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

Haemodynamic and metabolic effects of elevated plasma concentrations of free fatty acids (FFA) were studied during acute ischaemic left ventricular failure in closed-chest anaesthetized dogs. Embolization of the left main coronary artery with 50 micron plastic microspheres induced severe depression of left ventricular performance as indicated by a marked increase in left ventricular end-diastolic pressure (LVEDP), and marked reductions in LVdP/dtmax, cardiac output and myocardial oxygen consumption (MVO2). When stable conditions were reached, eight dogs received a triglyceride emulsion and heparin to raise plasma FFA. This was associated with increased MVO2 and further elevation of LVEDP. In two dogs receiving the triglyceride emulsion but no heparin, plasma FFA was not elevated, and MVO2 and LVEDP were unchanged. In conclusion, elevation of plasma FFA was associated with increased myocardial oxygen requirement and further depression of LV function in dogs with acute ischaemic LV failure.
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PMID:Haemodynamic and metabolic consequences of elevated plasma free fatty acids during acute ischaemic left ventricular failure in dogs. 407 Sep 53

Acute myocardial infarction causes depression of left ventricular function, but the capacity of the ventricle to recover from such an injury remains unknown. This problem was explored by measuring left ventricular function in eight intact conscious dogs before, 1 hr after, and again 6-8 days after myocardial infarction. Acute myocardial infarction was produced using a technique which entails gradual inflation over an average period of 1 hr of a balloon cuff previously implanted around the left anterior descending coronary artery. Occurrence of anterior wall infarction was detected electrocardiographically and later confirmed by postmortem examination. Left ventricular function was evaluated from the relationship between left ventricular developed pressure (left ventricular peak systolic pressure minus left ventricular end-diastolic pressure) and left ventricular end-diastolic pressure during transient aortic occlusion with a balloon catheter. Left ventricular function curves were obtained by plotting left ventricular-developed pressure at increasing left ventricular end-diastolic pressures up to 50 mm Hg. Acute myocardial infarction caused marked depression of left ventricular function measured 1 hr after onset of infarction, but 1 wk later all eight animals showed improvement with return of function toward the control levels. A small but significant descending limb was noted at left ventricular end-diastolic pressures above 35 mm Hg. Quantitatively, the descending limb was similar before, 1 hr after, and 1 wk after myocardial infarction. Hemodynamic data revealed evidence of left ventricular failure in all animals, but variability in individual hemodynamic parameters was noted. The data indicate that the marked depression of left ventricular function observed immediately after experimental acute myocardial infarction undergoes considerable resolution within 1 wk, but that functional recovery remains incomplete.
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PMID:Experimental myocardial infarction. II. Acute depression and subsequent recovery of left ventricular function: serial measurements in intact conscious dogs. 540 8

Seventy four patients (66 men, eight women; mean age 54.3 years) underwent submaximal exercise testing 7-23 days (mean 10.7) after acute myocardial infarction. Follow up was a mean period of 11.3 months. When compared with patients with no exercise induced abnormality, ST segment elevation, ST shift (depression or elevation or both), ST depression, inability to complete five metabolic equivalents, and inadequate blood pressure response to exercise were predictive of subsequent cardiac events (cardiac death, left ventricular failure, recurrent myocardial infarction, angina). When the presence or absence of specific variables was assessed, only ST elevation and ST shift predicted subsequent cardiac events. The presence of exercise induced ST elevation was the only exercise test variable which predicted cardiac death. ST segment elevation was, therefore, the exercise induced abnormality which best predicted the risk of future complications.
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PMID:Submaximal exercise testing early after myocardial infarction. Prognostic importance of exercise induced ST segment elevation. 614 25

