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

During manually performed exercise, ECG revealed silent myocardial ischemia-related ST segment depression in 62 patients with atherosclerosis obliterans in the lower limbs in the absence of evident signs of coronary abnormalities. The patients displayed decreased cardiac output, elevated total peripheral resistance, structural and functional alterations in the end blood flow system, and diminished exercise tolerance as compared to healthy subjects and atherosclerosis obliterans patients with negative loading tests. The aforementioned abnormalities were also revealed in subjects suffering from atherosclerosis obliterans in the lower limbs and documented coronary heart disease.
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PMID:[Clinico-functional characteristics of patients with arteriosclerosis obliterans of the lower extremities and painless myocardial ischemia]. 223 70

Treadmill and isometric tests were carried out in 108 patients with coronary heart disease confirmed at coronary arteriography versus 51 healthy subjects. Among myocardial ischemia criteria depressed S-T segment came out as most reliable (probability of valid diagnosis greater than 90%), less significant was wave T inversion, wider wave R amplitude, painful syndrome (probability 70%). The rise and depression of oblique upward segment S-T, abnormal T amplitude proved inferior to the above signs (probability less than 50%). To achieve valid diagnosis of coronary heart disease and to assess its severity, exercise tests should produce reliable criteria of myocardial ischemia.
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PMID:[Comparative value of electrocardiographic criteria of myocardial ischemia in exercise tests]. 223 45

An experimental trial was conducted to measure the effects of a patient-nurse contract on patients' emotional state during hospitalization in the Coronary Care Unit (CCU). The contractual agreement focused on areas of environmental restrictions and nursing care in the CCU that might decrease patients' sense of control. Forty-one patients with documented coronary heart disease, never previously hospitalized, were randomly assigned to either a control or an experimental group upon admission to the CCU. The control group was oriented to the routines of the unit by one of the nursing staff, while the experimental group made individualized contracts with a nurse regarding family visitation, schedules for daily hygiene, patient teaching, activity and the room environment. A significant difference existed between the two groups over time for the three dependent measures of anxiety, depression and hostility (p less than .001). Twenty-four hours after completing baseline measures, the control group was significantly more anxious (p less than .01) and hostile (p less than .05) than the experimental group. At 48 hours, the experimental group reported significantly lower anxiety (p less than .01), depression (less than .05), and hostility (p less than .05) compared to the control group. These findings suggest that a strategy designed to enhance cardiac patients' sense of personal control may facilitate emotional adaptation to hospitalization.
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PMID:Patient-nurse contracts in critical care: a controlled trial. 226 46

This study examined the combined effects on 132 normal adults of social insecurity, anxiety symptoms, and daily hassles on changes in the level of depressive symptoms over a 1-month period. It was hypothesized that social insecurity, a factor linked to coronary heart disease and sympathetic arousal, is also an important antecedent of depression for those who have experienced a high level of anxiety and chronic stress. Results of multiple regression analysis indicate that these three factors in combination (a 3-way interaction) predict changes in depressive symptoms. The nature of this interaction was more complex than hypothesized.
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PMID:Social insecurity, anxiety, and stressful events as antecedents of depressive symptoms. 227 1

Correlations between cardiovascular effects of a quantified dose of nicotine and personality measures previously shown to predict coronary heart disease were obtained. Thirty male smokers smoked a popular brand of a regular strength cigarette (1.0 mg FTC-estimated nicotine delivery) on one occasion and a nicotine-free cigarette on another occasion by means of a quantified smoke delivery system. Partial correlations controlling for effects of body weight, questionnaire-assessed nicotine tolerance, and cardiovascular responses to the nicotine-free control cigarette showed Jenkins Activity Survey Type A scores to correlate positively with nicotine-induced increase in diastolic blood pressure but negatively with nicotine-induced increase in systolic blood pressure. Partial correlations indicated that trait anxiety and depression were significantly associated with nicotine-induced heart rate increases but not with nicotine-induced blood pressure responses.
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PMID:Cardiovascular responses to a quantified dose of nicotine as a function of personality and nicotine tolerance. 227 27

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 determinants of the altered whole blood filterability observed during coronary ischemia are still under discussion. Since no studies have been carried out to date on what exactly causes these alterations during the early stages of controlled ischemia in coronary heart disease, a model was set up using a bicycle ergometer test (with a 25 W increase every 2 minutes). Blood samples were taken from 48 stable angina pectoris patients and from a group of 28 matched controls before and immediately after exercise and 8 minutes later. Plasma viscosity, the filterability (through 5 microns diameter pore filters) of whole blood, erythrocytes, and polymorphonuclear and mononuclear leukocytes (separated by density gradient) were monitored. Alterations in whole blood filterability could be linked only to an impairment in polymorphonuclear cell filterability in those stable angina pectoris patients who reported chest pain and/or whose ST segment depression was greater than or equal to 2 mm.
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PMID:Stable angina pectoris and controlled ischemia: what causes the abnormalities in whole blood filterability? 229 74

