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

In a population reportedly excessively prone to ischaemic heart disease (IHD) i.e. South African (SA) whites, a 3-community study of 7188 subjects aged 15-64 showed a high prevalence of chest pain by questionnaire (9.5% of males, 7.7% of females) or by ECG findings suggestive of IHD (12.8% males, 6.7% females). In the oldest decile (55-64 years) the prevalence of chest pain and/or ECG findings was 33.4% of males and 26.1% of females. For all ages, 18.4% of males and 13.1% of females were apparently affected. Though females were as likely as males to have a history of chest pain they had fewer ECG findings suggestive of IHD and the history was less likely to have been confirmed by a doctor. The significance of individual findings, assessed by the strength of their associations with symptomatic history and age, appeared to differ between the sexes; though very common, medium S-T depression was not classed as suggestive of IHD in females, while left ventricular hypertrophy was unimpressive in males. Large and medium Q waves, large S-T depression, large and medium T wave inversion were positive in both sexes, but left and right bundle branch block only in males. There was little overlap between a history of chest pain and suggestive ECG findings; however, a previous diagnosis of IHD by the family doctor increased the overlap by up to 6 times.
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PMID:The prevalence of ischaemic heart disease in three rural South African communities. 669 35

A series of 1000 12 lead ECGs recorded in 1000 consecutive ambulatory patients were analysed by the Telemed (V Version) programme and its interpretation and the precision of the French translation were compared with the interpretation of two physicians using standard criteria. The computer identified 90% of the 285 ECGs coded as "normal" by the physicians, 69% of the 57 ECGs coded as "borderline" and 96% of the 658 ECGs coded as "abnormal". The computer interpretation was correct in 74% of cases and acceptable in 87,4% of cases. The computer classified 80% of the 240 arrhythmias correctly. Atrial fibrillation was detected in 91% of cases, and ventricular and supraventricular extrasystoles in 88% of cases. The recognition of other arrhythmias was not as good but the small number of cases did not allow statistical evaluation. The 148 cases of axis deviation and 98% of ventricular conduction defects were identified. The programme detected 84% of transmural infarcts, the sensitivity being greater for anterior or lateral than inferior infarctions. The majority of undiagnosed infarcts were "possibles" according to the criteria of the Minnesota Code. Of 536 ECGs with ST-T segment abnormalities, 81% were classified correctly; ST depression of less than 0.5 mm comprised the majority of false negatives. The sensitivity of the programme to left ventricular hypertrophy was excellent (95%) with a specificity of only 92,5% as the programme uses the Romhilt-Estes criteria which are more liberal than those of the Minnesota Code. The comparison of the sensitivity and specificity for the commonest ECG changes showed excellent all round diagnostic performance of the Telemed programme. In conclusion, despite the large number of abnormal ECGs, the level of computer-physician concordance was high. The French translation of the V Version of the Telemed programme is therefore suitable for clinical use Nevertheless, the computer interpretation should still be checked by a physician.
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PMID:[Value of the automated analysis of the electrocardiogram by the Telemed program (V version)]. 679 19

Seven hundred and seventeen hypertensive middle-aged men (HTs) were compared with 4,438 normotensive men (NTs). The association between the prevalence of hypertension and a number of demographic, physical, biochemical and electrocardiographic characteristics was examined by multiple logistic analysis. HTs were characterized by significant elevations of pulse rate, relative weight, serum uric acid, and high-density lipoprotein-cholesterol. HTs had a higher percent of major electrocardiographic findings, such as ischemic T wave changes, ST depression and, most significantly, left-ventricular hypertrophy. They were 4.7 yr older than the NTs and were more often of Central European than of Middle Eastern descent. Mortality in HTs over a 4.5-yr period was dose-response related to casual systolic and diastolic blood pressure readings at baseline. The age-adjusted HT/NT mortality ratio was approximately 2.5:1. Cardiovascular and cerebrovascular disease accounted for 69% of the total mortality among HTs as compared with 48% among NTs. The estimated mortality fraction attributable to hypertension was 23%. This figure provides an estimate for the goal of hypertension control in the community.
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PMID:Hypertension in middle-aged men. Associated factors and mortality experience. 683 46