The influences of glyceryl trinitrate, isosorbide dinitrate and sodium nitroprusside intravenously on haemodynamics, coronary circulation and myocardial oxygen consumption were investigated in closed chest dogs (n = 8). In an attempt to simulate heart failure the dogs received blood transfusion (15 ml/kg) in the presence of halothane-induced myocardial depression. All three nitrates reduced the loads for the left ventricle. With isosorbide dinitrate and sodium nitroprusside the preload and pulmonary pressure decreased to a greater extent than with glyceryl trinitrate. The haemodynamic results suggest that sodium nitroprusside is the favourable nitrate in left ventricular failure because it produces a balanced reduction in the ratio of pre- and afterload. Four micrograms/kg X min sodium nitroprusside induced marked coronary dilatation; glyceryl trinitrate had only a slight coronary vasodilating effect. With isosorbide dinitrate the myocardial blood flow remained well adapted to oxygen demand, the coronary vascular resistance did not change. Sodium nitroprusside produced a significant change of the transmural myocardial blood distribution-expressed as the epi/endocardial blood flow ratio. The ratio was increased by sodium nitroprusside, much more than by glyceryl trinitrate or isosorbide dinitrate.
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PMID:The effects of glyceryl trinitrate, isosorbide dinitrate and sodium nitroprusside on haemodynamics, coronary blood flow and myocardial oxygen consumption - an experimental study. 640 78

We have assessed the prognostic significance of ST segment depression in the anterior precordial leads in patients with an acute inferior infarction. Eighty-four patients with ST segment depression greater than or equal to 1 mm in at least 2 chest leads (Group A) and 82 patients without ST depression (Group B), all admitted to the hospital within 24 hours from the onset of an acute inferior myocardial infarction, were evaluated. Patients with an old infarction, those with intraventricular conduction abnormalities or other causes that could modify the ST segment were excluded from the study. The number of patients affected by complications during the hospital stay was significantly higher in group A (54 patients of group A vs 27 of group B, p less than 0,001). Death, left ventricular failure, ventricular arrhythmias were considerably higher in group A. Moreover we observed that the persistence of the ST segment depression for more than 24 hours identified a subgroup of patients with a very strong risk of complications, particularly death and left ventricular failure. The follow up after 3-6 months, however, did not show any significant difference in both groups. In conclusion, from our study it appears that patients with an inferior infarction precordial ST segment depression have a graver prognosis in the acute phase while their mid-term fate does not seem to be influenced by the presence of this electrocardiographic abnormality.
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PMID:[Depression of the ST segment in precordial derivations: prognostic value in inferior myocardial infarct]. 650 Feb 15

Heart failure is associated with a reduction in tissue norepinephrine concentration, catecholamine fluorescence, and tyrosine hydroxylase activity. We hypothesized that this attrition of sympathetic nerve function might also be associated with a reduction in the ability of the neuronal membrane to sequester catecholamines. Since the heart does not release epinephrine, the cardiac extraction of epinephrine should be an index of the membrane uptake system. In 12 patients with documented left ventricular failure (pulmonary edema) secondary to mechanical overload and in 10 patients with no history of heart failure, we measured simultaneous plasma catecholamine concentrations in the aorta, coronary sinus, and femoral vein. The aortocoronary sinus extraction of epinephrine was 43 +/- 17% in the group with no evidence of heart failure but 0 +/- 14% in the group with failure. Net norepinephrine outflow (release minus extraction) was significantly higher in the group with failure, possibly because of reduced extraction. There was neither a reduction in the ability of the lower limb to extract epinephrine nor an increased norepinephrine outflow from the limb. These findings suggest that the sympathetic neuronal membrane uptake system is also depressed in the failing heart and that if the mechanism of catecholamine sequestration in the heart is related to that in the lower limb, the ablation of sympathetic nerve function is specific to the heart and is not a result of a generalized depression of the peripheral sympathetic nervous system.
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PMID:Reduced aortocoronary sinus extraction of epinephrine in patients with left ventricular failure secondary to long-term pressure or volume overload. 686 2

A 46-year-old patient showed spontaneous angina with anterior S-T segment depression 30 hours after an inferior acute myocardial infarction. Myocardial ischemia, which was resistant to drug therapy and induced acute left ventricular failure, was promptly reversed by intra-aortic balloon pumping (IABP). Coronary angiography demonstrated diffuse, severe atherosclerotic disease. Efficacy of IABP in this case of spontaneous angina might be ascribed to an increase of the coronary cross-sectional area in response to the increased intraluminal pressure ("passive vasomotion").
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PMID:[A case of postinfarction spontaneous angina: physiopathological study of the therapeutic effectiveness of intra-aortic balloon pumping]. 688 60

