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

In some patients with coronary disease hyperactivity of the lungs is commonly observed when the myocardial scintigraphic images are recorded during exercise. Pulmonary activity of radionuclide tracers has been reported in the literature and quantified in different ways. The present study contributes to this quantification by suggesting a new index: the pulmonary activity to cardiac activity percentages ratio during exercise and blood redistribution. The value of the new index has been evaluated comparatively in 11 subjects with normal coronary arteries (0.76 +/- 0.09) and in 39 patients with angiographically proven coronary disease (0.92 +/- 0.10; p less than 0.001). Remarkably, this index hardly varies in normal subjects and therefore is a highly specific aid to diagnosis. In coronary patients, multivariate analysis has shown that it correlates in decreasing order of intensity with: (1) a left ventricular end-diastolic pressure of 14 mmHg or more; (2) a moderate rise in heart rate at exercise; (3) a moderate heart work; (4) an ST depression of 2 mm or more; (5) a multilocular myocardial ischaemia at scintigraphy. Our index did not prove capable of discriminating between one-, two- or three- vessel diseases. In view of the data obtained in this study and those found in the literature, this index should be regarded as a reliable marker of left ventricular dysfunction during stress. Being relatively inexpensive and easy to obtain, it complements myocardial scintigraphy and may be useful in clinical practice.
Arch Mal Coeur Vaiss 1987 Dec
PMID:[Quantitative study of the pulmonary uptake of thallium 201 during exercise and redistribution in the coronary patient]. 313 5

A 42-year old man with non-obstructive myocardiopathy complicated by paroxysmal atrial fibrillation treated with amiodarone (200 mg per day) received flecainide in daily doses of 400 mg for undocumented palpitations. Ten syncopes and numerous malaises occurred during the following two months. Electrophysiological testing was performed, showing prolongation of HV to 80 ms and discreet widening of QRS to 100 ms. Programmed atrial stimulation failed to demonstrate a second degree subnodal block and to induce tachycardia. In contrast, ventricular stimulation elicited a critical SH delay (260 ms), always followed by a left delay-type complex preceded by His bundle deflection which suggested reentry within the His-Purkinje system. Three extrasystoles on imposed rhythm started sustained ventricular tachycardia with the same 270 ms cycle morphology and reproducing the symptoms. Each V wave was preceded by an H potential, with HV varying from 100 to 300 ms. Three weeks after flecainide was discontinued, HV was 60 ms, and no ventricular tachycardia could be triggered by programmed stimulation. The patient remained symptom-free throughout the 5-month follow-up. This case illustrates the proarrhythmic effect of the flecainide-amiodarone combination. The mechanism of provoked tachycardia probably involves ventricular reentry through the His bundle branches, induced by a critical depression of conduction below the His bundle.
Arch Mal Coeur Vaiss 1988 Apr
PMID:[Bundle branch reentry tachycardia: a possible mechanism of flecainide proarrhythmia effect]. 313 16

The respective diagnostic values of CM5 and V5 leads in exercise tests were studied in 100 patients, 89 of whom had coronary disease. Mean maximum ST depression and mean R wave amplitude at rest and at peak exertion were very much greater with CM5 than with V5 (p less than 0.0001). These two parameters seemed to vary concurrently. The contribution of both leads to the diagnosis in terms of sensitivity is probably the same; the more severe the coronary disease, the more pronounced the ST depression on CM5 tracings as compared to V5 tracings. A significant ST depression (1 mm) also appears more rapidly on the bipolar MC5 lead.
Arch Mal Coeur Vaiss 1988 Oct
PMID:[Respective diagnostic value of CM5 and V5 leads in exercise tests. Comparative study of 100 cases]. 314 57

