes without angina were observed in 23,7% of patients.
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PMID:[24-hour ECG monitoring by the Holter system in early diagnosis of coronary disease]. 152 54

The effect of the angiotensin-converting enzyme (ACE) inhibitor quinapril on myocardial ischaemia was tested in a randomized double-blind cross-over study of 16 men (mean age 62 [44-75] years) with angiographically demonstrated coronary heart disease, exercise-induced ST-segment depression and stable angina. Exercise ECGs were recorded before and 4 hours after a single dose of 10 mg quinapril and after a 14-day course of 10 mg quinapril twice daily. The single dose decreased the average ST-segment depression from 1.12 mV (placebo) to 0.74 mV (P less than 0.05); after 14 days on quinapril the ST-segment depression decreased from 0.91 mV (placebo) to 0.72 mV (P less than 0.05). While heart rate remained unchanged the average resting arterial blood pressure fell from 136/80 to 120/74 mmHg (P less than 0.05) after a single dose and from 141/83 to 127/78 mmHg (P less than 0.05) after 14 days on the drug. These data indicate that ACE inhibitors should be considered as a means of treating coronary heart disease and angina.
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PMID:[The angiotensin-converting enzyme inhibitor in the treatment of angina pectoris]. 156 26

This study measured the prevalence of chronic medical conditions in 4,549 middle aged persons attending three large general practices in Dublin over the course of a calender year. The prevalence of the following conditions were measured: coronary heart disease, hypertension, stroke, diabetes, asthma, chronic bronchitis, rheumatic disorders, dyspepsia, depression, anxiety disorders, psychoses, and cancer. In order to obtain a valid denominator for the study a second community based study was carried out in the same areas to determine what proportion of persons visit their general practitioner over the course of a year. Overall 40.5% of males and 44% of females suffered from a least one of the twelve conditions, with rheumatic disorders having the highest prevalence (14.5%) and psychotic disorders the lowest (0.75%).
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PMID:General practice estimates of the prevalence of common chronic conditions. 147 57

A geriatric study was conducted on 213 institutionalized geriatric glaucoma patients (mean age 83.9 years) and 100 control patients (mean age 81.3 years). A 12-lead electrocardiogram (ECG) analyzed according to the Minnesota code was recorded for 212 glaucoma patients and 95 control patients. The most frequent finding (in 56% of the glaucoma patients and in 38% of the control patients, P less than 0.05) was a negative or isoelectric T-wave, suggestive of ischemic heart disease. ECG findings suggestive of coronary heart disease (Q/QS patterns, ST-segment depression, negative or isoelectric T-wave, third or second degree AV block, left bundle branch block or right bundle branch block, intraventricular block or atrial fibrillation or flutter) was seen significantly more often in glaucoma patients (164/212; 77%) than in the control patients (59/95; 62%). Seventeen percent of the glaucoma patients had atrial fibrillation (AF), which was significantly more than for the control group (8/95; 8%). There was no difference in the number of ECG changes between patients with bilateral open-angle glaucoma and bilateral angle-closure glaucoma. The mean intraocular pressure of patients having AF (15.9 +/- 8 mmHg) was significantly lower than that of the other patients (18.4 +/- 11 mmHg) (P less than 0.05). Fifty-five glaucoma patients were considered blind (visual acuity less than 0.05 in the better eye). The visual acuity of patients having AF was lower than that of the other patients, and severe visual field defects (arcuate scotoma or a residual field in the temporal periphery) occurred, slightly more frequently in patients with AF (in 70% vs 51% of the other patients). Arrhythmias, especially AF, are connected with impairment of visual acuity and visual field defects in glaucoma patients. The result of this retrospective study indicate that ECG changes occur frequently, suggesting coronary heart disease in elderly glaucoma patients.
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PMID:Electrocardiographic changes in institutionalized geriatric glaucoma patients. 159 83

Exercise-induced bundle branch block is an uncommon electrocardiographic entity said to be associated with coronary heart disease. Thirty-seven patients were studied to determine if exercise hemodynamics and stress/rest thallium scans could identify those patients with coronary heart disease. Eighteen patients of the study group also had coronary angiography. Group I (n = 17) with normal thallium scans and group II (n = 20) with abnormal thallium scans had significantly different maximal heart rate, maximal blood pressure, and double product in exercise as well as duration of exercise. Clinical evaluation of the patient study group permitted a division of the patients into two subgroups: group A, atypical chest pain or abnormal exercise electrocardiogram (n = 12), and group B, definite or probable angina (n = 25). Group B patients had significantly more abnormal thallium scans (17/25) than group A patients (3/12) (p less than 0.04). When compared to coronary angiography, stress/rest thallium scans had a predictive accuracy of 85% for coronary heart disease. While exercise-induced ST-segment depression and R wave amplitude increases are not specific in exercise-induced bundle branch block, exercise hemodynamics and stress/rest thallium scans can help diagnose patients with coronary heart disease. These test findings added to a clinical evaluation permit a more accurate stratification of the patients and indicate which patients need further study.
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PMID:The clinical significance of exercise-induced bundle branch block. 164 63