When coronary artery surgery is well performed one can anticipate an operative mortality of +/- 1%, a perioperative infarction rate of +/- 4% and a graft patency rate of 5 years of 80-85%; about 90% of patients are likely to obtain relief from angina pectoris. Moreover, life expectancy is prolonged in patients with left main obstruction, triple- and double-vessel (when the left anterior descending (LAD) coronary artery is involved) disease, and isolated LAD artery disease above the first septal perforator. An extensive area of jeopardized myocardium is common to all these anatomical subgroups. In 1981, absolute indications for coronary angiography and coronary artery surgery in operable cases included medically refractory angina, unstable angina (non-responders, those whose condition was previously stable, and those with marked ST-segment depression during pain), unstable infarction (subendocardial infarction and infarct extension) and left ventricular failure with a demonstrably ischaemic myocardium. In all other patients with coronary artery disease, decision regarding surgery is based on coronary anatomy and the extent of viable, but jeopardized, myocardium. Although coronary angiography is the only technique that will unequivocally identify severe anatomical disease, selection of patients for this procedure is at present determined by the result of a stress exercise test. The 1980s will focus more sharply on additional subgroups of patients who will benefit from coronary artery surgery.
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PMID:Coronary artery surgery-beyond the crossroads? 697 6

Haemodynamic and metabolic effects of the new antiarrhythmic drug melperone were studied during acute ischaemic left ventricular failure in closed-chest anaesthetized dogs. Embolisation of the left main coronary artery with 50 micrometer plastic microspheres induced severe depression of left ventricular performance as evidenced by a marked increase in left ventricular end-diastolic pressure and a marked reduction in the maximum rate of left ventricular pressure rise (LVdP/dtmax), cardiac output, and stroke volume. Six dogs received intravenous melperone 1.0 and 2.5 mg . kg-1 (cumulative dose) 90 and 115 min after the embolisation, respectively. Six other dogs received no treatment and served as controls. Melperone effected a marked reduction in left ventricular end-diastolic pressure, a slight but transient increase in LVdP/dtmax, a moderate reduction in heart rate, a moderate reduction in mean aortic blood pressure and total peripheral resistance and a moderate increase in stroke volume. Melperone moderately decreased myocardial O2-consumption, while myocardial lactate uptake remained unchanged. In conclusion, in contrast to commonly used antiarrhythmic drugs which may all induce cardiodepression, melperone improved left ventricular function in dogs with acute ischaemic left ventricular failure.
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PMID:Haemodynamic and metabolic effects of the antiarrhythmic drug melperone during acute left ventricular failure in dogs. 732 89

To determine whether changes in sarcomere length affect the inotropic response of the heart to angiotensin II (ANG II) differently in dilated and failing myocardium, papillary muscles were removed 2 days after infarction, and the effects of ANG II were studied at various muscle lengths. Myocardial infarction, which averaged 52% of the left ventricle inclusive of the interventricular septum, was characterized hemodynamically by left ventricular failure and right ventricular dysfunction. ANG II administration at 100% the muscle length where force development is maximal (Lmax) produced a 12% depression of developed tension in papillary muscles from noninfarcted ventricles and a 37% decrease in developed tension in the viable myocardium of infarcted rats. In contrast, at 85 and 92.5% Lmax and in the presence of ANG II, control muscles increased active tension by 16 and 1.0%, whereas muscles from coronary occluded hearts augmented developed tension by 13 and 22%, respectively. In conclusion, ANG II exerted a positive inotropic effect on rat myocardium at muscle lengths on the ascending limb of the Starling curve but a negative inotropic action at the muscle length normally associated with maximum force development. This phenomenon emphasizes that hormonal influences on the contractile state of the diseased heart may be modulated by the interaction of end-diastolic pressure, sarcomere length, and ventricular size and shape.
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PMID:Length-dependent modulation of ANG II inotropism in rat myocardium: effects of myocardial infarction. 814 79


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