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)

The thromboxane (TX) synthetase inhibitor dazoxiben (80 micrograms/kg X min) and the prostacyclin analogue iloprost (0.6 micrograms/kg X min) were investigated in a cat model of acute myocardial ischaemia (MI) plus reperfusion. The agents were i.v. infused starting 30 min after LAD occlusion until the end of the observation period (5h). Dazoxiben significantly reduced the MI-induced increase in TXB2 and platelet ATP secretion. Dazoxiben did not influence the MI-induced depression in platelet count (PC), the fall in CK-specific activity or the ECG alterations associated with reperfusion whereas iloprost resulted in a nearly complete recovery of these parameters. These data suggest an efficacy of PGI2 administration but not of TX synthetase inhibition in preserving the myocardium from reperfusion injury. These data indicate that reperfusion-induced tissue damage appears not to be a thromboxane-dependent phenomenon.
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PMID:Comparison of the thromboxane synthetase inhibitor dazoxiben and the prostacyclin mimetic iloprost in an animal model of acute ischaemia and reperfusion. 608 83

The purpose of this study was to evaluate the detectability of stress-induced ischemic lesion in patients with previous myocardial infarction using single photon emission computed tomography (SPECT) producing thallium-201 (T1-201) myocardial perfusion imagings (MPI). Seventy patients underwent stress SPECT by symptom-limited graded bicycle ergometer exercise using a dual-headed rotating gamma camera (Toshiba GCA70A) equipped with a computer system (GMS90). After intravenous administration of 2.5 mCi of T1-201, stress SPECT data at 10 minutes and delayed SPECT data at 3 hours after the injection were collected in the 64 X 64 matrix form covering 360 degrees directions by camera sweep of 180 degrees in 6 minutes, which were immediately followed by conventional planar imagings (PL). Transaxial tomographic image reconstruction was performed by convolution method using a Shepp-Logan's filter. Thereafter, sagittal and coronal tomographic images were reconstructed for about 2 minutes. Image interpretation was assessed visually. The results were as follows: Sensitivity and specificity in detecting the affected vessel with more than 75% stenosis by segmental analysis of myocardial images were higher by SPECT than by PL (LAD 89% and 65%, LCX 68% and 56%, RCA 89% and 76% in sensitivity and LAD 94% and LCX 75%, 92% and 94%, RCA 81% and 59% in specificity, respectively). Sensitivity in detecting both single (82%) and multivessel disease (76%) was fairly high. Detectability of stress-induced ischemia (i.e. occurrence of a new defect in patients with previous myocardial infarction and ST-segment depression in ECG) was significantly higher in SPECT (67%) than in PL (39%, p less than 0.005) and in ECG (39%, p less than 0.005). A perfusion defect in the extensive anterior wall, marked left ventricular dilatation and the widening of the angle toward the apex composed of septal and anterolateral walls in transaxial images were the findings characteristic of anterior myocardial infarction with severe dyskinesis. We conclude that stress SPECT is a useful noninvasive technique for the documentation of the number of vessels affected and severe wall motion abnormality of the LV and for the detection of stress-induced ischemia in previous myocardial infarction.
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PMID:[Detectability of stress-induced ischemic lesion in previous myocardial infarction using 201T1 myocardial single photon emission computed tomography]. 633 58

The predictive value of exercise stress testing was assessed by correlating the results with coronary angiography in a group of 100 patients 50 with inferior and 50 with anterior wall infarction. The following observations were made: --The exercise ECG was positive in 57 p. 100 of cases, more commonly in the inferior infarction group (74 p. 100), ST depression representing over 3/4 of the responses to exercise. On the other hand, the test was only positive in 40 p. 100 of anterior wall infarctions, ST depression again being the most commonly recorded response (65 p. 100). --The overall incidence of post-infarction angina was 45 p. 100; it was more common after inferior (70 p. 100) than anterior infarction (22 p. 100). --Multivessel disease was also more severe in the inferior infarction group (86 p. 100) than in anterior infarction (46 p. 100). However, ventricular aneurysms were twice as common in the anterior infarction group. --Exercise testing detected 80 p. 100 of cases with multivessel disease, especially when the LAD artery was involved, in the inferior infarction group. In the anterior infarction group, almost 50 p. 100 of patients with multivessel disease were not diagnosed. Despite an overall sensitivity of 73 p. 100 the predictive value of exercise stress testing was excellent (84 p. 100). In conclusion, in the presence of persisting angina after myocardial infarction coronary angiography should be performed to determine the severity of the multivessel disease. Exercise stress testing is a useful but imperfect method of detecting this high risk group. Its predictive value is however better in inferior (94 p. 100) than in anterior wall infarction (65 p. 100). Persisting angina was found to be a parameter of very high specificity (100 p. 100) for the presence of multivessel disease.
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PMID:[Predictive value of the exercise test after primary infarction]. 640 28

