Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The electric stimulation of the lateral ventricular walls carried out in experiments on dog heart (open-thorax), as well as the analysis of the clinical, radiological and electrocardiographic data recorded in 462 cases with QRS macrovoltage led to the following conclusions: a) in 22% of the cases (hospital cardiologic examinations) this anomaly cannot be accounted for either by age, blood pressure or cardiac hypertrophy; b) a temporarily perturbed development of the ventricular depolarization, i.e. a "jerky" depolarization, not stagnant enough to produce an intraventricular block, may generate great negativity and positivity myocardial masses responsible for the appearance of large dipoles, namely of the increased QRS voltage; c) the coincident ischemia and macrovoltage of the QRS major wave, as well as the subsequent evolution of incipient CHD in a series of patients point to the hypothesis according to which the regional myocardial ischemia may induce a QRS macrovoltage by means of the above mechanism.
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PMID:Mechanisms and significance of QRS macrovoltage in the absence of cardiac hypertrophy. 10 95

To study the effect of apnea and hypoventilation-induced hypoxemia on the heart, we carried out polysomnographic recordings over 4 nights with electrocardiographic tracings in 30 patients with and without coronary heart disease. Evaluations of the data were based on the 2nd and 4th nights. In six subjects, five with coronary heart disease, we found 85 episodes of nocturnal ischemia, mainly during REM sleep (83.5%), high apnea activity, and sustained and progressive hypoxemia. Complex ventricular ectopy was observed in 14/13 patients (nights 2/4) and repetitive ventricular ectopy in 5/3. There was no significant difference in the quality and quantity of ventricular ectopy during wake and sleep states between the CHD group and the control group. In one patient ventricular bigeminy was observed only at a threshold of SaO2 below 60%. Bradyarrhythmia was made evident in four subjects from the CHD group and correlated mainly with apnea activity. We suppose that patients with sleep apnea and CHD are at cardiac risk because coronary heart disease can be aggravated by insufficient arterial oxygen supply due to cumulative phase of apnea and hypoventilation. The reduced hypoxic tolerance of the heart may lead to myocardial ischemia and increased electrical instability.
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PMID:Nocturnal myocardial ischemia and cardiac arrhythmia in patients with sleep apnea with and without coronary heart disease. 192 Dec 30

After an extensive analysis of the world literature (121 references), beginning from the first reported case by Antopol and Kugel, 1933, the general review of the problem stressed especially the following morphologic characteristics and clinical significance of the anomalous origin of the left circumflex coronary artery (LCxA) from the right coronary artery (RCA): The place of the anomalous origin of LCxA from RCA among all other variations and anomalies of LCxA. The anatomical and topographical characteristics of LCxA originating from RCA in normal heart as well as in congenital heart diseases--CHD (especially complete transposition of great arteries--TGA). The formal genesis of LCxA from RCA according to original new Ogden's theory, taking into account the dual origin of the coronary arteries and the peritruncal angioblastic ring that surrounds the developing aorta and pulmonary artery. The frequencies of the origin of LCxA from RCA in autopsy and coronarography series. The importance of LCxA (by its origin and/or caliber) in determination of the right, left or codominance of the coronary arteries including the peculiarities in cases of isolated aortic stenosis and bicuspid aortic valve. The importance of recognizing LCxA from the RCA during implantation of artificial aortic, mitral and tricuspid heart valves, during mitral valve anuloplasty, closure of ostium primum defect as well as during aorto-coronary venous bypass. The LCxA from RCA, especially its proximal segment, shows more frequent and an earlier, faster and heavier obstructive atherosclerosis, causing different manifestations of coronary heart disease and sudden death. Also, mitral insufficiency can be caused by ischemia of the papillary muscles of the left ventricle. The awareness of the possibility that LCxA may arise from the RCA can prevent many complications during cannulations of the coronary arteries for diagnostic coronarography and myocardial perfusion during heart operations. The authors presented their 30 autopsied cases of LCxA from RCA, analysing morphological and topographic data as well as their clinical significance and association with other CHD. There were 6 isolated cases and 24 cases associated with other CHD (20 with TGA and 4 with other CHD). Our first autopsied case of LCxA from RCA was diagnosed as associated with tetralogy of Fallot in 1964. During the period 1964-1985 we had 1015 cases of CHD (including 132 cases of TGA).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Pathologic morphology and clinical significance of the anomalous origin of the left circumflex coronary artery from the right coronary artery. General review and autopsy analysis of 30 cases]. 213 27

Shenshao Tongguan Pian (SSTGP) is composed chiefly of saponins from the stem and leaf of Ginseng and Radix Paeoniae Alba, etc. The authors applied this remedy for the treatment of angina pectoris of CHD. From 1982-1988, the authors carried out a randomized double blind trial on altogether 565 cases of CHD divided into an experimental group to be treated with SSTGP and a control group treated with another TCM proprietory medicine, Dan Qi Pian, that had been used for many years clinically. The total effective rate of treating angina pectoris was 94.71% and ECG improvement rate 63.38% in experimental group whereas 66.99% and 23.38% respectively in the control group, the difference being very significant (P less than 0.01). Experiments with animals proved that SSTGP had more potent actions on CV system, such as dilatation of coronary arteries, promotion of coronary perfusion flow, lowering oxygen consumption of heart muscle, resisting the coronary spasm, anoxia and ischemia of heart muscle elicited by pituitrin, and prolongation of survival time of mice under anoxic state. In addition, laboratory examination also revealed SSTGP could promote the left ventricular output, lower the blood viscosity and inhibit the aggregation of blood platelets. Both acute and chronic toxicity tests showed SSTGP has no toxicity nor side effects. Therefore SSTGP is a new, safe and effective TCM proprietory remedy for CHD and angina pectoris.
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PMID:[Clinical and experimental study of shenshao tongguan pian in treating angina pectoris of coronary heart disease]. 226 17

