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)

1) In "left-sided" cardiac diseases, the effects of nitroglycerin on arterial pressure and heart rate were noted to be modest and disappeared within 15 minutes whereas the effect upon venous pressure, measured on the median cubital vein, lasted for approximately 30 minutes. 2) At 30 minutes after a dose of nitroglycerin there occured a significant depression of venous pressure elevation on exertion in patients with such "left-sided" cardiac diseases as ischemic heart disease, arteriosclerotic heart disease and hypertensive cardiovascular disorder. In patients with mitral insufficiency and aortic stenosis, on the other hand, the exertional venous pressure elevation was significantly suppressed 7 minutes after nitroglycerin although the suppression did not longer exist 30 minutes after administration. 3) The arterial pressure, heart rate, resting venous pressure and venous pressure elevation on exertion were virtually not affected by the administration of nitroglycerin in "right- or both-sided" cardiac disorders. 4) There was no significant change in cardiac output 30 minutes after a sublingual dose of nitroglycerin. The data obtained seem to stress importance of the effect of dilating capacitance vessels in the mechanism of antianginal action of nitroglycerin.
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PMID:[Effect of nitroglycerin on peripheral venous pressure at rest and during exercise in patients with heart diseases (author's transl)]. 40 92

We have recently detected accumulation of lysophosphoglycerides, catabolites of phospholipids, in ischemic myocardium early after coronary occlusion. In the present study we delineated effects of selected concentrations of albumin-bound lysophosphatidyl choline (LPC) comparable to those accompanying ischemia in vivo on action potentials of isolated canine Purkinje fibers. Lysophosphoglycerides induced concentration-dependent (0.75-3.0 mM) decreases in resting membrane potential, overshoot of phase 0, maximal velocity of upstroke (Vmax) of phase 0, and action potential duration. The highest concentrations (2.0-3.0 mM) induced fractionation of the action potential into several components, unresponsiveness to external stimulation, and enhanced automaticity at normal and reduced membrane potentials. LPC induced a rightward shift in the membrane response curve, a 40-fold prolongation of conduction time, and an increase in the ratio of effective refractory period to action potential duration such that the effective refractory period persisted beyond action potential duration, resulting in postrepolarization refractoriness. These electrophysiological alterations were entirely reversible after 70 minutes of perfusion without LPC, with the exception of a persistent depression in the Vmax of phase 0. Lysophosphatidyl ethanolamine (LPE) elicited alterations in action potentials indentical to those elicited by LPC. Furthermore, LPC (3.0 mM) induced comparable alterations in action potentials recorded from isolated rabbit papillary muscles. Since lysophospholipids accumulate early after myocardial ischemia, and since concentrations equivalent to those occurring in vivo induce electrophysiological alterations resembling those seen in ischemic myocardium in vivo, lysophosphoglycerides may be of major importance as biochemical mediators of malignant dysrhythmia induced by ischemia.
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PMID:Potential arrhythmogenic electrophysiological derangements in canine Purkinje fibers induced by lysophosphoglycerides. 42 75

A prospective study in 12 adult male patients undergoing coronary-artery revascularization was conducted to compare the effects of a morphine versus a halothane anesthetic technique on several indices of myocardial oxygen supply and demand. Indices reflecting myocardial contractility, preload, afterload, and heart rate were measured. Undesirable increases in systemic and pulmonary capillary wedge pressure were minimized using sodium nitroprusside as needed. In the period after sternotomy but before revascularization, patients anesthetized with morphine (mean 2.1 mg/kg) had significant (P less than .05) increases in rate-pressure product, tension-time index, blood pressure, and heart rate, as well as relative myocardial ischemia, evidenced by significant ST-segment depression in the V5 lead of the EKG and a decreased diastolic pressure-time index/tension-time index compared with patients anesthetized with halothane (mean .75 per cent inspired). Few difficulties associated with myocardial depression were seen in patients anesthetized with halothane. Halothane, at least in a well-monitored environment, is safe for use in patients without severe ventricular dysfunction undergoing coronary-artery revascularization.
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PMID:Indices of myocardial oxygenation during coronary-artery revascularization in man with morphine versus halothane anesthesia. 43 35

