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

In patients with myocardial infarction (MI) the presence or absence of lesions in vessels other than the one which perfuses the infarcted area, has implications regarding coronary bypass surgery, long term anticoagulant therapy, work capacity and prognosis. We investigated whether involvement of a 2nd or 3rd vessels as demonstrated by coronary angiography can be predicted on the basis of angina pectoris and/or ischemic ST-segment depression during exercise. Inferior myocardial infarction (IMI, n = 146) Severe lesions (greater than or equal to 75%) of a 2nd or 3rd vessel were found in 61.7% of patients with IMI, who developed angina pectoris and ischemic ST-segment depression, in 18.6% of patients with ST-segment depression only, in 9.1% of patients with angina pectoris only and in 3.4% with neither angina pectoris nor ST-segment depression. Anteroseptal infarction (ASI, n = 116) Severe lesions (greater than or equal to 75%) of a 2nd or 3rd vessel were found in 30.2% of patients with ASI, who developed Angina pectoris and ischemic ST-segment depression; in 26.6% of patients with ST-segment depression only, in 20.0% of patients with angina pectoris only and in 3.0% of the patients with neither angina pectoris nor ST-segment depression. The clinical implications of the results are discussed.
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PMID:[Stress tests and coronary angiography in chronic myocardial infarct]. 122 60

Fibrinolytic activity and platelet adhesiveness are normal in cases of angina pectoris and healed myocardial infarction, whereas fibrinolytic activity is diminished in acute myocardial infarction. Exercise increases fibrinolytic activity in normal people but the effect on it of submaximal exercise in patients with ischaemic heart disease is not known. Resting platelet adhesiveness and fibrinolytic activity were determined in 20 patients suffering from ischaemic heart disease and eight healthy controls. Both groups were then subjected to submaximal exercise on a motor-driven treadmill. The ST segment of the electrocardiogram and the heart rate were monitored during exercise by an on-line digital computer. Fibrinolytic activity determinations were repeated immediately after exercise. There was a significant increase in fibrinolytic response in both groups but it was significantly less in the ischaemic groups (36-2%) compared with the controls (55-9%) (P less than 0-01). The ST segment depression was 2-3 mm in the ischaemic group and 0-52 mm in controls--also a significant difference (P less than 0-01). There was no correlation, however, between the ST change and the fibrinolytic response. A diminished response in the ischaemic group may favour their predisposition to thrombotic episodes.
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PMID:Effect of submaximal exercise on fibrinolytic activity in ischaemic heart disease. 122 43

Sixty-five patients with myocardial infarction were observed for comparison of the values of nalorphine and Micoren in prevention of respiratory depression caused by fentanyl. The patients were divided into 4 groups receiving NLA II with or without nalorphine, morphine or Micoren. In all cases paO2, paCO2 and acid-base equilibrium were determined before and after administration of drugs. In the group receiving only NLA II paO2 fell in 50% of cases, in other groups receiving nalorphine or Micoren it increased in most cases. The paCO2 increased in most cases in groups receiving only NLA II or NLA II with nalorphine with or without morphine and respiratory acidosis developed in 4 cases. In the group receiving NLA II with Micoren paCO2 fell. The results indicate the necessity of administration of respiratory stimulants with NLA II and Micoren appears to be preferable to nalorphine in this respect.
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PMID:The effects of nalorphine and Micoren on blood oxygenation and acid-base equilibrium in patients with myocardial infarction treated with neuroleptanalgesia II. 124 37

A 6 year follow-up study of 438 patients who underwent maximal treadmill stress testing revealed the following annual incidence rate of coronary events (death, myocardial infarction or onset or progression of angina pectoris): 13 percent in 84 subjects whose stress test produced 2 mm downsloping S-T segment depression, 9 percent in 230 subjects with 2 mm horizontal S-T depression and 9 percent in 124 subjects who had an upsloping S-T segment with 2 mm S-T depression measured 0.08 second from the J point. Coronary angiograms were obtained in another group of 248 subjects who underwent maximal treadmill stress testing. They revealed major (greater than 50 percent) obstruction of two or three vessels in 67 percent of 62 subjects with a downsloping S-T pattern on the stress test, in 60 percent of 116 subjects with horizontal S-T depression and in 57 percent of 70 subjects with upsloping S-T depression. Patients with an upsloping pattern of S-T depression during stress testing had the same incidence of coronary events as those with a horizontal pattern of S-T depression. Upsloping S-T depression should not be confused with isolated J point depression. Subjects with an upsloping segment also had the same incidence of major two or three vessel disease as those with horizontal depression. Subjects with a downsloping pattern has a slightly greater incidence of coronary events and major two or three vessel disease.
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PMID:Upsloping S-T segments in exercise stress testing. Six year follow-up study of 438 patients and correlation with 248 angiograms. 124 30

Short-term results of aggressive surgical management were compared with results of medical management in forty-three patients with preinfarction angina admitted to the coronary-care unit (CCU) over an 18 month period. These patients were selected from 1,609 consecutive admissions to the CCU because they met strict criteria for preinfarction angina: severe chest pain at rest, ST-segment elevation or depression during pain which subsided rapidly after cessation of pain, and normal serum enzymes (CPK, SGOT, and LDH). Twenty-three patients had coronary angiography, done with operating room and pump standby. One patient, who had total occlusion of the left main coronary artery, died during the study. Twenty-one of the remaining patients were considered surgical candidates, and were treated immediately after angiography with 1 to 3 vein bypass grafts. There was one late postoperative death and, of the 20 survivors, 2 had ECG evidence of acute myocardial infarction and one had mild angina at time of discharge. In contrast, of the 21 patients treated medically, 13 sustained acute MI, resulting in 8 instances of congestive heart failure and 4 cases of ventricular fibrillation. Four patients died in cardiogenic shock. With the use of rigid criteria, a small subgroup of patients with variant angina at high risk of developing AMI has been identified and categorized as having preinfarction angina. Our experience suggests that aggressive surgery immediately following coronary angiography offers a lower incidence of MI, morbidity, and death than does medical management.
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PMID:Management of preinfarction angina. Evaluation and comparison of medical versus surgical therapy in 43 patients. 124 46

