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)

Under observation were kept 80 patients with signs pointing to the sick sinus syndrome. Most of them suffered from ischemic heart disease, from atherosclerotic cardiosclerosis and acute myocardial infarction. Persistent sinus bradycardia with active and passive heterotopic arrhythmias were recorded in 42 patients. Sino-auricular block of the II and III degrees or asystolia of the atria with ectopic arrhythmias were observed in 37 cases. A number of patients displayed fibrillary bradyarrhythmia, extrasystole with post-extrasystolic depression of the rhythm and other disturbances. The so-called tachycardia-bradycardia syndrome characterized by the presence of tachycardiac arrhythmias occurring against the background of a marked bradycardia was registered in 25 persons. Fifteen patients demonstrated attackes of the Morgagni-Adams-Stokes syndrome, usually associated with lengthy periods of cardiac asystole. The treatment of ectopic arrhythmias in patients with the sick sinus syndrome presents considerable difficulties, but in many of them these disorders could be successfully eliminated by a careful and rigidly controlled application of antiarrhythmic agents (isoptin, ajmalin, pulsnorma, rhythmodan, beta-adrenergical blocking agents). For some patients exhibiting a tendency toward asystole electric stimulation of the heart is indicated.
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PMID:[Syndrome of sino-atrial node asthenia]. 79 80

Measurement of the sinus node recovery time has been proposed as a diagnostic tool for recognition of the sick sinus syndrome. The latter is most frequently encountered in elderly patients with hypertension, coronary heart disease, and atherosclerosis. In order to provide normal values for the sinus node recovery time in this particular population group, atrial pacing studies were carried out in 30 subjects over 50 years of age, all with peripheral vascular disease and some with angina pectoris (10), residua of infarction (6), or hypertension (7). On stimulation, 7 patients maintained a I:I atrioventricular conduction up to the rate of 180/min. Second degree atrioventricular block developed in all other cases. On six occasions, Wenckebach's periods appeared at the relatively slow pacing rate of 120/min. The maximum postoverdrive pause ranged from 680 to 1600 ms with an average of 1100 ms plus or minus 190 (10). For each pacing speed, a correlation was found between the duration of the pause and the control intrinsic cardiac rate, longer pauses being associated with longer resting PP intervals. Beyond 120/min, the duration of the pause was seen to shorten progressively as the driving rate was increased. Finally, the behavior of the sinus node pacemaker following interruption of pacing showed individual variations. After pacing at relatively slow rates, a prompt return to near control values was consistently observed, whereas, after fast rates of driving, a phase of secondary depression developed in about one-half of the studied cases.
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PMID:Sinus node recovery time in the elderly. 112 18

A criterion to determine the indication for pacemaker implantation in the sick sinus syndrome by overdrive suppression is proposed. Overdrive suppression was performed in 10 patients with the sick sinus syndrome (SSS) and another 10 patients with normal sinus rhythm (NSR) who served as controls. In the SSS group, 9 patients had complained of such severe symptoms as Adams-Stokes attack and/or congestive failure and were referred to our laboratory for pacemaker implantation. One other patient, an apparently robust young man (20 years old) referred for detailed cardiac examination, had no remarkable symptoms except for arrhythmias, but was found dead two months later. Atrial pacing for overdrive suppression was carried out at first at various rates ranging from 60 to 180 beats/min for 15 sec, and then at a rate of 100 beats/min for various durations ranging from 5 to 180 sec. After cessation of the atrial pacing, asystolic pauses were measured and the maximum (maximum pause) among the pauses obtained was used as a parameter indicating depression of cardiac automaticity. The maximum pause in the SSS group ranged from 5.6 to 9.0 sec (mean +/- SD = 7.0 +/- 1.2), WHILE THOSE IN THE NSR group ranged from 0.7 to 1.5 sec (mean +/- SD = 1.2 +/- 0.14). Therefore, the maximum pause was considered not only to reflect the severity of the symptoms necessitating pacemaker implantation in the 9 patients of the SSS group but to have warned us of sudder death in another patient. We concluded that overdrive suppression is useful as a supplementary challenge to determine indications for pacemaker implantation for the sick sinus syndrome, and that prolongation of the maximum pause beyond 5.0 sec is the critical level for pacemaker implantation.
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PMID:Overdrive suppression in diagnosis of sick sinus syndrome. 115 46

A total of 105 patients with suspected sick sinus syndrome were examined. All of them underwent transesophageal pacing and endoscopical investigation. A relationship is shown between lesions of the gastrointestinal tract and emergence of the sinus vagal depression leading to various disturbances of cardiac rhythm.
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PMID:[The role of gastroduodenal diseases in the development of cardiac arrhythmia of the sick sinus syndrome type]. 187 60