Trends in Australian heart disease mortality were assessed for association with the business cycle. Correlation models of mortality and unemployment series were used to test for association. An indicator series of "national stress" was developed. The three series were analyzed in path models to quantify the links between unemployment, national stress, and heart disease. Ischemic heart disease (IHD) mortality and national stress were found to follow the business cycle. The two periods of accelerating IHD mortality coincided with economic recession. The proposed "wave hypothesis" links the trend in IHD mortality to the high unemployment of severe recession. The mortality trend describes a typical epidemic parabolic path from the Great Depression to 1975, with a smaller parabolic trend at the 1961 recession. These findings appear consistent with the hypothesis that heart disease is, to some degree, a point source epidemic arising with periods of severe economic recession. Forecasts under the hypothesis indicate a turning point in the mortality trend between 1976 and 1978. (Am J Public Health 69:772-781, 1979).
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PMID:Ischaemic heart disease mortality and the business cycle in Australia. 45 9

The purpose of this study was to determine the incidence of ST-segment depression during anesthesia and operation. Graded exercise testing has demonstrated a high correlation between ST-segment depression and myocardial ischemia. Therefore, 11 patients without and 29 patients with known coronary-artery disease were monitored during surgical procedures with a commercially available exercise electrocardiographic monitor (Viagraph). Comparisons were made between this device, which monitored lead V5, and the standard operating room monitor, which monitored lead 11. Eleven of 29 patients in the disease group demonstrated significant ST depression. Nine of the 11 ischemic episodes were not recognized on the standard operating room monitor. Retrospective review of anesthetic records of those 11 patients with ST-segment depression revealed rate--pressure product values greater than 11,000 for ten of them. Postoperatively, three of the 11 patients with significant ST-segment depression had changing electrocardiograms compatible with ischemia. None of the control group demonstrated significant ST-segment depression. The incidence of ischemia was 38 per cent during anesthesia and operation in the coronary-artery-disease group. Lead V5 analysis is superior to lead 11 analysis in detecting ST-segment depression. The period in which intubation is performed is one of the highest-risk intervals during anesthesia and operation, particularly when it is associated with an increased rate--pressure product.
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PMID:Myocardial ischemia during non-cardiac surgical procedures in patients with coronary-artery disease. 49 52

Case histories of four elderly patients with central nervous system signs of digitalis toxicity were reviewed. Evidence of toxicity included lethargy, depression which was not present previously, confusion, restlessness, emotional instability, hyperventilation, and vertigo. Vomiting developed four days after the onset of the mental changes. No cardiac arrhythmias were observed. Digoxin serum levels ranged between 4.2 and 7.0 ng/ml. Serum potassium values were within normal limits. Three of the four patients recovered with a return of their mental status to the pretoxic state. The fourth case was fatal. At autopsy long-standing myocardial ischemia was the only significant finding.
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PMID:Digitalis delirium in elderly patients. 53 71

The left ventricular systolic ejection phase was cineangiographically analyzed in an attempt to evaluate left ventricular performance. Forty-eight patients were classified into five groups: (1) 9 controls; (2) 5 patients with PMD (congestive type) (COCM); (3) 9 patients with PMD hypertrophic type) (HCM), (4) 9 patients with ischemic heart disease (IHD); and (5) 16 patients with mitral stenosis (MS). The rate of volume change (deltaV/deltat) and the volume change as a percentage of stroke volume (deltaV/SV) in patients with COCM and IHD were lower in the early systole and higher in the mid-systole as compared with the control group. Normalized systolic ejection rate (NSER) and velocity of circumferential fiber shortening (Vcf) for the early and late systole were significantly lower in patients with COCM and IHD than in the control group. In two patients with IHD in whom normal indices of left ventricular performance and no asynergy were observed, NSER and Vcf were normal in the late systole but were significantly lower in the early systole. In all 48 patients, deltaV/deltat, deltaV/SV, NSER and Vcf were compared statistically with conventional ejection phase indices and isometric phase indices. delthV/SV for the midstystole showed a negative correlation with EF, MNSER and mVcf. NSER and Vcf for all three phases showed a good correlation with Vmax, max dp/dt and R-max dp/dt but a better correlation with EF, MNSER and mVcf. It was concluded that NSER and Vcf for the early systole were sensitive indices of left ventricular performance and may be utilized to detect subtle depression of left ventricular performance.
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PMID:Quantitative analysis of left ventricular ejection phase by means of left ventricular cineangiography. 59 71

