Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and twenty-five consecutive patients being submitted for coronary cinearteriography were subjected to preliminary graded exercise testing using a Quinton treadmill and ECG data computer. Patients with disease of the left main coronary artery are at particular risk during coronary arteriography and it was hoped that exercise testing might identify these patients. This hope was not realised. A satisfactory end point to the exercise test was either the attainment of 85% of the maximal heart rate assessed for age, or ST segment depression greater than 2 mm. Exercise induced angina also formed an end point to the test and was considered a positive result. Results were determined by McHenry's discriminant analysis. The sensitivity of the exercise test was 66, 88 and 92% for one, two and three vessel disease respectively. Specificity was at least 83%. Exercise induced ST segment elevation occurred in four patients all of whom had previous extensive anterior wall infarction. Exercise testing is without risk in patients with ischaemic heart disease provided well defined precautions are taken.
 ...
PMID:The correlation of the computer quantitated treadmill exercise electrocardiogram with cinearteriographic assessment of coronary artery disease. 28 92

The effect of coronary arterial bypass surgery on exercise-induced ventricular arrhythmias and their relation to sudden death was examined in 102 patients with stable angina pectoris randomly assigned to medical and surgical therapy (54 and 48 patients, respectively). Symptom-limited treadmill tests were performed at entry and at 1 and 5 years. The surgical group demonstrated significant improvement in exercise performance at 1 year compared with the medical group, and at 5 years exercise-induced ischemia as evidenced by S-T depression and exertional angina remained substantially decreased in the surgical group with little change in the medical group. However, the frequency and severity of exercise-induced ventricular arrhythmias in each group remained unchanged at 1 and 5 years from those at entry. Similar results were obtained from an evaluation of ventricular arrhythmias in the electrocardiogram at rest. With the exception of exercise-induced ventricular tachycardia and fibrillation, no relation was found between ventricular arrhythmias and sudden death. Coronary bypass grafting does not decrease the frequency or severity of exercise-induced or resting ventricular arrhythmias. In patients with stable angina pectoris, with the exception of ventricular tachycardia and fibrillation, exercise-induced ventricular arrhythmias are poor predictors of sudden death. The data suggest that exercise-induced ventricular arrhythmias may not be related to ischemia but to other effects of exercise such as cardiac stimulation by catecholamines or other factors.
 ...
PMID:Effect of coronary arterial bypass surgery on exercise-induced ventricular arrhythmias. Long-term follow-up of a prospective randomized study. 31 62

The effects of glucose-insulin-potassium (GIK) and placebo normal saline (S) infusion on treadmill-walking time to angina, ST depression, heart rate (HR), systolic blood pressure (SBP), rate pressure product (RPP), blood glucose (G), lactate (L) and free fatty acids (FFA) were studied in 14 non diabetic patients with exertional angina. For the whole group, the post-GIK walking time to angina (393 +/- 33 sec, mean +/- SEM) was greater than the values during control GIK (319 +/- 20 sec, p less than 0.02) and post-S infusion (334 +/- sec, p less than 0.05), but circulatory and ST responses were similar in post-GIK and post-S studies. 7 of the 14 patients experienced significantly greater improvement in exercise tolerance following GIK (467 +/- 39 sec) in comparison to control GIK (313 +/- 29 sec, p less than 0.001) and post-S infusion (334 +/- 32 sec, p less than 0.005) and exercised to a higher HR, SBP and RPP after GIK than after S infusion. At the onset of angina these patients had similar ST-segment depression before and after GIK but when ST segments were assessed after GIK at the same exercise duration when angina had occurred during the control and post-S studies, there was significantly less ST depression (p less than 0.01). Of the remaining 7 patients exercise tolerance following GIK deteriorated in 3, remained unchanged in 2 and increased by 12 and 48 sec in 2 patients in comparison to post-S values. Comparison of post-GUK and post-S values for G, L and FFA for the whole group showed significantly lower resting values of FFA and post-exercise values of G following GIK infusion. The differences in clinical and circulatory responses between patients who improved and those who did not improve following GIK were not related to the angiographically determined severity of coronary artery disease or to GIK-induced metabolic changes. Results suggest that some patients with angina pectoris do benefit from GIK infusion but the response in a given patient to this therapeutic modality is unpredictable.
 ...
PMID:Effects of glucose-insulin-potassium infusion on the angina response during treadmill exercise. 38 19