Forty patients with sick sinus syndrome, 15 women and 25 men with a mean age of 53.83 +/- 13.34 years, were studied using a maximal graded bicycle stress test. None of the patients were using a pacemaker or being treated with drugs that would interfere with the sinus node function; one patient had family myocardiopathy and eight suffered from essential hypertension. All patients, including those suffering from very marked bradycardia (less than 40 beats/min) responded to the increased effort with increased heart rate. The exercise test was stopped in 22 patients (55%) after the appearance of clinical signs and in 4 (10%) after ST-segment depression greater than 1 mm. Eight (20%) finished the stress test after reaching the maximal heart rate according to age, due to an increase in sinus rate. The exercise produced or increased extrasystoles in five patients (12.5%), but only one was forced to suspend the test. The Q-T interval, corrected for heart rate according to Bazett's formula (QTc), was measured on the resting ECG before the start of the test and on the ECG recorded immediately following the end of the exercise in all patients, except one with atrial fibrillation. In 24 patients (60%), a QTc mean increase of 0.040 +/- 0.022 sec was observed at the end of the stress test. Fourteen (35%) had the usual shortening due to the increase in heart rate. One patient showed no variation of the QTc. A lengthening of the QTc at the end of the exercise in more than half of the patients was the most intriguing electrocardiographic change.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postexercise electrocardiographic and clinical changes in patients with sick sinus syndrome. 270 31

This study compared the psychosocial hypotheses generated by 12 internists and 12 family physicians as they reviewed three patient presentations with diagnoses of congestive heart failure, common duct stone, and sick sinus syndrome. Family physicians, compared to internists, produced a significantly higher proportion of psychosocial hypotheses on two of the three cases. Diagnoses considered more frequently by family physicians included anxiety, anxiety-depression, psychogenic pain, alcoholism, and other alcohol-related diseases. These results are consistent with the findings of previous studies reporting that family physicians attend to psychosocial problems to a greater degree than do internists.
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PMID:Family physicians' and internists' consideration of psychosocial hypotheses during the diagnostic process. 274 26

Effects of a new selective beta1 partial agonist, ICI 118,587, on cardiac function were assessed in clinical settings. In 7 patients, responses to multistage treadmill exercise were studied before and after an acute intravenous injection of the drug. The heart rate and blood pressure were not altered by ICI 118,587 at rest but increases in both parameters in response to exercise were significantly reduced. Neither oxygen consumption nor plasma norepinephrine level was modified by the drug both at rest and during exercise. The long term effects of ICI 118,587 were assessed in 6 patients with mild to moderate cardiac failure consequent upon ischemic heart disease. After chronic administration of the drug exercise duration was increased. The symptom-limited maximal oxygen consumption increased by 16%, associated with prolongation of the exercise tolerance. In those patients who also had symptoms of angina pectoris, exercise levels which caused angina during the control study were tolerated without symptoms after ICI 118,587. Twelve patients with nocturnal bradycardia resulting from atrial fibrillation of sick sinus syndrome were treated with ICI 118,587. Monitoring of heart rate by 24-hour Holter ECG showed that ICI 118,587 increased minimal heart rate during sleep. Being a beta1-adrenoceptor partial agonist, it has both agonist and antagonist properties. Thus, ICI 118,587 buffers the heart from an excessively low sympathetic tone which may occur during sleep and from an excessively high tone during exercise. It appears to be of benefit in the treatment of mild to moderate cardiac failure consequent upon ischemic heart disease. It also improves oxygen demand-supply imbalance without inducing further myocardial depression or inappropriate bradycardia at rest. ICI 118,587 may therefore be described as a cardiostabilizer.
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PMID:Cardiovascular effects of ICI 118,587, a new beta-adrenoceptor partial agonist in man. 287 3

