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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty patients with acute myocardial infarction were studied serially to evaluate the extent and nature of functional cardiovascular impairment and the time course of recovery. Reinfarction or death occurred in six patients. Peak workload during bicycle exercise in a subgroup of 25 patients with maximal initial test and complete follow-up increased from 334 to 409 kpm/min (P less than 0.01) bwtween three and six weeks. There was further significant (P less than 0.01) improvement between three and six months from 438 to 488 kpm/min. The incidence of ischemia at a constant workload decreased between three and six weeks without any significant changes in heart rate or blood pressure. Mean cardiac output during exercise at three months was 6.5 and at six months 7.8 L/min (P less than 0.05). Corresponding values for stroke volume were 61 and 72 ml (P less than 0.05). The data suggest that in clinically stable patients there is an early improvement of the relation between myocardial oxygen supply and demand and a late improvement of functional capacity associated with increased stroke volume and cardiac output.
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PMID:Cardiovascular function during early recovery from acute myocardial infarction. 92 62

Exposure to ambient particulate matter (PM) is associated with increased mortality and morbidity among subjects with cardiovascular impairment. We hypothesized that exposure of spontaneously hypertensive (SH) rats to PM impairs the recovery of cardiovascular performance after coronary occlusion and reperfusion-ischemia. SH rats were exposed by intratracheal instillation to saline, standard urban PM (Ottawa dust EHC-93, 10 mg/kg body weight) or endotoxin (lipopolysaccharides LPS, 350 EU/animal) to induce a similar pulmonary inflammation. At 4 h postexposure, hearts were isolated and retrograde perfused in a Langendorff model. The experimental protocol included 35 min of coronary occlusion followed by 120 min of reperfusion, during which left ventricular developing pressure (LDVP), coronary flow (CF), and heart rate (HR) were measured. Baseline LVDP in particle-instilled SH rats was significantly decreased compared to saline-instilled animals. In addition, after ischemia the recovery of LDVP was much slower in rats pretreated with PM or LPS compared to saline instilled rats. The direct effects of the soluble PM fraction and the role of Zn2+ were also tested cardiomyocytes (H9C2 cells). Both particle-free filtrate and Zn2+ inhibited ATP or ionophore-stimulated calcium influx in cardiomyocytes. This inhibitory effect was related to an effect on calcium channels, as shown with Nifedipine. This study provides evidence that exposure to instillation of PM has reversible acute effects on the recovery of cardiac physiological parameters after ischemia. The effect may be caused by a direct action of soluble metals on calcium homeostasis in heart, but pulmonary inflammation may also play a significant role.
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PMID:Ambient particulate matter affects cardiac recovery in a Langendorff ischemia model. 1686 54

Perinatal asphyxia (PA) is a burdening pathology with high short-term mortality and severe long-term consequences. Its incidence, reaching as high as 10 cases per 1000 live births in the less developed countries, prompts the need for better awareness and prevention of cases at risk, together with management by easily applicable protocols. PA acts first and foremost on the nervous tissue, but also on the heart, by hypoxia and subsequent ischemia-reperfusion injury. Myocardial development at birth is still incomplete and cannot adequately respond to this aggression. Cardiac dysfunction, including low ventricular output, bradycardia, and pulmonary hypertension, complicates the already compromised circulatory status of the newborn with PA. Multiorgan and especially cardiovascular failure seem to play a crucial role in the secondary phase of hypoxic-ischemic encephalopathy (HIE) and its high mortality rate. Hypothermia is an acceptable solution for HIE, but there is a fragile equilibrium between therapeutic gain and cardiovascular instability. A profound understanding of the underlying mechanisms of the nervous and cardiovascular systems and a close collaboration between the bench and bedside specialists in these domains is compulsory. More resources need to be directed toward the prevention of PA and the consecutive decrease of cardiovascular dysfunction. Not much can be done in case of an unexpected acute event that produces PA, where recognition and prompt delivery are the key factors for a positive clinical result. However, the situation is different for high-risk pregnancies or circumstances that make the fetus more vulnerable to asphyxia. Improving the outcome in these cases is possible through careful monitoring, identifying the high-risk pregnancies, and the implementation of novel prenatal strategies. Also, apart from adequately supporting the heart through the acute episode, there is a need for protocols for long-term cardiovascular follow-up. This will increase our recognition of any lasting myocardial damage and will enhance our perspective on the real impact of PA. The goal of this article is to review data on the cardiovascular consequences of PA, in the context of an immature cardiovascular system, discuss the potential contribution of cardiovascular impairment on short and long-term outcomes, and propose further directions of research in this field.
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PMID:Getting an Early Start in Understanding Perinatal Asphyxia Impact on the Cardiovascular System. 3217 94