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)

To determine whether myocardial ischemia is accompanied by variation in heart rate and/or blood pressure, ST-segment analysis on Holter-ECG and ambulatory blood pressure monitoring was performed in 78 patients (64 males/14 females) with essential hypertension. Thirteen out of 55 patients (24%) with angiographically proven coronary artery disease (CAD) showed ST-segment depression (ST-D; group A pos). We observed 41 ST-D (1-11 ST-D; median: 2) lasting from 1 min to 70 min 15 s (median: 4 min 42 s) and an average depression of 185 +/- 48 mV. In comparison, in 6 of 23 patients (26%) with a normal angiogram 24 ST-D (1-10; median: 3; group B pos), which showed longer duration (1 min to 109 min 20 s; median: 11 min 10 s) and less depression (137 +/- 47 mV) have been found. 73.3% of all ST-D in group A pos and all in group B pos were preceded by an average increase in heart rate of 13 bpm. Exclusively, 12 episodes of ischemia (29.3%) in patients with CAD and 8 (33.3%) in patients without CAD were accompanied by an increase in blood pressure, which was more distinct in group A pos. Transient myocardial ischemia can be shown in hypertensive heart disease unrelated to CAD. A clear correlation between an increase in blood pressure and ST-D could not be proven.
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PMID:[Blood pressure variability and transient myocardial ischemia in patients with essential hypertension]. 151 10

To evaluate the clinical significance of asymptomatic ischemic heart disease, exercise electrocardiography and stress myocardial scintigraphy were performed. These were correlated with symptoms during exercise tests and histories of myocardial infarction (MI). The study subjects consisted of 70 patients with coronary artery disease, including 34 with MI, and 36 without MI but with angina pectoris. Stress tests were performed using bicycle ergometer under electrocardiographic monitoring throughout the test. Transient myocardial ischemia was confirmed by perfusion defects on thallium myocardial imaging demonstrated immediately after exercise, but not 3 hours after the stress test. Asymptomatic ST depression was observed in 18 of 34 patients with MI (53%) and in 21 of the 36 patients with angina (58%); however, transient myocardial perfusion defects were confirmed in 61% of the patients with MI (11 of 18 patients), but in only 33% of those with angina (7 of 21 patients). The difference was statistically significant (p less than 0.05). It was suggested that there are some differences in the clinical significance of asymptomatic ST depression between the patients with MI and those without MI but with angina pectoris.
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PMID:[Stress myocardial scintigraphy in coronary artery disease: its clinical significance]. 181 79

Out of 432 patients with coronary heart disease, 106 (24.5%) were found to have transient myocardial infarction during ECG monitoring of ST segment for 10 hours of daily activity. High-grade ventricular arrhythmias were revealed in 74.6% of mainly male and middle-aged subjects. 63.4% of the patients exhibited congestive heart failure, 48.1% had postinfarct cardiosclerosis, and 25.5% presented with diabetes mellitus. Transient myocardial ischemia was more frequently detected during exercise and more rarely during emotional stress (21.7%), meal (19.8%), and smoking (7.8%). Asymptomatic episodes of ST segment elevation were recorded in 36.8%, while asymptomatic episodes of ST segment depression, in 29.2%. The duration of asymptomatic episodes of ST segment elevation and depression was twice and 1.5 times, respectively, less than that of symptomatic ones. Substantial myocardial perfusion and metabolic impairments were revealed with an asymptomatic ST segment depression frequency of at least one an hour, an amplitude of more than 2 mm, and a duration of no less than 40 min.
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PMID:[Clinical evaluation of transient myocardial ischemia]. 223 60

The availability of ambulatory ECG monitoring allows identification of transient myocardial ischaemia, the clinical relevance of which is currently being investigated. Ninety-four consecutive patients with ischaemic heart disease and a positive exercise test (greater than or equal to 1 mm ST-segment depression) were studied to evaluate the prevalence of transient myocardial ischaemia (either painless or painful) during 24-h dynamic electrocardiogram (ECG) and the clinical, angiographic and ergometric variables predicting its appearance. Two-hundred-and-eighty-one episodes of transient electocardiographic myocardial ischaemia were recorded in 69 patients (73.4% of all patients). Transient myocardial ischaemia was more frequent, although not significantly so, in patients with diabetes, with previous myocardial infarction, or with multivessel disease. When tested by multivariate analysis, neither the clinical variables nor the severity of coronary artery disease allowed prediction of the occurrence of transient myocardial ischaemia during dynamic ECG. The duration of exercise testing up to the ischaemic threshold (ST-segment depression = 1 mm) and the peak heart rate during exercise were more accurate predictors of transient myocardial ischaemia (P = 0.019 and 0.012 respectively). Patients with transient myocardial ischaemia had a lower ischaemic threshold (355 +/- 175 vs 498 +/- 150 s, mean +/- SD, P = 0.001) despite a lower peak heart rate (129 +/- 18 vs 137 +/- 12 beats min-1, P = 0.047) than patients without transient myocardial ischaemia. In conclusion, exercise testing may help select patients for examination by dynamic ECG.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transient myocardial ischaemia: a multivariate analysis on clinical, angiographic and ergometric variables. 231 14