An anaesthetic method without intubation has been used for the first time in Hungary in 107 laryngomicroscopic operations. The method includes: Vagolytic, analgetic, sedative, vasodilatator, coronary flow enhancing, antihypertensive and antitussive premedication. Administration of the sedative anaesthetic gamma-OH, void of respiratory depression, in doses of 60 mg/kg body weight (given in 2 portions), combined with diazepam, without relaxation and intubation. Supplemental analgesia and inhibition of reflexes by means of mucosal and nerve-block anaesthesia. The premedication, supplemented by endonasal nitroglycerin, reduced the increase of blood pressure, which is a characteristic feature of laryngomicroscopic operations. The combined premedication was found to be effective as well in preventing the usual cardiac arrhythmias, partly reflectory, partly due to the depression of the sinus node (sick sinus syndrome). Nevertheless, the authors emphasize the importance of continuous ECG monitoring. Operation conditions met requirements in 102 cases (intubation had to be performed in 5 patients). The method's primary field of indication includes the microsurgical manipulation of glottic synechiae, as well of lesions in the interarytenoid space or on the vocal processes. Except for the removal of bleeding papillomas, haemangiomas or cysts, the method is expedient for the microsurgical therapy of benign changes, as well as for the topical diagnosis of malignant neoplasms in other laryngeal structures. The advantages of the method are safety, maintenance of normal oxygenation, easy prevention of aspiration, as well as good visibility and photodocumentation of the free operation field, undisturbed manipulation without time limit and, last but not least, simple performance requiring no additional expensive equipment.
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PMID:[A modified method of anesthesia without intubation in microsurgical treatment of the larynx]. 647 35

Sinus node recovery time (SNRT) is frequently used to assess sinus node function in patients with suspected sick sinus syndrome (SSS). Although SNRT is assumed to reflect sinus node automaticity, this assumption remains unproven. The purpose of this study was (1) to test the hypothesis that SNRT in patients with and without SSS reflects sinus node automaticity, and (2) to assess the role of sinoatrial conduction time in the measurement of SNRT. A total of 16 patients (mean +/- SD age 63 +/- 9 years), seven of which had SSS, form the basis of this report. An electrogram of the sinus node was obtained for each of the 16 patients, and overdrive pacing was performed in each at cycle lengths of 1000 to 300 msec. SNRT was measured (1) on the sinus node electrogram (direct method, measuring SNRTd) as the interval from the last pacing stimulus artifact to the onset of the upstroke slope of first postpacing sinus beat and (2) on the high right atrial electrogram (indirect method, measuring SNRTi). Results were as follows: (1) The longest SNRTd was significantly shorter than the longest SNRTi (989 +/- 304 vs 1309 +/- 356 msec, p less than .001). (2) For the first postpacing sinus beat there was a significant prolongation of sinoatrial conduction time as compared with that for sinus beats before pacing (319 +/- 152 vs 99 +/- 35 msec, p less than .001). Sinoatrial conduction time normalized within 3.6 +/- 0.96 postpacing sinus beats. (3) At the pacing cycle length that resulted in the longest recovery time, sinus node depression was seen in 56% of patients, sinus node acceleration was noted in 26%, and no appreciable change in sinus node automaticity was observed in 19%. (4) Sinoatrial conduction time for the sinus beat before pacing and that for the first postpacing beat was longer in patients with SSS when compared with in patients without SSS. (5) In patients with SSS the abnormal SNRTi, when corrected for the degree of prolongation of sinoatrial conduction time for the first postpacing beat, became normal in five of six patients. We conclude that (1) SNRTi reflects both sinus node automaticity and sinoatrial conduction time, whereas SNRTd reflects sinus node automaticity, (2) overdrive atrial pacing results in marked prolongation of sinoatrial conduction time for the first postpacing beat, which is longer in patients with SSS when compared with in those without SSS, and (3) in patients with SSS the inference of abnormal sinus node automaticity on the basis of a prolonged corrected SNRTi is usually incorrect.
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PMID:New application of direct sinus node recordings in man: assessment of sinus node recovery time. 647 69

In order to evaluate the relative role of the automatic nervus system and of the intrinsic electrophysiologic properties on the sinus node function, we measured the corrected sinus node recovery time before and after autonomic nervous system blockade in 24 patients. Fourteen had a sick sinus syndrome, five had a carotid sinus syncope, two had syncope of unknown origin associated with bradycardia. Beta blockade was obtained by infusing metoprolol intravenously at a dosage of 0.2 mg/kg; complete automatic blockade was achieved by further i.v. administration of atropine at a dosage of 0.04 mg/kg. After beta blockade, the corrected sinus node recovery time increased in patients with sick sinus syndrome and intrinsic slow heart rate, whereas it decreased in patients with carotid sinus syncope or with syncope and bradycardia. In patients with sick sinus syndrome and normal intrinsic heart rate the response was variable. A positive direct correlation was found between the changes of the corrected sinus node recovery time induced by beta blockade and those induced by autonomic blockade; that is, both either prolonged or shortened the corrected sinus node recovery time. The changes of the corrected sinus node recovery time after beta blockade alone were inversely correlated with the intrinsic heart rate. We conclude that patients with intrinsic depression of the sinus node have an increased sympathetic tone.
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PMID:[Influence of beta block and autonomic nerve block on the recovery time of the sinus node in sick sinus syndrome and carotid sinus syndrome]. 651 82


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