The effect of a controlled-release formulation of isosorbide-5-mononitrate (IS-5-MN) was studied in patients with coronary heart disease (CHD), with the aim of comparing the acute effect with that after chronic administration on parameters of ischemia. To determine whether any tolerance developed, several aspects of ischemia were observed: ECG signs, clinical parameters, and left ventricular function. Fifteen patients with angiographically proven CHD were examined with 12-lead exercise ECG before, 2 h and 4 h after the first dose and after 10 days of therapy with 60 mg IS-5-MN (Coleb-Duriles) once daily. After 7 days, three radionuclide ventriculographies were performed: control, 2 h after nitrate and 2 h after 75 mg gallopamil. Plasma concentrations of IS-5-MN were measured before every exercise test. The results showed a reduction of total ST-segment depression from 0.59 mV to 0.29 mV after 2 h (NS) and 4 h (P less than 0.05) on the 1st day and from 0.48 mV to 0.32 mV (P less than 0.05) and 0.31 mV (NS) after 10 days. The severity of angina pectoris was diminished by about 50%. The effect on exercise duration and time to ST-segment depression by more than 0.1 mV remained unchanged after 10 days, whereas the effect on blood pressure, heart rate and time to onset of angina was attenuated. The mean decrease in ejection fraction (EF) from rest to exercise was reduced from--5.9% to -1.9% (P less than 0.05) after nitrate, while an increase of +1.4% was seen after gallopamil (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lack of tolerance after chronic administration of controlled-release isosorbide-5-mononitrate. Interaction of nitrate and gallopamil. 235 12

In using National Cholesterol Education Program guidelines (for desirable low risk, a total cholesterol level less than 200 mg/dl, and for high risk, a level of high-density lipoprotein cholesterol (HDLC) less than 35 mg/dl), our specific aim was to examine lack of concordance in classification of coronary heart disease (CHD) risk by HDLC less than 35 mg/dl in subjects with total cholesterol less than 200 and to determine whether lack of concordance increased as group CHD risk increased. We studied four cohorts ranging from putatively low to high CHD risk. These included self-referred subjects in a public urban total cholesterol screening (n = 897), hospitalized patients with depression (n = 144), Cholesterol Center referrals at presumed high CHD risk (n = 1120), and patients having coronary arteriography (n = 145) because of presumed coronary artery disease. Total cholesterol was less than 200 mg/dl in 25% of subjects from the urban sampling, in 54% of hospitalized patients with depression, in 27% of Cholesterol Center referrals, and in 41% of those undergoing cardiac catheterization. In these four cohorts, of subjects with total cholesterol less than 200, 7%, 26%, 25%, and 48%, respectively, had HDLC less than 35 mg/dl. The likelihood of having total cholesterol less than 200 and HDLC less than 35 mg/dl was 1.7% in urban public subjects, 6.8% in Cholesterol Center referrals, 13.9% in depressed patients, and 20% in cardiac catheterization patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lack of concordance in classification of coronary heart disease risk: high-risk HDL cholesterol less than 35 mg/dl in subjects with desirable total serum cholesterol, less than 200 mg/dl. 240 50

The American College of Sports Medicine (ACSM) has published exercise guidelines identifying individuals who should have an exercise test prior to clearance for exercise participation and whether a physician should supervise the test. These age and health status criteria (apparently healthy, higher risk, and diseased) were developed using clinical judgement and opinion rather than empirical data. Thus, there is a need to validate the recommendations with actual data. We studied the results of 24,332 maximal treadmill tests in men (n = 18,076) and women (n = 5,626) as they associated with age and baseline health status. Commonly accepted criteria for abnormal exercise tests were used (i.e., 1 mm ST segment depression at 0.08 s, systolic blood pressure drop with exercise, complex ventricular ectopy, etc.). There were 895 and 183 abnormal exercise tests in men and women, respectively. Men and women who were apparently healthy had lower abnormality rates per 1,000 tests than those considered to be at higher risk for coronary heart disease and those who had preexisting disease. Further, when those who were at higher risk were considered, those men with only one risk factor had significantly lower abnormality rates than did men with more than one risk factor (95% confidence intervals (CI) per 1,000 tests: 1 risk factor = 36.1-46.4; greater than 1 risk factor = 47.5-62.5). Abnormality rates in women with 1 risk factor were also lower than those in their peers with greater than 1 risk factor, but not statistically so (95% CI per 1,000 tests: 1 risk factor = 24.9-43.0; greater than 1 risk factor = 25.3-54.4).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An empirical evaluation of the ACSM guidelines for exercise testing. 240 17


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