The aim of this study to assess the predictive value of exercise stress testing (ET) compared with coronary angiography-left ventriculography (CLV) in 102 patients undergoing physical rehabilitation (PH) after myocardial infarction (MI). The ET was optimised in its performance by the PH and in its interpretation by the selection of the parameters according to the site of MI. In anterior MI, angina (30%) and ischemic ST depression outside the acute period (35%) had little predictive value of multivessel disease which was demonstrated in 40% of cases; on the other hand, ST elevation in the same area as MI (65%) had an 88% predictive value for severe LV impairment which was found in 66% of cases. In inferior MI, ischemic ST depression (75%) more than angina (27%) was of greater predictive value (82%) for multivessel disease which was demonstrated in 59% of cases. The sensitivity was 97% and the specificity 64%; the LAD artery was diseased in 48% of cases. LV function was preserved in 63% of cases, but ET was not useful in the prediction of this parameter. In all cases of MI, the absence of ST changes predicted single vessel disease in 94%; ventricular arrhythmias (5%) stopped the patients reaching a discriminative exercise level but indicated poor LV function. The extreme values of heart rate and double product improved the correlations between ET and CLV. Therefore, ET may provide some of the information of CLV before the usual evolutive criteria and may help avoid this investigation in patients with favourable results, especially with inferior infarction. Although it has no absolute value, systematic ET is justified after MI as it enables the most severe cases to be distinguished from the most benign.
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PMID:[Correlations between coronary and ventricular angiography and the exercise test after myocardial infarction]. 641

Eighty patients admitted to hospital between 1975 and 1980 for "non-transmural" myocardial infarction (72 men, 8 women, mean age 56 +/- 9 years) were studied. The diagnosis was based on a severe attack of pain of over 30 minutes duration, increased serum cardiac enzyme levels (CKMB greater than 24 U; SGOT greater than 60 U), pyrexia and signs of inflammation. The patients were divided into two groups according to their ECG changes: Group A: "rudimentary" infarction with prolonged T wave inversion from V1 to V5, narrow transient Q waves and reduction of R wave amplitude in the corresponding leads; Group B: persistant prolonged, intercritical ST depression greater than 2.5 mm (subendocardial infarct). All patients underwent selective coronary angiography and left ventriculography in the RAO projection within 15 days of admission. The angiographic data (coronary score, ejection fraction, alinetic perimeter) were compared to those of 2 randomly chosen control groups: Group C: 30 inferior wall infarcts with coronary angiography and regularly followed-up; Group D: 30 transmural anterior infarcts with coronary angiography, regularly followed-up. Four factors were analysed during follow-up: the incidence of death after discharge from hospital, transmural infarction, unstable angina and cardiac failure. All patients were treated medically (nitrate derivatives, betablockers, calcium antagonists). Sixteen patients in Group A (p less than 0,025) were operated and excluded from the prognostic study. The angiographic data showed a high incidence of isolated, severe LAD disease in Group A (59.2% of cases) and that multivessel disease was commoner in Group B (78.4%). A collateral circulation revascularising the LAD was observed in 42% of patients in Group A. (ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[So-called rudimentary or nontransmural myocardial infarction. Coronary lesions, course and prognosis]. 643 44

To assess the results of transluminal coronary angioplasty (TCA), 42 patients (mean age 50 years) with for coronary artery disease were investigated at rest and during exercise with the ECG (n = 40), thallium-201 myocardial scintigraphy (n = 23) and equilibrium-radionuclide ventriculography (n = 32). Each method of stress testing was quantified: the exercise ECG by means of an ischemia score, incremented with increasing ST-segment depression and decremented as a function of duration of exercise and workload in watts; thallium-201 scintigraphy by means of an index for minimal to maximal perfusion region (vitality index) and redistribution factors; equilibrium-radionuclide ventriculography by means of global ejection fraction and maximum systolic volume change with respect to the end-diastolic volume. The patients were divided into three groups: 30 had successful TCA defined as demonstrating at least a 20% reduction in the stenosis; six underwent aortocoronary bypass operation (nine grafts; complete revascularization in four patients); and in six patients TCA was unsuccessful. TCA was successful in 24 LAD stenoses, 5 RCA stenoses, and in one proximal anastomosis of an aortocoronary bypass graft. Dilatation could not be achieved in three LAD stenoses and three stenoses of the RCA. In those in whom it was successful, TCA yielded an average reduction of coronary artery stenosis from 84 to 43%. Both TCA and bypass operation (OP) led to comparable degrees of functional improvement. The ischemia score decreased from 2.8 to 0.9 after TCA and from 1.6 to 0 after OP. The vitality index increased from 67 to 77% and from 74 to 81% after TCA and OP respectively while the corresponding redistribution factors decreased (TCA: at 1 hour from 5 to 1% and at 3.5 hours from 11 to 4%; OP: at 1 hour from 2.2 to 1.4% and at 3.5 hours from 7.6 to 4.1%. The global ejection fractions at rest improved from 46 to 52% and from 38 to 45% and during exercise from 42 to 50% and from 36 to 43% after TCA and OP respectively. The maximum--dV/dt/EDV increased at rest (TCA: from 2.7 to 3.5 per second; OP: from 2.1 to 3.8 per second) and during exercise (TCA: from 3.1 to 4.0 per second; OP: from 2.6 to 3.3 per second). In the group with unsuccessful TCA, no significant differences in the latter parameters were observed. Ten of the 30 patients who had undergone successful dilatation were reinvestigated after three months. Maintenance of good functional results could be documented in eight while deterioration was seen in two patients, one with a significant restenosis and one who developed a new narrowing distal to the successfully dilated stenosis. Thus, the results show that in selected cases, TCA can render improved ventricular function and perfusion comparable to that of aortocoronary artery bypass surgery.
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PMID:[Improved myocardial function after transluminal coronary angioplasty (author's transl)]. 697 30

