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)

Combinations of antianginal drugs may be used for an additive effect against angina, but also to off-set unwanted effects of one drug with another, either by direct effects or by a reduction of dosage of each drug. Based on earlier studies with separate drugs we have now examined the effect of 150 mg bupranolol combined with 40 mg isosorbide dinitrate (ISDN) in one retarded tablet, given twice daily. 22 patients with CHD entered the study, 11 of those with and 11 without signs of ischemia during exercise. In an acute radionuclide ventriculographic (RNV) study 2 h after the tablet, ejection fraction (EF) during exercise increased only in patients with exercise ischemia (+6%, p less than 0.001). In the other patients EF did not change. After 21 days of treatment echocardiographically determined end-systolic and end-diastolic diameters decreased, resulting in an increase of shortening fraction by 15.6% (p less than 0.05). Heart rate, systolic and diastolic pressure and ST-segment depression decreased significantly. In another acute RNV study the effect of a venous vasodilator, molsidomine 4 mg s.l., was examined after nifedipine 10 mg s.l. in 19 patients with CHD, 9 with and 10 without exercise ischemia. Differences between drugs were most prominent during exercise. In the nonischemic group EF rose by 6.6% after nifedipine (n.s.) and by 14% after molsidomine (p less than 0.01 against control). In the group with ischemia EF rose by 12.6% after nifedipine and by 17.4% after additional molsidomine, significant against control (p less than 0.01) as well as against nifedipine (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Interactions of vasodilators with calcium entry- and beta-blockers in patients with coronary heart disease. 302 1

In 82 CHD male patients aged 35-54 years with well-preserved working capacity (threshold load, 600-750 kgm/min) who had underwent bicycle ergometer test, the time course of changes in the major hemodynamic parameters was found to be significantly similar to that of healthy individuals. The cases who stopped performing bicycle ergometer tests because of anginal attacks, and ST segment depression or either showed a more significant elevation in systolic and diastolic blood pressure at the maximum load rate and lower increase in heart rate than in healthy subjects, which may be regarded as a compensatory mechanism that prevents a further decrease in coronary flow. Diminished increase in stroke index and cardiac index suggests reduced myocardial contractility.
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PMID:[Hemodynamic shifts during physical exercise in patients with ischemic heart disease]. 322 50

101 consecutive male patients were examined by means of clinical interviews and depression, anxiety, personality, psychometric and life stress tests. The examinations took place preoperatively, on the 9th postoperative day (average) and 7.5 months after surgery. The mean age of the patients was 52.2 years and the mean duration of CHD was 6.7 years. Prior to surgery 77% had experienced myocardial infarction and 85% belonged to NYHA class III or IV. 74% had a 3-vessel disease. When the NYHA classification was used as criterion for rehabilitation the result was excellent. Postoperatively 80% belonged to NYHA class I or II. Hospital mortality rate was 4% and one patient died from myocardial infarction prior to the final follow-up. Preoperatively 17% of the study group were working. 87% of the patients experienced negative effects on work life, caused by CHD. Postoperatively 33% worked regularly. The postoperative work situation correlated with the duration of preoperative unemployment (p less than 0.0001), the patient's own opinion about work return (willingness/unwillingness to return to work) (p less than 0.01), as well as with the amount of negative life stress experienced preoperatively (p less than 0.01). Only 13% of the series experienced positive effects on work life, caused by CABG surgery. The majority of the patients had experienced negative effects on social and economic life (51%), as well as on sexual life (70%), caused by CHD. After surgery improvements were noted by 36% on social life and by 27% on sexual life. 15% experienced impairment of sexual life postoperatively. According to the Beck Depression Inventory 29% showed depression preoperatively, and 10% postoperatively. The difference is significant (p less than 0.0001). Clinically the figures tended to be higher. The same tendency holds for anxiety scores as measured by the Hamilton anxiety scale. The incidence of postoperative psychoses was 35%. Higher age (p less than 0.01) and/or absence of psychosomatic diseases (p less than 0.05) correlated with higher frequency of psychoses. Even though cardiological rehabilitation according to the NYHA classification was excellent, 22% of the series did not think their expectations were fulfilled. Psychic and social rehabilitation was in several aspects unsatisfactory, and the patients did not seem prepared for this. The importance to consider rehabilitation from a psychosomatic standpoint is clearly shown. To predict the result of rehabilitation preoperatively is not possible.
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PMID:Psychosomatic aspects of coronary artery bypass graft surgery. A prospective study of 101 male patients. 326 Apr 43

In order to document the possible influence of stress limiting factors (STLF: chest pain, ST-segment depression) on exercise-induced blood lactate increase in CHD patients (post myocardial infarction) 88 males were examined in a stepwise bicycle stress test. Blood lactate samples were drawn at the end of each stress step. The patients were divided into 2 groups without (n = 45) and with (n = 43) STLF, higher blood lactate concentrations, however, were only observed in relation to the exercise intensity reached at the end of the stress test. Neither the symptom chest pain nor the degree of ST-depression showed a significant influence on the physical performance capacity and the lactate concentration at the anaerobic threshold. Nevertheless, a physical performance capacity above 1 W/kg seems to be necessary to reach the anaerobic threshold level. When the lactate measurement is used in CHD patients, the influence of age on the maximum lactate concentrations must be considered.
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PMID:Influence of symptom-limited stress on blood lactate behaviour in coronary heart disease (CHD) patients. 344 29

