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 association between ventricular ectopic activity (VEA) and ischemic episodes during everyday activities was investigated in ambulatory patients with stable angina pectoris. Seventy-five consecutive patients with proven coronary artery disease, ischemic episodes on Holter monitoring and positive treadmill tests, but without known ventricular arrhythmias, were prospectively studied. In these 75 patients, a total of 719 ischemic episodes were recorded during 127 twenty-four-hour monitoring periods. Forty-three patients had either no or only very low baseline VEA (less than 14 ventricular premature complexes [VPCs]/24 hours); none of these patients had increased VEA during any ischemic episode. However, among 32 patients who had greater than or equal to 14 VPCs/24 hours (average 243 VPCs/24 hours), increased VEA during ischemic episodes was observed in 11 (31%). These 11 patients had a total of 174 ischemic episodes and the increased VEA appeared in 47 (27%) of the episodes. During 40 of the ischemic episodes the number of single VPCs increased significantly compared to the baseline background VEA: during 4 episodes trigeminy appeared and during another 3 bigeminy was observed. More complex VEA was not observed. Among the 11 patients with increased VEA, only 4 developed VPCs during treadmill testing. No correlation was found between the severity of the ischemic episodes (degree of ST depression and duration of ischemia) and the increased VEA. In 83% of these episodes the increased VEA appeared during the last (possibly reperfusion) phase. No correlation was found between the appearance of ventricular arrhythmias during ischemic episodes and the presence or absence of chest pain at the same time.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ventricular ectopic activity during myocardial ischemic episodes in ambulatory patients. 224 81

This study was designed to compare the direct actions of bupivacaine and lidocaine on the isolated perfused guinea pig Langendorff heart preparation. Sixty min after mounting, either bupivacaine HCl (0.3 or 3 micrograms/ml) or lidocaine HCl (10 or 30 micrograms/ml) was added to the perfusate, and the effect (if any) was compared to untreated control values 30, 60, and 90 min later. Although the highest concentrations of both drugs invariably produced statistically significant reductions in heart rate, df/dt, coronary blood flow, and myocardial oxygen consumption (MVO2), these reductions were consistently greater after bupivacaine. Moreover, arrhythmias occurred in 6 of 12 preparations in those hearts exposed to 3 micrograms/ml of bupivacaine. Most often these arrhythmias consisted of heart block and bi- or trigeminy. Additional studies indicated that the reduction in coronary blood flow and MVO2 produced by 3 micrograms/ml of bupivacaine was a consequence of its direct negative inotropic and chronotropic action. Although the myocardial depression produced by bupivacaine and lidocaine could be reversed readily by substituting fresh perfusate, increasing the extracellular calcium concentration in stepwise increments did not augment the negative inotropic or chronotropic effect produced by 3 micrograms/ml of bupivacaine or 10 micrograms/ml of lidocaine. We conclude that 3 micrograms/ml of unbound bupivacaine is more cardiotoxic than 30 micrograms/ml of unbound lidocaine in this model.
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PMID:Comparative cardiotoxicity of bupivacaine and lidocaine in the isolated perfused mammalian heart. 673 75

To evaluate the cardiac demands of hunting deer, continuous ambulatory electrocardiograms were obtained in men with and without coronary artery disease (CAD) and compared with their responses to maximal treadmill testing. A volunteer sample of 25 middle-aged men (mean +/- SD 55 +/- 7 years of age), 17 of whom had known CAD, completed the study. Peak heart rate (HR) during 7 different deer hunting activities was expressed as the mean percentage of the maximal HR (HRmax) attained during treadmill testing. Periods of sustained sinus tachycardia were identified. Arrhythmias and ST-segment depression during deer hunting that were not apparent during treadmill testing were documented. Overall, 22 of 25 subjects demonstrated HR responses >85% HRmax for 1 to 65 minutes. Ten subjects exceeded the HRmax achieved during treadmill testing for 1 to 5 minutes. The relative HR response during ambulatory activity in the field was inversely related to cardiorespiratory fitness, expressed as METs (r = -0.59; p = 0.0020). Three subjects had ischemic electrocardiograms during deer hunting, but not during treadmill testing. Complex arrhythmias in the field not detected by treadmill testing included ventricular bi-trigeminy, ventricular couplets, and 8 runs of ventricular tachycardia (3 to 28 beats) in 3 subjects with documented CAD. In conclusion, deer hunting can evoke sustained HRs, ischemic ST-segment depression, and threatening ventricular arrhythmias in excess of those documented during maximal treadmill testing. The strenuous nature of deer hunting coupled with presumed hyperadrenergia and superimposed environmental stresses may contribute to the excessive cardiac demands associated with this activity.
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PMID:Electrocardiographic responses to deer hunting activities in men with and without coronary artery disease. 1763 Oct 64

A 70-year-old woman with extensive psychiatric history, including depression and bipolar disorder, and past medical history of mitral valve prolapse repair (3 years ago) was brought in from the psychiatry ward to the emergency department for evaluation of ECG changes following electroconvulsive therapy (ECT). ECG done after the procedure showed ST elevations in V2-V3 and new T-wave inversions in the precordial leads. Troponin level was 0.23 ng/ml. An echocardiogram revealed apical akinesis with segmental wall motion abnormalities and a decreased ejection fraction of 30-35%. Cardiac catheterization revealed clean coronaries. A repeat echocardiogram 6 weeks after the event showed a normal ejection fraction. A diagnosis of tako-tsubo cardiomyopathy was made. ECT causes a significant increase in bigeminy, trigeminy, and supraventricular tachycardia. ECT is associated with a low mortality rate; in the range of 0.01-0.1% and 75% of these are attributable to cardiovascular causes. To our knowledge, this is the first reported case of tako-tsubo syndrome immediately following electroconvulsive therapy.
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PMID:Tako-tsubo cardiomyopathy following electroconvulsive therapy. 1943 Mar 44

Midazolam in an autoinjector was evaluated in an open-label dose escalation study involving 39 healthy participants. Safety and pharmacokinetic parameters were determined for doses ranging from 5 to 30 mg. No serious adverse events were noted during the study. Two participants (30 mg) experienced changes in their electrocardiogram (trigeminy and prolongation of QRS complex) that met the criteria for dose-limiting adverse events. No significant respiratory depression was noted during the study. The midazolam doses studied exhibited a median t(max) of 0.5 hours with a geometric mean terminal elimination half-life value of 4.1 hours (range, 2.9-4.5 hours). The extent of systemic exposure, assessed by area under the curve (AUC) and maximum concentration (C(max)), tended to increase proportionally with increasing doses from 5 to 30 mg; however, for the male 30-mg group, there was evidence of a larger than proportional increase in AUC.
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PMID:Human safety and pharmacokinetic study of intramuscular midazolam administered by autoinjector. 2046 72