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

Patients suffering from myocardial infarction (MI) form the high risk group. Residual ischemia, impaired left ventricular function and dysrhythmias are life endangering. Sudden death is more frequent in this group than in the one of patients with CHD. Therefore before discharge from the hospital we applied to the patients after MI series of noninvasive methods to disclose ventricular dysrhythmias. 136 patients after MI, mean age 56 (36-74), were examined. From those 90 patients underwent early exercise test and stress interview--application of common and specific mental stress. Holter ambulatory monitoring was applied to 18 post MI patients and echocardiography to 23 ones. A control group constituted 20 apparently healthy men, mean age 54 (44-64), which underwent exercise test and stress interview too. We have shown the incidence of ventricular dysrhythmias is always significantly higher (p < 0.01) in the post IM group than in the healthy one at exercise test and stress interview. The incidence in the post MI group is 49.4% at specific stress, 38.2% at common stress and 34.5% at exercise test. Significantly higher is the incidence at specific stress than at common stress or early exercises test, respectively (p < 0.05). Patients with dysrhythmias at both mental stresses have significantly lower exercise performance and workload at exercise test narrow correlation with disclosure at Holter monitoring is observed. Stress interview aids identification of risk group of post MI patients with serious ventricular dysrhythmias and demonstrates importance of psychotherapeutic care after MI. This method of mental stressing completes noninvasive test s and it is good way to II. phase of rehabilitation after myocardial infarction.
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PMID:[The stress interview after acute myocardial infarct]. 850 66

Work resumption of patients after myocardial infarction is primarily dependent on left-ventricular function, stress-related ischemia and rhythm-disturbances, additionally the general physical and psychological state play an important role. -The basic examination includes not only the history and physical examination, but also resting ECG, ECG exercise testing, 2-dimensional echocardiogramm and Holter-ECG. Additionally, stress-echocardiogramm, nuclear exercise testing and invasive procedures can be necessary. It is possible to estimate the work-capacity of the patient by classifying the ECG testing and by regarding further details of the disease. The return-to-work-rate does not only depend on the severity of a CHD, but also on the age, education, social class, high physical activity during work, job related satisfaction, family situation and available suitable jobs on the labor market.
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PMID:[Evaluating work capacity after myocardial infarct]. 913 27

The aim of our study was to evaluate the erythrocytic morphology in vascular patients, with or without diabetes, showing cell alterations correlated to blood viscosity and intra-erythrocytic calcium. We studied 108 subjects: 20 normal subjects, 58 vascular patients (25 suffering from CHD, 19 from CVD, 14 from POAD) and 30 non-insulin-dependent diabetes patients with vascular disease in metabolic compensation (13 CHD, 9 CVD, 8 POAD). Erythrocytic morphology, blood viscosity and intra-erythrocytic calcium were evaluated. Our results show that bowls, the most deformable red cells, decreased significantly in vascular patients and in POAD diabetics, while the discocytes, having a stiffer form, greatly increased in subjects suffering from ischemic disease and in POAD diabetics. The altered red cells (echinocytes and knizocytes) reached a statistical significance in CVD and POAD diabetics. Comparing the percentage of discocytes to intraerythrocytic calcium content in vasculopathic subjects, we obtained a significant correlation. No evidence of a relationship between discocytes and blood viscosity was found, even if blood viscosity significantly increased in patients affected by ischemic disease. These results suggest that ischemia decreases the deformability of red cells which is supported by the study of red cells morphology, by the erythrocytic morphology index (EMI), which becomes < 1, and by the evaluation of cytosolic calcium content.
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PMID:Evaluation of erythrocyte morphology as deformability index in patients suffering from vascular diseases, with or without diabetes mellitus: correlation with blood viscosity and intra-erythrocytic calcium. 969 35