Follow-up surveillance of 1136 coronary patients (918 men and 218 women) observed in Seattle community practice reveals a higher incidence of subsequent myocardial infarction, cardiac arrest or cardiac death in over 4% who manifested ST elevation during maximal exercise testing and recovery. Quantitative measurements of 100-beat signal-averaged ECG responses transmitted by dataphone from 15 testing sites provide objective classification into ST depression (less than O mV) and ST elevation (greater than O mV) during exercise and five minutes of recovery. Whereas the annual incidence of CHD events in 18.3% of men with ST depression only during exercise is 2.0%/year, it is 4.1%/year in 71.6% of men with ST depression persisting into recovery and 8.2%/year with ST elevation during exercise and recovery (P less than 0.05). Even higher event rates occur with exercise of short duration and in a subgroup who had invasive studies which demonstrated at least two vessels with 70% or more stenosis and ejection fractions under 50%.
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PMID:Unusual prognostic significance of exercise-induced ST elevation in coronary patients. 369 8

Pretest probability of coronary heart disease should be considered in interpreting exercise test results. In general, 90% of patients with typical angina pectoris, 50% of patients with atypical angina pectoris, and only 10% of patients with nonanginal chest pains have CHD. Marked ST-segment depression in multiple leads is a good indication of extensive coronary artery disease, especially when it occurs early during exercise or at submaximal exercise, and if associated with a blunted or a hypotensive BP response.
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PMID:Angina: DDx of atypical presentations in the elderly. 375 81

Lipids and lipoproteins were measured in 139 men and 145 women who were noninsulin-dependent diabetics (NIDDs) aged 45 to 64 years. Of these, 27 men and 16 women had had a previous definite myocardial infarction (MI). The NIDDs with MI (MI+) showed lower values of HDL and HDL2 cholesterol concentrations than NIDDs without previous MI (MI-) or NIDDS without any symptoms or electrocardiographic signs of coronary heart disease (CHD-). The inverse relationship between HDL, HDL2, and CHD was evident in both sexes, but it was particularly strong among male NIDDs. The difference in HDL and HDL2 cholesterol concentrations between the MI+ and MI- groups or between the MI+ and CHD- groups persisted after adjustment by analysis of covariance for the effect of physical activity, alcohol intake, obesity, duration of diabetes, and glycemic control. It is concluded that in a cross-sectional study, even among NIDDs with generally low HDL and HDL2 cholesterol concentrations, the presence of CHD is associated with a further depression of HDL and HDL2 cholesterol levels. Prospective studies are needed, however, to confirm that the association is predictive and not a consequence of CHD.
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PMID:Association of low HDL and HDL2 cholesterol with coronary heart disease in noninsulin-dependent diabetics. 407 98

Bicycle ergometry in 40-59 year-old male patients with coronary heart disease, identified during mass prophylactic examination on the basis of epidemiological criteria, has shown that in patients with angina pectoris of effort and no myocardial infarction in history positive exercise tests are observed in 20,8% of cases, while in patients with painless CHD forms positive results are observed in 15.4% of cases. Positive exercise tests are the most often in patients with daily anginal attacks and in those with ST depression and flat negative T waves.
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PMID:[Bicycle ergometry test results in persons with ischemic heart disease detected in mass screening]. 686 Apr 81

In a study of the psychosocial characteristics of the coronary prone personality, a semi-structured questionnaire and Type A/B, anxiety and depression scales were sent to residents of Rolleston registered on the Rakaia electoral district roll. Amongst the 256 respondents who replied there were no significant differences between proportions of Type A and B individuals found in various age, sex, smoking, drinking, CHD family history, exercise and recent stress categories. However, Type A men (but not women) who had experienced a stressful crisis during the preceding 12 months obtained higher anxiety scores than nonstressed men. Recently stressed Type B women (but not men) obtained higher anxiety scores than nonstressed women. Likewise, recently stressed women (but not men) obtained higher depression scores than nonstressed women. There was also some evidence of less frequent alcohol consumption in respondents from families in which a parent or sibling had suffered from CHD.
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PMID:Psychosocial characteristics of coronary prone personality. 695 56

Tobacco smoking is the leading preventable cause of death in the United States and an important cause of CHD. The effect of smoking on the cardiovascular system and coronary risk factors is pervasive. Unfavorable effects include acute increases in blood pressure and coronary vascular resistance, reduction in oxygen delivery, enhancement of platelet aggregation, increased fibrinogen, and depression of HDL cholesterol. Smoking cessation reduces cardiovascular morbidity and mortality rates relatively rapidly, even among individuals who stop smoking only after the age of 65 or after developing the clinical manifestations of CHD including myocardial infarction. Behavioral smoking-cessation programs and nicotine-replacement therapy each have been demonstrated to be effective for the treatment of smoking. The most effective treatment currently available is to combine the two. Nicotine-replacement therapy is safe and effective in patients with stable coronary heart disease. Although the threat or diagnosis of CHD is a powerful stimulus to spontaneous smoking cessation, many smokers continue to smoke after events such as myocardial infarction or CABG surgery. Studies have demonstrated that physician advice to stop smoking, supplemented by brief counseling by a nurse and follow-up, dramatically increases the smoking-cessation rate of patients hospitalized with myocardial infarction and is highly cost effective. In the outpatient setting, physician advice and counseling is also effective in helping smokers with or without CHD to stop smoking. This article outlines a simple protocol that has been demonstrated to be effective for counseling smokers.
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PMID:Cigarette smoking and coronary heart disease: risks and management. 907 91


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