ECGs of 36 hypokalemic patients (K/s 1.0-3.5 mM/l) were analysed. The sum of the S-T depression and the U wave amplitude in leads II and V3 was used and constituted the uncorrected hypokalemic index. To correct the hypokalemic index, the figure obtained during normokalemia is subtracted from that obtained during hypokalemia. The corrected hypokalemic index gives an approximation of the K/s irrespective of other factors permanently influencing the ECG, such as treatment with antiarrhythmic drugs, coronary insufficiency, and ventricular hypertrophy. The corrected index was greater than 4.0 at a K/s of less than 2.0 mM/l. Eight out of nine patients with a K/s 2.1-2.6 had an index of 1.5-3.5. All patients with a K/s greater than 2.6 mM/l had an index less than 1.5.
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PMID:A hypokalemic index ECG as a predictor of hypokalemia. 712 58

1) Body surface mapping was performed in 15 patients with ischemic heart disease and 5 control subjects before and after isoproterenol infusion. In ischemic heart disease, ST map developed negative areas in the left anterior chest wall extending from mid line to left axillar line after isoproterenol. This distribution on ST depression was different from that of left ventricular hypertrophy or complete left bundle branch block which spared mid anterior chest. The point of maximal ST depression corresponded to one of the conventional chest lead in 6 of 15 cases. In other 9 cases, the point of maximal ST depression was mostly located superiorly to V3-V5. epsilon ST depression correlated well with the maximal ST depression (r = 0.90) but not very well with ST depression at V5 (r = 0.70). On 201 T1 stress scan, a reversible large perfusion defect was detected in 2 out of 5 patients with marked ST depression. These findings suggested that isoproterenol induced ST map changes are useful in diagnosis of myocardial ischemia. 2) Body surface map was obtained in 16 cases with chronic pulmonary disease. The location of the maximum R and initial R was relatively inferior to that of normal controls. Relatively deep S waves were frequently observed. Pulmonary function tests correlated with the maximum R voltage but not with the deepest S. Cases with relatively high pulmonary conus voltage were proved to have right ventricular hypertrophy on 201 T1 myocardial scintigraphy or on echocardiography.
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PMID:Characteristics of body surface mapping in the aged. 729 99

Nineteen long distance runners and 19 age- and sex-matched sedentary controls were evaluated by echocardiography and electrocardiography (ECG) at rest and after 12 minutes of treadmill exercise. Seven of ten male athletes exhibited ECG abnormalities of prominent precordial voltage, early repolarization, and one had right ventricle hypertrophy; only three of nine females had ECG abnormalities. The resting and postexercise heart rates and blood pressures were lower in athletes than controls (P less than 0.001). The athletes increased their left ventricular end-diastolic volume and stroke volume and had a moderate increase in heart rate. Controls markedly increased only their heart rate to the same level of exercise. One female athlete and one female control had 1 mm of ST segment depression with exercise. The right ventricular wall thickness was equal to or greater than 6 mm in athletes versus equal to or less than 5 mm in controls. The left ventricular wall was thicker in athletes than controls, the resultant left ventricular mass was 60% more in athletes due to left ventricular hypertrophy (P less than 0.001). We concluded left ventricular hypertrophy is present in athletes as a result of endurance running.
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PMID:Electrocardiographic and echocardiographic characteristics of long distance runners. Comparison of left ventricular function with age- and sex-matched controls. 746 92

Left ventricular hypertrophy in arterial hypertension is characterized by myocyte hypertrophy, myocardial fibrosis, and structural changes of the intramural coronary arteries. Hypertensives with or without left ventricular hypertrophy have a reduced coronary vasodilator reserve due to alterations of the coronary microcirculation. The impairment in coronary vasodilator reserve is likely to initiate a process of malperfusion and malnutrition concomitant with increased metabolic demands. Further, malperfusion is supported by an increase in diastolic filling pressure, which will enhance the extravascular component of coronary resistance. The sum of interactions of these structural alterations of myocardium, interstitium, and coronary vasculature are likely to initiate and maintain a process of myocardial malperfusion and malnutrition, which can provoke functional depression of the myocardial performance, a loss of contractile proteins, an increase in interstitial fibrosis, and, not least, an overall decrease in contractile function in long-standing cardiac hypertrophy. Finally, the reversal of these processes by adequate antihypertensive treatment may contribute to renormalization of cardiac function and to prevention of late cardiac failure in hypertensive heart disease.
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PMID:Systolic ventricular dysfunction and heart failure due to coronary microangiopathy in hypertensive heart disease. 749 18