Reproducibility of myocardial ischemia induced by atrial pacing (P) was investigated in 25 patients (pts) without previous anterior myocardial infarction and showing a positive exercise stress test. The second period of atrial pacing (P2) was exerted 20 minutes after the first (P1). During P2, a reduction in the parameters reflecting myocardial oxygen requirements (maximal left ventricular pressure, dp/dt max, TTI*HR values) was noted, while the signs of ischemia were less pronounced (ST depression decreasing from 2.3 +/- 1 mm to 1.6 +/- 1.0 mm; % of lactate extraction (%L) decreasing from - 6.4 +/- 25.5 to + 8.5 +/- 19.2; p less than 0.5). The 25 pts were divided into 2 groups according to the ejection fraction (EF greater than .55 16 pts Gr.F+; EF less than .55 9 pts Gr.F-). The distribution of coronary lesions was the same for the 2 groups. During P1 GR.F+ registered a negative % L as opposed to Gr.F-. During P2, the difference in the % L between the 2 groups was also significant (2.6 +/- 19.9% F+ vs 18.9 +/- 14.3% F-; p less than .05). Collateral circulation had no effect upon the results, neither for P1 or P2. This study shows that a second period of atrial pacing, 20 minutes after the first, induced lesser ischemia than the first period of atrial pacing. This phenomenon could explain the paradoxical improvement observed in certain patients after a first episode of angina. These results have implications as regards the necessity of double blind studies compared to placebo when using this technique in the evaluation of the effects of anti-ischemic drugs.
Arch Mal Coeur Vaiss 1988 Dec
PMID:[Reproducibility of myocardial ischemia induced by atrial stimulation]. 314 36

Cardiac tolerance to intravenous digital subtraction angiography (ANVV) was evaluated by a prospective study in a continuous series of patients of both sexes investigated for various arterial diseases and classified initially into "cardiac" and "non-cardiac" cases. Ischemic and rhythmic electrocardiographic modifications were monitored, the contrast medium (PC) used being randomly selected between Ioxaglate and Iopamidol. Of the first 46 patients studied, 40% had had more than one auricular and/or ventricular extrasystole (ES), 18% had painless depression of the ST segment (greater than or equal to 0.5 mm) and 46.7% both effects. In the 17 "cardiac" patients, depression of ST and the ES were more frequent (p less than 0.02 and p less than 0.05 respectively) than in the 29 "non-cardiac" cases. There was absence of difference between Ioxaglate and Iopamidol with respect to frequency of disorders of repolarization, but Ioxaglate appeared to provoke more ES than Iopamidol (respectively 13 of 23 and 5 of 22 cases, p = 0.02). Major cardiac complications were not reported, and it is concluded, after discussion of cardiovascular effects of PC injection, that intravenous digital subtraction angiography is generally well tolerated but requires some precautions in patients with cardiac affections.
J Mal Vasc 1987
PMID:[Evaluation of cardiac tolerance of intravenous digital angiography]. 329 96

The effects of three purine derivatives of adenine, adenosine triphosphate (Striadyne), purified adenosine triphosphate and adenosine, on conduction tissue, were studied in closed chest dogs with endocavitary recording catheters. The dogs were anaesthetised with pentobarbital and ventilated, then three bipolar catheters were positioned to allow atrial pacing and recordings of atrial and His bundle potentials. The purines studied were administered by rapid bolus intravenous injection. The dosage was identical based on a predetermined dose-response curve (dose of 2 mg/kg). The study of the effects on atrioventricular conduction was carried out before and after administration of antagonists: atropine, 0.08 mg/kg and aminophylline, 10 mg/kg. Twelve dogs were studied for each purine: 6 with initial premedication with atropine and then aminophylline, and 6 with the inverse sequence. Lengthening of AV conduction was due exclusively to nodal depression. No variation in the HV interval was observed (HV = 35 +/- 4 ms). Lengthening of AH interval was observed very soon after injection of the drugs (5 to 10 seconds) with a peak effect between 20 and 40 seconds. Reversion to the initial value always occurred in under 2 minutes. In the model studied, Striadyne and purified adenosine triphosphate were much more powerful than adenosine, both in intensity and duration; high degree AV block was obtained in 10 out of 12 cases with Striadyne and in 8 out of 12 cases with purified adenosine triphosphate, but in only 2 out of 12 cases with adenosine. The use of specific antagonists demonstrated the different modes of action of the three purines.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Jan
PMID:[Mode of action of purinergic derivatives of adenine on auriculo-ventricular conduction. Experimental study in dogs]. 391 75