Most episodes of myocardial ischemia in patients with known coronary artery disease (CHD) are asymptomatic. Silent myocardial ischemia (SMI) is an important predictor of adverse outcome in patients with proven coronary artery disease. beta-blockers are effective in suppressing ischemia, and improve clinical outcome in patients with coronary artery disease. At present, it is common practice to stop treatment with beta-blockers in clinically asymptomatic patients after coronary artery bypass graft (CABG) and/or myocardial re-vascularization (PTCA/Stent), although the possible presence of SMI/inducible ischemia after myocardial re-vascularization is not known. We examined 56 asymptomatic CHD patients after coronary artery bypass graft (n=36), percutaneous coronary angioplasty PTCA/stent (n=15), or both (n=5); therapy with beta-blockers was stopped in all of them after myocardial revascularization. All these patients underwent a dobutamine stress echocardiography test (DSE test). The DSE test was proposed to these asymptomatic CHD patients to investigate the possible presence of SMI/inducible ischemia after myocardial re-vascularization. All patients had history of myocardial infarction or evidence of mildly impaired left ventricular function at rest as assessed by cardiac catheterization. Abnormal DSE studies occurred in eight of the 56 patients (14%; 95% C.I.: 6-26%). Therapeutic approaches specifically targeted at reducing total ischaemic burden include pharmacologic therapy and myocardial revascularization. On the basis of these data, it can be concluded that asymptomatic CHD patients after myocardial re-vascularization must be re-evaluated to rule out SMI/inducible ischemia that can be treated (e.g. with beta-blockers) reducing cardiovascular morbidity and mortality.
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PMID:Induced ischemia detected by dobutamine stress echocardiography in coronary heart disease patients after myocardial re-vascularization. Experience in a District General Hospital. 1200 83

The aim of the present study was to investigate the prognostic value of plasma interleukin-8 (IL-8) for early complications after percutaneous coronary intervention (PCI). The pre- and postprocedural plasma levels of IL-8 and serum C-reactive protein (CRP) were examined by immunoassay, and the expression of CD11b/CD18 on neutrophils was assessed by flow cytometry. Early complications (abrupt occlusion, threatened abrupt occlusion, early recurrence of ischemia, myocardial infarction, cardiac sudden death, and target vessel revascularization) occurred intra-procedure and 30 days after PCI and were observed in 121 consecutive patients with coronary heart disease. Sixteen patients with early complications had high preprocedural levels and high postprocedural differentials of IL-8, CRP, and CD11b/CD18 compared to those without complications (all P < 0.05). The occurrence of complications showed a significant increase in the patients according to the tertiles of IL-8, CRP, and CD11b/CD18. Preprocedural levels of IL-8 (RR = 5.864, CI = 1.658-20.734, P = 0.006) and diabetes (RR = 1.587, CI = 1.246-2.132, P = 0.038) were independent predictors of early complications. There were significant correlations in the postprocedural differential between IL-8 and CD11b/CD18 (r = 0.776, P = 0.002) in patients with complications. The results reveal that the early complications after PCI contribute to preprocedural inflammatory responses. Normal levels of IL-8 may be powerful negative predictors of early complications in patients with CHD following PCI.
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PMID:Plasma levels of IL-8 predict early complications in patients with coronary heart disease after percutaneous coronary intervention. 1290 27

We studied the effect of phenol antioxidant probucol on free radical oxidation of LDL isolated from blood plasma of healthy donors. Oxidation was induced by co-incubation of LDL with cultured peripheral blood monocyte-macrophages and human umbilical vein endothelial cells under conditions of ischemia-reperfusion. In addition, the effect of probucol therapy on oxidability of plasma LDL in CHD patients was examined. Probucol (0.1-10 microM) efficiently protected LDL from free radical oxidation in vitro and in vivo.
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PMID:Effect of antioxidant probucol on cell-mediated LDL oxidation in vitro and in vivo. 1463 89

In experimental animals, bradykinin type-1 receptors (BK-1Rs) are induced during inflammation and ischemia, and, by exerting either cardioprotective or cardiotoxic effects, they may contribute to the pathogenesis of heart failure. Nothing is known about the expression of BK-1Rs in human heart failure. Human heart tissue was obtained from excised hearts of patients undergoing cardiac transplantation (n = 13), due to idiopathic dilated cardiomyopathy (IDC; n = 7) or to coronary heart disease (CHD; n = 6), and from normal hearts (n = 6). The expression of BK-1Rs was analyzed by means of competitive RT-PCR, Western blot analysis, and immunohistochemistry. Expression of BK-1R mRNA was increased in both IDC (2.8-fold) and CHD (2.1-fold) hearts compared with normal hearts. The observed changes were verified at the protein level. Expression of BK-1Rs in failing hearts localized to the endothelium of intramyocardial coronary vessels and correlated with an increased expression of TNF-alpha in the vessel wall. Treatment of human coronary artery endothelial cells with TNF-alpha increases their BK-1R expression. These novel results show that BK-1Rs are induced in the endothelium of intramyocardial coronary vessels in failing human hearts and so may participate in the pathogenesis of heart failure.
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PMID:Increased expression of bradykinin type-1 receptors in endothelium of intramyocardial coronary vessels in human failing hearts. 1584 Sep 6