A comparison of the clinical data and those of ECG under physical exercises with the results of coronary angiography is presented for 130 patients with the ischaemic heart disease, aged 28 to 68 years; 63 of them had survived myocardial infarction, 63 had angina of effort, 65--angina at rest and angina of effort, 2 presented no complaints. The comparison of the clinical and coronarographic data demonstrated a high correlation in cases of angina; in 85.3% of the patients with typical angina pectoris coronary angiography revealed anatomic changes in the coronaries. Having compared the data to the positive exercise test with the results of coronary angiography, the authors found that 87.9% of the examined patients have--with a positive exercise test--coronary lesions and the S--T segment depression during physicial exercises 1 mm below the iso-electric line, which permits to diagnose anatomic changes in the coronaries. According to the authors, an acute onset of the disease, a brief history (up to 1 year) and a prompt restoration of the ECG following physical exercises are typical rather for local lesions of one coronary branch.
 ...
PMID:[Comparison of the electrocardiographic, clinical and coronarographic data in ischemic heart disease after physical exertion]. 103 Jul 54

In our department we have reviewed the use of ergonovine maleate as a provocative agent for inducing coronary spasm during coronary arteriography. From January 1978 to December 1991 the test has been performed in 116 patients. According to their symptoms, the patients were divided into 4 groups: (A) patients with exertional angina: 16 patients (13.8%), (B) patients with angina at rest: 64 patients (55.2%), (C) patients with atypical chest pain: 29 patients (25%), and (D) patients with previous myocardial infarct: 7 patients (6%). We have subdivided the patients with angina at rest, according to the electrocardiogram recorded during pain, into: (1) 16 patients with ST-segment elevation; (2) 14 patients with ST-segment depression or T wave inversion; (3) 5 patients with electrocardiogram unchanged during angina; (4) 29 patients with no electrocardiogram recorded during angina. In 67 patients (57.7%) the coronaries were normal, 17 patients (14.6%) had mild irregularities, 26 patients (22.4%) had non critical fixed obstructions (< or = 70%), and in 6 patients (3.5%) there were fixed coronary narrowings > or = 70%. The left ventricle was normal in 85 subjects (73.2%), hypo or akinetic in 31 (26.8%). After routine coronary angiography and ventriculography, ergonovine maleate, 0.05 up to 0.4 mg, was given intravenously. The ergonovine test was considered positive when a focal spasm narrowed a normal coronary artery, or one with a mild fixed obstruction (< or = 50%) to more than 70%, or when a 70% stenosis became occluded. The development of angina and/or electrocardiographic changes were not taken as a criteria of positivity. Thirteen tests (11.2%) were considered positive.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[The use of ergonovine in the hemodynamics laboratory]. 129 54

Six patients (2 males and 4 females, mean age of 46 years) with X syndrome were reported in this paper. All patients presented with typical exertional angina pectoris. In 4 patients the angina had a variable threshold of onset, it often occurred at rest and occasionally nocturnally. The electrocardiogram during chest pain showed ST segment depression of more than 0.05-0.1 mV in all 6 patients. The treadmill or bicycle ergometer exercise test was positive in 4 cases (ST segment depression > 0.1 mV), equivocal in 1 (ST segment < 0.1 mV) in whom the 201Tl exercise myocardial perfusion scan showed sign of ischemia, and negative in 1 in whom atrial pacing at heart rate of 135 beats/min induced angina and ST segment depression of 0.1-0.15 mV. Echocardiograms and X ray chest films revealed no sign of ventricular hypertrophy or enlargement. The 201Tl exercise myocardial perfusion scan was performed in 5 patients, which showed signs of ischemia in 4 patients and suspected to have ischemia in 1. Left ventriculograms and coronary angiograms were normal in all 6 patients. Ergonovine provoking test (total dose of 0.4 mg) was negative in 5 patients, it was not performed in 1 in whom there was no evidence of coronary artery spasm by angiogram during appearance of electrocardiographic ischemic changes and chest pain. Left ventricular endomyocardial biopsy was performed in 1 patient, which showed significant smooth muscle cell proliferation in the medial layer of a small artery with diameter of 62.5 mu which produced narrowing of the lumen.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[X syndrome--report of six cases]. 130 21

Identification of patients with angina but normal coronary arteriograms (syndrome X) using noninvasive means would be desirable. The ability of four established exercise electrocardiographic methods to identify angina patients with and without coronary artery disease was compared with that of a method based on a combination of the above (combined method). A treadmill score, a multivariate method, the ST segment recovery loop, the ST/heart rate adjustment, and the combined method were applied to 112 patients who had typical exertional angina and positive exercise tests (greater than 1 mm ST segment depression); 90 had documented coronary artery disease and 22 had syndrome X. The combined method and the treadmill score had a significantly higher diagnostic accuracy (both 81%, as 91 of the 112 patients were correctly identified by both methods) than the multivariate (66%) and ST segment recovery loop (64%) methods (p less than 0.05). The ST/heart rate adjustment had a lower sensitivity for syndrome X than any other method (1 of 22). Thus methods that involve the assessment of both ST and non ST segment variables have greater accuracy in separating syndrome X and coronary artery disease patients than methods relying more heavily on ST segment changes.
 ...
PMID:A combination of electrocardiographic methods represents a further step toward the noninvasive identification of patients with syndrome X. 134 74