In 11 patients (2 female, 9 male) suffering from angiographically proven CHD (age 45-60 years; 54.3 years on an average) the efficacy of a once-daily oral medication with 120 mg ISDN/50 mg ISMN and diltiazem (D) each in a long-acting preparation was examined in a placebo-controlled study. Each period lasted for 3 days; 2 capsules were given at 0700 a.m. one capsule at 5 p.m. Long-term ECG-recordings for 24 hrs (Tracker recorder, Pathfinder III) were performed twice under placebo and once during the third day of ISDN or ISMN, ISDN/ISMN + D in the morning and JSDN or ISMN in the morning and D in the afternoon. The rate of ischemic events declined from 10.4 to 4.7, 3.3 and 2.2; the duration of ischemia in 24 hours declined from 128 min to 43 min, 44 min and 34 min. The product of ST-depression (mV) and time of duration (min) showed an equivalent course. A more than 80% reduction of ischemia (duration and frequency) was achieved by a combination therapy in 72% of the patients. Minimal increase of heart rate at the beginning of ST-depression increased significantly during all periods of therapy, maximal increase of heart rate at that time showed a decrease only during combination therapy with D, the mean value did not change significantly. The once-daily application of ISDN/ISMN (50 mg) in a long-acting preparation (120 mg) led to a significant reduction of silent myocardial ischemia. The efficacy of ISDN/ISMN can be improved by D (120 mg, long acting preparation) up to a greater than 80% reduction in frequency and duration of ischemic events.
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PMID:[Combination therapy with slow release isosorbide nitrate and diltiazem in silent myocardial ischemia]. 268 57

After finding that Fomitiporia Runctata Murr had been used to treat angina pectoris as a folk remedy, medical workers of Fujian Sanming Fongous Institute engaged in the separation and identification of flora, and made out sugar-coated tablets of GML. This article reports clinical observation of tablets of GML treating 270 cases of CHD. Among the control group, 31 cases were treated by Persantine, 20 cases by Huo Xin Dan, 30 cases by compound Salviae miltiorrhizae. Among 222 cases of angina pectoris, 80 cases acquired evident effect (36%), 98 cases acquired improvement (44%), 42 cases failed to respond to the treatment (19%) and 2 cases became worse (1%). Total effective cases were 178 and total effective rate was 80%. There were 250 cases who had ECG evaluation: 37 cases acquired evident effect (15%), 95 cases showed improvement (38%), 116 cases had no change (46%) and 2 cases became worse (1%). Total effective cases were 132 and total effective rate was 53%. There was no significant difference between the effect of tablets of GML and that of Persantine, Huo Xin Dan and compound Salviae miltiorrhizae. According to the clinical laboratory observation, there were many functions of GML, such as antimyocardial ischemia, regulating heart rate, antiectopic cardiac rhythm and improving cardiac function and disorder in hemorrheology. The authors also used GML to treat 90 cases of arrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A clinical study of guan mai Le in the treatment of coronary heart disease]. 276 25

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

Myocardial ischemia without symptoms (= silent ischemia = Sl) has become a well known clinical entity in subjects with heart disease and in apparently healthy subjects. Detection of Sl is easiest and least expensively done with exercise ECG-testing (X-ECG). Data on the significance of Sl in the present report is derived from long-term follow-up of 2014 men aged 40-59 yrs, studied 1972-75, restudied in 1979-81 and 1986-88. The sources of information are: 1) 50 men with Sl detected with X-ECG/coronary angiography in 1972-75; 2) subjects with positive X-ECG in 1979-81 (but not in 1972-75); 3) preliminary data from the last follow-up study; and 4) complete data on cardiovascular mortality by Aug. 1987. The survey data indicate: a) Sl detected with X-ECG, confirmed with angiography is an indicator of later severe CHD-complications over 12-15 yrs; b) positive X-ECGs (not validated invasively) increase the risk of future CHD events and death from CHD 2-4 fold compared with subjects with normal X-ECG of similar age; c) limited isotope studies from the 1986-88 study indicate a very high specificity of a positive X-ECG in CHD, and d) cardiovascular mortality is very accurately predicted by factors known to be associated with the development of CHD. In accordance with the world literature, Sl is frequently observed in apparently healthy middle-aged and old men, and increases the risk of future CHD considerably when encountered.
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PMID:Coronary heart disease without angina pectoris: silent ischemia. 322 15

A total of 168 patients admitted to the intensive care department with the diagnosis of unstable angina pectoris (UA), were investigated. Proceeding from the clinical criteria, the patients were divided into 2 groups: with primary (the 1st group) and progressive (the 2nd group) angina. The diagnosis was confirmed by the transesophageal pacing test (TEPT) performed in parallel with two-dimensional echocardiography. Positive TEPT was noted in 84% of the patients in the 2nd group and in 39% of the patients in the 1st group. The volume and expression of ischemia at the height of stimulation (ECTG findings) did not differ in both groups. Some patients with negative TEPT (in both groups) demonstrated an unfavorable time course of volumetric indices: an increase in end systolic and end diastolic volumes, a decrease in the ejection fraction. However, the diagnosis of CHD could not be excluded. Patients need further examination.
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PMID:[Coronary reserve and myocardial function in unstable stenocardia]. 324 42

The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative-quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and symptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis, cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The "normal" values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with 111In-antimyosin and 99mTc-Isonitriles are presented including correlative results between global ejection fraction determination according to gated 99mTc-isonitrile and conventional 99mTc-erythrocyte ventriculogram (r = 0.75; n = 10).
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PMID:Myocardial scintigraphy--25 years after start. 328 85


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