We wanted to determine whether there are episodes of myocardial ischemia in hypertensive patients with a normal coronary angiogram. ST-segment analysis on 24-h-Holter ECG was performed in 35 patients (18 males/17 females; mean age 54.6 +/- 10.4 years) with essential arterial hypertension (systolic/diastolic blood pressure 189.7 +/- 29/99.5 +/- 15 mm Hg). Left ventricular muscle mass (LVMM), enddiastolic volume (EDV), and the relation of mass to volume (M/V) were measured by ventriculography. Stenosis of coronary vessels was excluded by angiography in all patients. In 16 of 35 patients we observed 6.63 +/- 6.73 episodes of transient myocardial ischemia (ST-segment depressions greater than or equal to 1 mm, duration of the episode greater than or equal to 1 min). The duration of the episodes was 29.3 +/- 58.1 min, the maximal ST-segment depression 1.6 +/- 0.6 mm. In 95% of the episodes the patients did not experience any angina pectoris ("silent ischemia"). The degree of left ventricular muscle mass did not differ in hypertensive patients with and without transient myocardial ischemia (185.2 +/- 48.3 vs 227.1 +/- 71.5 g/m2). Systolic wall stress i.e. afterload was significantly higher in hypertensive patients with ST-segment depressions than in those without. In conclusion, these results demonstrate that transient myocardial ischemia often occurs in hypertensive patients. It seems that left ventricular hypertrophy by itself (myocardial factor) does not play a major role. Transient myocardial ischemia occurs mainly in hypertensive patients with eccentric myocardial hypertrophy i.e. low mass-volume ratio and high systolic wall stress. Accordingly, the occurrence of transient myocardial ischemia in hypertensive patients seems to be dependent on the myocardial energy demand.
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PMID:[Transient myocardial ischemia in hypertensive patients]. 252 20

Transient myocardial ischemia is more frequently silent than accompanied by angina. The frequency of ischemia varies markedly from day to day, so that in order to accurately define the total ischemic burden, it may be necessary to quantitate ischemic episodes for periods longer than 24 hours. Therefore, a programmable, digital device was developed for long-term, interactive, ambulatory monitoring of the electrocardiogram, which uses variations in a time-averaged ST level as an indicator of myocardial ischemia. The electrocardiographic signal is digitized at 256 Hz and analyzed by an algorithm. If ST depression is planar or downsloping and persists for more than 40 seconds, and if the ST depression is equal to or more than a user-programmed threshold, the device marks the onset of an ischemic event and times it. The algorithm has been validated by comparison of its analysis of the ST segment to human and computerized analyses of frequency-modulated Holter recordings and stress tests. To assess the feasibility and utility of long-term monitoring, patients with documented coronary artery disease were monitored continuously for 14-day periods. Of 26 patients enrolled, 8 completed a protocol for individualization of anti-ischemic therapy using transdermal nitroglycerin. Over 90% of ischemic episodes in this group of patients, all of whom had had a previous myocardial infarction, were silent. Treatment with 10 mg of transdermal nitroglycerin reduced the number of ischemic episodes by 59% and the duration of ischemia by 60% (p less than 0.001); there was no diminution in the effectiveness of treatment from week 1 to week 2.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Quantitation of transient myocardial ischemia by digital, ambulatory electrocardiography. 312 90

Transient myocardial ischaemia during daily life, detected by ambulatory electrocardiographic monitoring, was investigated in 42 patients with chronic stable angina and documented coronary artery disease. Ambulatory monitoring was initiated for 36 hours after all prophylactic antianginal medication had been withdrawn for 5 days. There were 196 episodes of ST-segment depression, 145 (74%) of which were not accompanied by angina. As well, a tendency to more prolonged and greater ST-segment change with symptomatic ischaemic episodes was noted. A diurnal variation in transient ischaemia both with and without symptoms was observed, the highest frequency being in the morning hours. Transient myocardial ischaemia was more frequent in patients with double or triple vessel disease, compared with single vessel disease, but with a great variation. Heart rate at the onset of ischaemia during ambulatory monitoring was significantly lower than heart rate at the onset of ST-segment change during exercise testing (100.2 +/- 14.6 vs. 115.8 +/- 19.6 beats/min, p less than 0.01), which may indicate different pathophysiological mechanisms. Transient impairment in coronary oxygen supply seems to be of importance during ischaemic episodes out of hospital.
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PMID:Transient myocardial ischaemia during ambulatory monitoring out of hospital in patients with chronic stable angina pectoris. 318 81

Transient myocardial ischemia during cardiac surgery causes a loss of energy sources, contractile depression, and accumulation of metabolites and H+ ion resulting in intracellular acidosis. The reperfusion following ischemic cardioplegia recovers intracellular pH, activates Na+-H+ exchange and Na+-Ca2+ exchange transports and consequently produces Ca2+ overload, which yields cell death. Among the various Ca2+ entry pathways, the Na+-Ca2+ exchanger is known to play one of the major roles during the ischemia/reperfusion of cardioplegia. Consequently, information on the changes in intracellular Ca2+ activities of human cardiac myocytes via the Na+-Ca2+ exchanger is imperative despite previous measurements of Ca2+ current of human single myocytes. In this study, human single myocytes were isolated from the cardiac tissues obtained during open-heart surgery and intracellular Ca2+ activity was measured with cellular imaging techniques employing fluorescent dyes. We report that the Na+-Ca2+ exchanger of adult cardiac myocytes is more susceptible to hypoxic insult than that of young patients.
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PMID:Hypoxia delays the intracellular Ca2+ clearance by Na+-Ca2+ exchanger in human adult cardiac myocytes. 1145