We evaluated the effects of a single oral dose of 5 mg of isradipine compared to placebo in a randomized, double-blind, crossover study using gated radionuclide angiography at rest and during exercise in 20 patients with stable chronic angina. Isradipine improved both anginal symptomatology and ST-segment depression during exercise, with a concomitant favorable effect on the isotopic parameters exploring systolic and diastolic left ventricular function. There was a marked increase of the ejection fraction during exercise with isradipine compared to placebo (61 +/- 14% vs. 55 +/- 15%, respectively, p less than 0.001) as well as a significant improvement in the peak ejection rate and the peak filling rate at rest [2.56 +/- 0.62 vs. 2.16 +/- 0.54 end diastolic volume (EDV) per second and 2.14 +/- 0.59 vs. 1.87 +/- 0.37 EDV/s, respectively] and during exercise (3.49 +/- 0.97 vs. 3.10 +/- 1.07 EDV/s and 4.05 +/- 1.34 vs. 3.65 +/- 1.25 EDV/s, respectively). We conclude that isradipine has a beneficial effect on the clinical and electrocardiographic signs of exercise-induced ischemia, leading to a significant improvement of the systolic and diastolic parameters of left ventricular function. Therefore, isradipine is potentially a useful treatment for patients with exertional angina and hypertension, alone or associated with beta blocker medication.
 ...
PMID:Effects of oral isradipine on left ventricular function at rest and during exercise in patients with stable chronic angina: a double-blind, placebo-controlled crossover study. 137 79

In patients with chronic stable exertional angina pectoris, the antianginal and anti-ischemic efficacies and the safety of 25 mg carvedilol b.i.d. were compared with those of 20 mg nifedipine sustained-release (SR) in a double-blind, randomized, multicenter study. In 22 centers, 166 patients were enrolled. After washout and run-in phases with two symptom-limited seated bicycle exercise tests on placebo, eligible patients were allocated to one of the two parallel treatment groups. After 4 weeks of active treatment, an additional exercise test was performed 12 h after the preceding dose. The patients were issued diary cards to document the daily number of anginal attacks and glyceryl trinitrate applications. Symptom-limited total exercise time, time to onset of angina, and time to 1-mm ST-segment depression increased with both treatments vs. placebo baseline values. The changes were more distinct in the carvedilol group, but the between-group differences were not statistically significant. Angina symptomatology during daily life and glyceryl trinitrate consumption were markedly improved by each treatment. Adverse events on treatment, particularly those correlated to vasodilation, were less frequent in the carvedilol group.
 ...
PMID:Efficacy and safety of carvedilol in comparison with nifedipine sustained-release in chronic stable angina. 137 39

Stress-induced wall motion abnormalities are a sensitive marker of myocardial ischaemia. Stress echocardiography has recently been the subject of increasing interest because of its improved feasibility and compatibility with new and effective alternative stresses. Transoesophageal atrial pacing (TAP) with 2-dimensional echocardiography (2-D echo) is a recently developed echo-cardiographic stress procedure that has been shown to be reliable and effective in both the diagnosis and evaluation of stress-induced myocardial ischaemia. TAP with 2-D echo was performed after treatment with placebo and intravenous gallopamil 0.03 mg/kg in 12 patients with stable, reproducible angina of effort. Compared with placebo, gallopamil treatment increased the time to 1 mm ST-segment depression (6.6 vs 5.3 minutes; p less than 0.05) and improved the ventricular wall motion score at a heart rate of 130 beats/min (17 vs 15; p less than 0.01) and 150 beats/min (13 vs 11; p = 0.07). Three patients who developed angina after placebo administration were symptom-free after gallopamil. Thus, gallopamil exerts a beneficial effect on atrial pacing-induced ischaemia, by increasing the pacing time to the ischaemic threshold and reducing the extent of dysfunctional myocardium during ischaemia.
 ...
PMID:The importance of stress-induced cardiac wall motion abnormalities in the evaluation of drug intervention. 137 86


1 2 3 4 5 6 7 8 9 10 Next >>