Different ECG criteria are evaluated with respect to their ability to identify individuals with critical lesions of the coronary arteries in a population of patients with severe angina. Six chest leads and the the limb leads were recorded in 85 patients by computer during maximal, symptom-limited exercise ECG testing. Averaging of ECG complexes enhances the signal quality and makes it possible to use measurements of the limb leads recorded during exercise. 14 patients with abnormal Q waves in lead V2 were excluded from ST analysis. In the remaining 71 patients, more than 1/3 mm ST depression in lead I and/or more than 2.0 mm ST depression in any of the chest leads had a sensitivity of 85% and a specificity of 67% for lesions in the main stem and/or proximal LAD and/or three-vessel disease. The predictive value of a positive test was 83%. This and other criteria were evaluated for different disease groups and a different stages during the exercise test.
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PMID:Computerized exercise ECG in the diagnosis of critical coronary lesions. 707 62

A case report of an operation after CABG and AVR was presented. The patient was a 52-year-old female. She underwent CABG with saphenous veins at 43 years old and AVR at 45 years old. She was admitted to our hospital due to acute myocardial infarction. Coronary angiography revealed that all the native coronary arteries were occluded at the proximal side, two grafts to RCA and CX were occluded, and LAD graft had a 99% stenosis. She became critically ill due to low cardiac output and acute renal failure. Endoartrectomy of the LAD graft was performed under CPB. Early postoperative course was uneventful. Severe ST depression in the pre-operative ECG normalized in the postoperative ECG. But she had a chest pain again in the 4th postoperative week. She became critically ill and died on the 43rd postoperative day. It was thought that redo CABG should have been performed after her condition improved.
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PMID:[A case report of an operation for graft stenosis with complete obstruction of the coronary artery]. 756 44

To extend the usefulness of multi-lead ambulatory electrocardiography, we attempted to construct body surface isopotential maps of ST segment using our newly designed multi-lead ambulatory electrocardiograph. Material consisted of 40 patients (pts) with angiographically proven coronary arterial stenosis. By a commercially-available 4-channel recorder and a specially designed adapter, 30-lead ECGs were sequentially recorded together with body position signals for 24 hours. Compensation for ST distortion and interpolation of ST level on time scale techniques were performed before construction of ST maps. The extension of ST depression area in pts with single LAD disease were larger than in pts with single LCX or RCA disease. As time elapsed, after occurrence of ischemia the extension and location of ST depression area were changed. These results were thought to be reasonable. In conclusion, the ambulatory recording of body surface ST maps may become useful for study of myocardial ischemia in daily life.
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PMID:[Body surface ST mapping in daily life using multi-lead ambulatory electrocardiograph]. 789 42

Seventy patients who underwent elective resection of symptomatic postinfarction apico-anterior left ventricular (LV) aneurysm with or without coronary revascularization are reviewed. The early (< or = 30 day) mortality was 5.7%. Mural thrombosis occurred in 29 cases (41.4%), unrelated to the degree of preoperative LV impairment and predictable from preoperative LV angiography in only seven cases. The response to surgery comprised significant overall improvement of global LV ejection fraction (LVEF) during rest and of all variables in stress testing. This LVEF recovery correlated significantly with that of peak ejections rate, a variable of myocardial contractility. Contrastingly, right ventricular ejection fraction (RVEF) at rest decreased slightly but significantly without correlation to preoperative RVEF or LVEF. In comparisons between patients with congestive heart failure or angina at rest as dominant symptom, the former group showed greater depression of preoperative watt and LVEF but better postoperative recovery of these variables, while right ventricular deterioration was significant only in the latter. Postoperative recovery was best in patients with poor preoperative LV function (LVEF < or = 20%), even when surgery comprised only aneurysmectomy in isolated but ungraftable LAD disease (5 cases). The observed RV deterioration may be 'nonspecific', but it must be kept in mind as a side effect of the operation, as it detracts unpredictably from postoperative ventricular recovery. Patients with well preserved preoperative LVEF, small LV aneurysm and marginal expected post-aneurysmectomy changes according to LaPlace's law are probably at risk, and surgery should then instead be directed towards preserving the remaining viable myocardium by direct revascularization.
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PMID:Surgery for chronic left ventricular aneurysm. Benefits and side effects. 819 30


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