The data from this study document that dobutamine is a powerful inotropic agent in anesthetized dogs with acute myocardial ischemia and in awake, unsedated ones with chronic myocardial infarction. Dobutamine significantly increases heart rate at relatively small doses in anesthetized dogs with acute myocardial ischemia but considerably larger amounts of dobutamine are required to significantly increase heart rate in awake, unsedated dogs with myocardial infarction. Dobutamine also significantly increases regional myocardial blood flow to all areas of the heart at 20mug/kg/min in both anesthetized dogs with acute myocardial ischemia and awake, unsedated ones with myocardial infarction. However, in anesthetized dogs 20mug/kg/min of dobutamine significantly increases epicardial ST-segment elevation during acute myocardial ischemia. Propranolol prevents the inotropic and chronotropic effects of dobutamine in both anesthetized and awake, unsedated dogs. This study suggests that during experimental acute myocardial ischemia dobutamine given at doses that significantly increase heart rate and contractility may increase the extent of myocardial damage. The data also suggest that this agent should be of value in the setting of severe myocardial depression without associated severe coronary artery disease to increase cardiac contractility at doses that do not markedly alter heart rate. The hemodynamic and coronary blood flow effects of dobutamine in patients with and without severe coronary artery disease should be evaluated.
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PMID:Influence of dobutamine on regional myocardial blood flow and ventricular performance during acute and chronic myocardial ischemia in dogs. 126 Sep 86

A study was made of the effort electrocardiogram (ECG) of 100 patients who had had a myocardial infarction and correlated in 46 cases with findings at coronography. Angina occurred in 38 cases. The ECG remained stable in 17 cases and showed changes in 83. In 60 patients, in those leads with pathological Q waves, isolated T wave changes (15 cases), ST elevation (43 cases) or ST depression were seen. In 17 cases there was isolated ST depression in leads free of any signs of infarction. In 6 cases alterations in rhythm or conduction were seen.
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PMID:[The exercise electrocardiogram after the acute phase of myocardial infection. Analysis of 100 cases]. 126 10

Inverted T waves due to coronary artery disease and previous myocardial infarction were observed to revert ot normal, upright position during ischemia in 38 patients. The normalization of inverted T waves was seen on the electroencephalograms of 19 patients during spontaneously occurring angina pectoris and of 11 patients when ischemia was provoked by treadmill exercise; for 8 patients, normalization occurred during the administration of isoproterenol hydrochloride and during the consequent episode of angina pectoris. The mechanism for normalization may be the algebraic sum of the extent of ST segment elevation and the amplitude of the T waves of acute ischemia plus the extent of preexisting ST segment depression and the degree of T wave inversion, to result in isoelectric ST segment and upright T wave. As with myocardial infarction, reciprocal changes may also be recorded. However, the reciprocal nature may be masked since either acute ST segment elevation of T wave inversion, or both, may not be recorded in the leads reflecting the ischemic area because of normalization.
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PMID:Normalization of abnormal T waves in ischemia. 126 47

The clinical implications of isolated late recovery ST depression were tested in patients with scintigraphically defined ischemia (coronary artery disease [CAD], n = 18) compared with patients without ischemia (n = 25). Spontaneous (78.4 versus 12.0%, P < 0.008) and exercise-induced angina (44.4 versus 0%, P < 0.0001) were more frequently seen in patients with CAD. Histories of unstable angina (33.3%), prior myocardial infarction (27.8%), ST elevated angina (22.2%) and significant stenosis in the left anterior descending artery (17 of 18, 94.4%) were almost exclusively seen in the CAD group. There was no significant difference between the two groups in capacity for exercise, maximum deviation of ST level or TV2 amplitude. Balloon angioplasty abolished late recovery ST changes in 63.6% of CAD patients. These results suggest that isolated late recovery ST depression, when accompanied with typical chest pain, may be considered as an indicator of myocardial ischemia, but this phenomenon is difficult to distinguish electrocardiographically.
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PMID:Isolated post exercise delayed ST depression as a sign of severe ischemia: the influence of percutaneous transluminal coronary angioplasty. 128 36

The effects of halothane on the effective refractory period (ERP) and the ventricular activation were examined in a canine myocardial infarction model, and compared with those of propranolol. Halothane reduced the heart rate and prolonged the ERP in both normal and infarcted zones. A prolongation of ERP with halothane was also observed during atrial pacing at the same rate as in control, but the effect was less than during sinus rhythm. Halothane (1 MAC) further delayed or blocked the delayed activation in the infarcted zones with only slight effects on the activation of the normal zones. Propranolol (0.2 mg/kg) prolonged ERP during sinus rhythm, but it did not affect either the ERP or ventricular activation during atrial pacing. In conclusion, halothane produced a selective depression of the delayed activation and the prolongation of ERP, which may be caused by both direct effects on the myocardium and secondary effects such as a reduction of the heart rate. These effects of halothane may contribute to its antiarrhythmic effects in the myocardial infarction model which have been previously reported.
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PMID:Comparison of the effects of halothane and propranolol on the effective refractory period and the ventricular activation in a canine myocardial infarction model. 128 97


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