Episodic mitral regurgitation due to ischaemia of one or both papillary muscles was studied in a review of 39 cases with complementary investigations and compared with previously reported data. The condition occurred after myocardial infarction in 69 p. 100 of cases (usually after inferior infarction: 54 p. 100) associated with ischaemia of the controlateral territory; there was no history of myocardial infarction in 31 p. 100 of cases. The patients were usually elderly (73 years), often hypertensive (77 p. 100) and diabetic (62 p. 100). The clinical syndrome was that of severe anginal pain, mitral regurgitation and left ventricular failure which was critical in some cases. The ECG showed typical ST depression (4.1 +/- 1.6 mm) especially in the antero-lateral leads; left bundle branch block (28 p. 100) with left axis deviation (18 p. 100), sometimes associated with changes of chronic infarction (64 p. 100) was also recorded. Mitral regurgitation and left ventricular failure regressed almost completely in typical cases between attacks, whilst the ECG showed slight residual sub-endocardial ischaemia (ST depression of 1.5 +/- 0.4 mm) in 30 cases and/or subepicardial ischaemia observed in the anterolateral leads in 13 cases. Phonomechanographic recordings (n = 32) showed moderate mitral regurgitation (1-2/6), usually parasystolic (47 p. 100) or early and mid systolic (36 p. 100) in 87.5 p. 100 of cases between attacks, aggravated by handgrip exercise and improved by trinitrin administration. Echocardiography (n = 27) only showed mitral valve changes in 2 patients (increased density of the papillary muscle in 1 case and prolapse of the anterior leaflet in 1 case); however, segmental wall hypokinetic (51 p. 100) or dyskinetic (15 p. 100) motion, was common with increased left ventricular end diastolic dimensions (mean 56.3 +/- 8.0 mm) and decreased fractional shortening (mean 0.30 +/- 0.07) (67 p. 100). Left atrial dimensions were increased (mean 39.7 +/- 6.4 mm) in 52 p. 100 of patients. Thallium 201 myocardial scintigraphy (n = 32) showed hypofixation in 57 (36 p. 100) and a lacuna in 23 (14 p. 100) of the 160 segments analysed. Left ventricular angioscintigraphy (n = 27; 135 segments) showed hypokinesia in 72 segments (53 p. 100); 2.7 segments per patient), akinesia in 19 segments (15 p. 100; 0.7 segment per patient) and dyskinesia in 2 segments (1.5 p. 100); 0.1 segment per patient). The global ejection fraction was 46 +/- 13 p. 100. Coronary angiography (n = 8) showed significant diffuse atherosclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)
Arch Mal Coeur Vaiss 1985 Jan
PMID:[Paroxysmal mitral insufficiency caused by ischemic dysfunction of the papillary muscles. Apropos of 39 cases]. 391 82