First heart sound (S1) energy spectra in isovolumic systole, hemodynamics, and angiographic left ventricular wall motion (LVWM) at rest and with atrial pacing were compared in 27 patients who underwent diagnostic cardiac catheterization and angiography because of chest pain. Eighteen patients were found to have coronary artery disease (CAD) and nine patients, normal coronary arteries. Eleven of the 18 CAD patients (61%) had a mean reduction in the spectral energy of S1 of 6.5 +/- 1.4 (SEM) dB below control (-52%), during interruption of ischemic stress of rapid atrial pacing, compared to only one of nine patients without CAD (P less than 0.05). Only five CAD patients (28%) had an abnormal rise (greater than or equal to 5 mm) in left ventricular end-diastolic pressure (LVEDP) either during or upon interruption of pacing, and six (33%) had ischemic ST-segment depression greater than or equal to mv in the ECG. Similarly two patients free of CAD (22%) had an abnormal increase in LVEDP, and none had ECG evidence of ischemia. Seventeen CAD patients (94%) had segmental LVWM abnormalities at rest or with interruption of pacing, while three patients with normal coronary arteries (33%) had abnormal angiographic LVWM (P less than 0.01). Thus, reduction is S1 spectral energy is a common accompaniment of myocardial ischemia. In the present study, it was more frequently observed than abnormalities in either the ECG or LVEDP, but was not was consistently seen as segmental left ventricular wall motion abnormalities.
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PMID:Spectral energy of the first heart sound in acute myocardial ischemia. A correlation with electrocardiographic, hemodynamic, and wall motion abnormalities. 62 70

ECG changes were followed up in 69 patients under continuous electrocardiographic monitoring before, during and after esophago-gastro-duodenoscopy (EGD). Of these 32 (46.5%) had ischemic heart disease (IHD). One or more varied abnormalities including supraventricular or ventricular ectopic beats, sinus tachycardia or sinus bradycardia, intermittent right or left bundle branch block, S--T segment depression (and increased preexisting S--T segment depression), T wave flattening or inversion appeared during EGD. Only one patient with IHD developed anginal chest pain during endoscopy. Despite the high incidence of recorded rhythm abnormalities, these were transient, and no treatments were needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during EGD, particularly when it is performed in patients with IHD.
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PMID:Continuous electrocardiographic monitoring during upper gastrointestinal endoscopy. 63 3

Although many patients with coronary artery disease (CAD) have a positive exercise test without pain, the frequency and significance of this "silent" ischemia is unclear. Therefore, we studied 122 consecutive clinically stable patients with angiographically defined CAD (greater than 75 per cent luminal stenosis) and a positive exercise test. Seventy-eight patients had pain or anginal equivalent during or after a positive exercise test; 44 did not, including 32 (26 per cent) with no symptoms at all. Patients were evaluated as to age, sex, prior myocardial infarction, congestive failure, hypertension, diabetes mellitus, and digoxin or propranolol therapy--in addition to anginal symptoms before, during, or after the exercise itself. Extent of CAD, presence of collaterals, and left ventricular ejection fraction were also determined. All exercise tests were evaluated for evidence of ST-T abnormalities or prior infarction on the control ECG as well as peak heart rate during exercise and post-exercise degree of ST segment depression. There were no significant differences between patients with and without exercise-induced pain in regard to any of the clinical and angiographic features noted above, demonstrating that "silent" myocardial ischemia during or after exercise testing is not uncommon and is not readily attributable to any obvious clinical or catheterization findings. Further studies are necessary to determine if patients with evidence of "silent" myocardial ischemia are especially prone to sudden death.
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PMID:"Silent" myocardial ischemia during and after exercise testing in patients with coronary artery disease. 63 80


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