Appraisal of the risk to which outpatients with chest pain are exposed is an important clinical problem that frequently occurs. The need to decide in day-to-day practice between a conservative or invasive approach in patients with chest pain is often difficult and the decision has grave implications. Stress echocardiography (SE) is readily accessible, the technology is relatively inexpensive, it is familiar and simple to handle, and measurements can be made directly in patients. Even today, its importance has hardly declined at all compared to cardiac MRT or myocardial scintigraphy. Owing to the large number of cases treated, diagnostics and prognostic appraisal of CHD are still a challenge in medical and economic terms. According to the Federal Office of Statistics, a gross expenditure of 6,740 Euros was incurred for every patient > 65 years old in Germany in 2002. 1,650 Euros (24%) was spent on treating diseases of the cardiovascular system. The cumulative data on the prognostic significance of SE indicate a roughly three to four times higher incidence of events in patients with definitive ischemia than in patients in whom ischemia is not detected. Patients with negative SE findings have a very good prognosis and usually do not require invasive diagnostics. Accordingly, consistent use of SE could specifically identify patients in whom a future event will occur and to reduce the number of patients receiving invasive investigations. This selective procedure might reduce health service costs.
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PMID:[Prognostic value of stress echocardiography]. 1633 70

The prevalence and risk factors for renal artery stenosis (RAS) and chronic kidney disease (CKD) are unclear in Japanese patients with peripheral arterial disease (PAD). To examine these issues, we performed renal angiography in 410 patients with PAD. Renal function and damage were assessed using the estimated glomerular filtration rate (eGFR) and urinary level of microalbumin (MA). Multiple logistic and multiple regression analyses were used to examine the relationships of potential risk factors with RAS and CKD. In all, 94 subjects (22.9%) had RAS >50% and 45 subjects (11.0%) had RAS >75%. The incidences of an abnormal level of MA and renal insufficiency (eGFR <60 ml min(-1) per 1.73 m(2)) were 37.0 and 60.7%, respectively. RAS > or =50% was associated with critical limb ischemia (CLI; hazard ratio (HR) 2.519; 95% confidence interval (CI) 1.203-5.276, P=0.014), coronary heart disease (CHD; HR 2.143; 95% CI 1.129-4.069; P=0.020) and hypertension (HR 1.907; 95% CI 1.009-3.628; P=0.045). RAS > or =75% had a relationship with hypertension (HR 3.093; 95% CI 1.002-9.548; P=0.048). eGFR was negatively correlated with age, uric acid and CHD (P=0.013), and MA had a significant positive correlation with low-density lipoprotein cholesterol, CLI, age, CHD and diabetes (P<0.001). These results show that the prevalences of RAS and CKD are very high in Japanese patients with PAD; that CLI and CHD are major risk factors for RAS; and that hyperuricemia, hypercholesterolemia and diabetes are risk factors for CKD in PAD. We also found that MA is a simple and noninvasive marker of renal dysfunction and general vascular damage.
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PMID:Prevalence and risk factors for renal artery stenosis and chronic kidney disease in Japanese patients with peripheral arterial disease. 2053 17

This report contains authors own data about hyperglycemia impact on main functional properties of endothelial cells, mesenchymal stem cells and circulating progenitor cells, which define their participation in angiogenesis. Obtained data shows that cultivation of endothelial cells in hyperglycemic conditions leads to decrease of their ability for targeted migration and vascular-like structures formation on matrigel, and to suppression of VEGF receptors expression in these cells. Mesenchymal stem cells cultivated in hyperglycemic conditions have altered expression profile, decreased ability to stimulate angiogenesis via paracrine activity. Hyperglycemia in CHD patients with concomitant diabetes mellitus type II most probably lead to circulating bone marrow progenitor cells mobilisation distortion in response to tissue ischemia and damage to the endothelium, that can infringe upon their participation in endothelium reparation and angio- and vasculogenesis in the ischemic conditions. Found distortions can be used as targets for the treatment aimed at cardiovascular complications prevention in diabetic patients.
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PMID:[Hyperglycemia impact on angiogenic properties of endothelial and progenitor vascular cells]. 2255 Jul 9


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