Of 32 patients with inferior myocardial infarction undergoing coronary angiography in the first 6 hours for intracoronary streptokinase thrombolysis, 19 (Group I) had ST depression of more than 1 mm in the anterior chest wall leads (VI-V4) whilst 13 (Group II) had no ST changes in these leads. Quantitative analysis of left ventricular angiograph showed a significantly lower ejection fraction in Group I (52 +/- 8.5%) compared to Group II (59 +/- 8%, p less than 0.05) and that this difference was due to a greater zone of inferior wall hypokinesia, irrespective of whether this was assessed by measuring its surface area (HKS cm2: Gr I: 11 +/- 6, Gr II: 4 +/- 3, p less than 0.01) or percentage ventricular perimeter (HK%: Group I 45 +/- 15, Group II 26 +/- 12, p less than 0.001). On the other hand, anterior wall motion was normal in both groups. Coronary angiography showed proximal obstruction of the right coronary artery in 84% of patients in Group I. In Group II, the coronary obstruction tended to be distal or incomplete. The prevalence and average severity of associated stenosis of the left anterior descending artery were the same in both populations. The success rate of thrombolysis was not significantly different between the two groups. In successful procedures with a patent artery on the 14th day, improved regional contractility was only observed in Group I (HKS cm2: 11.5 +/- 6 vs 8 less than 4.4, p less than 0.05; HK%: 47 +/- 14 vs 38 +/- 9, p less than 0.05): the hypokinetic zone was unchanged in Group II.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Aug
PMID:[Anterior lead ST-segment depression in inferior wall infarction. Early angiographic study. Effect on the results of intracoronary thrombolysis]. 393 87

Reciprocal changes of the ST segment in the acute phase of inferior myocardial infarction are common but their significance remain controversial. We studied this problem by comparing the ECG on admission of 83 patients with acute inferior myocardial infarction, with the clinical outcome and haemodynamic and angiographic data obtained on average 3 weeks after the onset of symptoms. Fifty nine patients (Group I) had ST depression greater than or equal to 1 mm in at least one of the leads V1 to V4; 24 patients (Group II) had no ST depression in this territory. The patients in Group I were older (59.6 +/- 6.4 vs 54 +/- 5.3 years, p less than 0.01), had higher total CPK (1 835 +/- 940 vs 875 +/- 305, p less than 0.01) and MB fractions (269 +/- 102 vs 95 +/- 35), more complications during the hospital period (80%, mainly haemodynamic vs 38%, p less than 0.01) and more severe left ventricular dysfunction: ejection fraction 52.2 +/- 6% vs 59.2 +/- 7%, p less than 0.05; cardiac index 2.75 +/- 0.4 l/min/m2 vs 3.25 +/- 0.3 l/min/m2, p less than 0.005). There was no difference in left ventricular wall motion between the groups on biplane angiography. However, coronary angiography showed left coronary disease to be more common in Group I (84%) than in Group II (37%), p less than 0.005. Left anterior descending and left circumflex disease was equally common. Patients with persistent ST depression after 48 hours had lower ejection fractions than those in whom it regressed within 48 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Oct
PMID:[Significance of ST segment depression in the precordial leads during the acute phase of inferior myocardial infarction]. 393 12

The authors report their experience of 2D echocardiography in the acute stage of myocardial infarction. One hundred patients, 60 men and 40 women, aged 60 +/- 4.5 years (range 32 to 69 years) were admitted to hospital with an uncomplicated inferior myocardial infarction and underwent 2D echocardiography on admission and coronary angiography 15 days later. Ten patients were excluded because unsatisfactory quality of the echocardiographic images. Forty-seven patients had initial ST depression of at least 1 mm in leads V1 to V4 (Group I) and 43 patients did not show these electrical changes (Group II). There were no significant differences in the clinical findings or in the cardiovascular risk factors between the 2 groups. On the other hand, inaugural necrosis was commoner in Group II (p less than 0.03) and cardiomegaly and CPK elevation greater in Group I (p less than 0.02). 2D echocardiography demonstrated the same degree of posterior wall hypokinesia or akinesia in the 2 groups. Septal hypokinesia was observed twice as commonly in Group I (p less than 0.03) both at echocardiography and ventriculography. Haemodynamic and angiographic data showed that double and triple vessel disease was commoner (p less than 0.05), that left anterior descending disease was more severe (p less than 0.03), left ventricular end diastolic pressure was higher (p less than 0.02) and the ejection fraction lower (p less than 0.02) in Group I, compared with Group II.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Oct
PMID:[Detection of disease of the anterior interventricular artery by 2-dimensional echocardiography in acute inferior infarction. Comparison with the electrocardiographic data]. 393 21


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