From clinico-pharmacological view the present paper gives a survey of the important drug group of the beta-receptor blockers. While non-selective blockers effect a global depression of the sympathico-adrenergic activity of the organism, the beta 1-selective blockers are characterized by a dose-dependent preferred affinity to the cardiac and renal beta 1-receptors. Thus in low and moderate dosages undesired pulmonary, vascular and metabolic effects can be avoided. Main indications for beta-receptor blockers are the arterial hypertension, the coronary heart disease and the tachycardiac disturbances of the cardiac rhythm. Apart from the increase of the life-quality of the patient the prognosis improving effect in clinical long-term studies confirmed for several beta-receptor blockers should be used therapeutically.
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PMID:[Beta receptor blockers. Their role and therapeutic importance]. 167 28

Increases in physical fitness are often associated with improvements in certain chronic diseases, such as hypertension and coronary heart disease. Recent evidence has shown that exercise also influences the neuroendocrine and immune systems, resulting in a potential to benefit those with chronic immunodeficiency diseases. Therefore, exercise may prove to have a profound impact on the management of the acquired immunodeficiency syndrome (AIDS). Our current work includes the investigation of the immunologic and stress-attenuating effects of an aerobic exercise training program for individuals at risk for AIDS. Upon completion of training, the subjects showed a significant increase in helper/inducer (CD4) cells and the inducer subset (CD45RA+CD4+) which activate suppressor/cytotoxic (CD8) cells. These increases, which average about 50 cells per cubic millimeter, are comparable to those observed in some studies of the AIDS drug comparable to those observed in some studies of the AIDS drug azidothymidine (AZT), but without the accompanying side effects. Also, individuals undergoing aerobic training reported no increases in anxiety and depression in response to notification of a positive HIV-1 serologic status. These findings taken together indicate that an aerobic exercise training program may enhance certain critical components of cellular immunity as well as acting as a buffer for the detrimental mood changes that typically accompany stress, thus providing a timely, promising behavioral approach to helping HIV-1-infected individuals.
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PMID:Aerobic exercise training in an AIDS risk group. 168 Jan 8

Seventeen patients with effort angina, a positive exercise test and at least one stenosed vessel in coronary angiography were studied. Following a crossover blind-design, each patient received at random either 400 mg/day oral celiprolol or 120 mg/day oral nicardipine. A treadmill exercise test and 24 hour Holter monitoring were accomplished at the end of each treatment period. Both drugs significantly prolonged exercise time and reduced maximum ST segment depression at similar stages of control testing. Nicardipine reduced resting diastolic blood pressure a mean of 18 mm Hg (p less than 0.005) and also systolic blood-pressure 11 mm Hg (p less than 0.005) while celiprolol only reduced systolic pressure 10 mm Hg (p less than 0.01). Resting heart-rate was lowered by celiprolol a mean of 9 beats/min (p less than 0.0001) while nicardipine slightly increased it. The double product at maximum effort decreased with celiprolol and increased with nicardipine. Six patients with 3 vessel disease continued having transient ischemic episodes during treatment with celiprolol and 5 had them with nicardipine. Both drugs were well tolerated by the patients. In conclusion celiprolol and nicardipine proved to be effective in the treatment of myocardial ischemia specially when coronary heart disease is not very advanced.
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PMID:[A comparative study of celiprolol and nicardipine in stable angina of effort]. 168 17

In a double-blind cross-over study, 10 patients with stable angina pectoris owing to coronary heart disease were investigated in supine position during rest and bicycle exercise for the effect of 0.4 mg of intravenous (i.v.) isradipine in comparison to 2 mg i.v. nifedipine on cardiac hemodynamics and myocardial ischemia. At rest, both drugs significantly decreased total peripheral resistance (TPR) and mean arterial blood pressure (MAP), whereas heart rate (HR) increased. The pressures and resistance of the pulmonary circulation remained uninfluenced at rest. During symptom limited-exercise, both medications reduced TPR despite an unchanged MAP. Mean pulmonary artery pressure decreased significantly after both medications, whereas right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR) decreased significantly only after nifedipine. The improvement of mean ischemic ST-segment depression averaged 44 +/- 6% (mean +/- SEM, p less than or equal to 0.01) after nifedipine and 45 +/- 7% (p less than or equal to 0.01) after isradipine. The time until angina appeared increased after isradipine by 89 +/- 28% (p less than or equal to 0.05) and after nifedipine by 105 +/- 42% (p less than or equal to 0.01). Significant differences between the two medications appeared only for cardiac output (CO) at rest (p less than or equal to 0.05), during which state the increase after isradipine was higher than after nifedipine, and for exercise HR (p less than or equal to 0.01), during which state only nifedipine induced a significant increase in frequency. We conclude that at the chosen dosages the hemodynamic and antiischemic effects of isradipine are similar to the effects that occur after nifedipine.
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PMID:Antiischemic and hemodynamic effects of intravenous isradipine, a new calcium antagonist, in coronary heart disease: a comparative double-blind cross-over study with nifedipine. 170 98


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