To determine the effects of chronic constriction of the left coronary artery on the function and structure of the heart, coronary artery narrowing was surgically induced in rats and ventricular pump performance, extent and distribution of myocardial damage, and the hypertrophic and hyperplastic response of myocytes were examined. Alterations in cardiac hemodynamics were found in all rats, but the characteristics of the physiological properties of the heart allowed a separation of the animals into two groups which exhibited left ventricular dysfunction and failure, respectively. Left ventricular hypertrophy occurred in both groups and was characterized by ventricular dilatation and wall thinning which were more severe in the failing animals. Multiple foci of myocardial damage across the wall were seen in all animals but tissue injury was more prominent in the endomyocardium and in failing rats. The anatomical and hemodynamic changes resulted in a significant increase in diastolic wall stress which paralleled the depression in ventricular performance. Myocyte cell loss and myocyte cellular hypertrophy were more severe with ventricular failure than with dysfunction. Finally, diastolic overload appeared to be coupled with activation of the DNA synthetic machinery of myocytes and nuclear mitotic division. In conclusion, a fixed lesion of the left coronary artery leads to abnormalities in cardiac dynamics with marked increases in diastolic wall stress and extensive ventricular remodeling in spite of compensatory myocyte cellular hypertrophy and hyperplasia in the remaining viable tissue.
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PMID:Ventricular remodeling in global ischemia. 757 15

We anesthetized 34 sumo wrestlers. All patients were male. Average age was 21.1. Their height was 181.9 +/- 4.5 (mean +/- SD) cm, and they weighted 135.2 +/- 16.9 kg. Anesthetic methods used were spinal anesthesia alone in 17 patients, general anesthesia alone in 9, general anesthesia + epidural anesthesia/or spinal anesthesia/or axillary block in 8. The preoperative data showed findings common to obese patients; liver dysfunction, abnormal blood sugar, and abnormal ECG such as ST depression or left ventricular hypertrophy. For intubation, fiberscopy was required in one patient, and almost all patients required high FIO2, otherwise SaO2 decreased. For spinal anesthesia or epidural anesthesia, we needed long needles of 8 to 15 cm.
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PMID:[Anesthesia for SUMO wrestlers]. 760 8

The relationship between ECG abnormalities and mortality was studied in 4797 males and 4320 females aged 25 to 74 years who took part in the Belgian Inter-university Research on Nutrition and Health (The BIRNH study). At entry all were free of angina, had no history of acute myocardial infarction and showed no evidence of an old infarction on their baseline ECG. They were followed for an average of 5.6 years, and follow-up for vital status was completed satisfactorily in 99.5%. ECG abnormalities were grouped using several classifications: any abnormality, major and minor abnormalities, ischaemic changes, left ventricular hypertrophy and the separate Minnesota codes IV (ST depression), V (abnormal T-wave) and VIII (arrhythmias). Using logistic regression analysis, adjustment of odds ratios for cardiovascular disease (CVD) mortality was done for age, systolic blood pressure, serum total cholesterol and uric acid, diabetes, smoking and antihypertensive drug treatment. Men outnumbered women more than twice in total and CVD mortality. Multivariate analysis showed that the presence of major abnormalities on the ECG was significantly related to CVD mortality in both men and women (adjusted odds ratios 2.73 and 4.40 respectively). In contrast, minor abnormalities were not independently associated with CVD mortality. In men, ST depression (OR = 5.58), signs of an ischaemic ECG (OR = 3.02) and an abnormal T-wave (OR = 2.58) were independently related to CVD mortality. In women primarily a ST depression (OR = 5.87) and arrhythmias (OR = 4.22) had a significant independent effect on CVD mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The predictive value of electrocardiographic abnormalities for total and cardiovascular disease mortality in men and women. 769 28


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