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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The data of intravital and postmortem coronary angiography were compared with those of morphological studies of the cardiac arteries in 20 patients with ischaemic heart disease. The purpose of the investigation was to study the correlation of the coronary lesion, including that of the distal arterial branches, by way of comparing intravital and postmortem coronary angiogrammes, with the data of morphological examinations of the cardiac arteries in cases of ischaemic heart disease. The errors of intravital diagnosis were found to comprise 12.7% and to be due to the nature of the anatomical lesion of the arteries, as well as to an incomplete opacification of the vessels in several observations. A term--vascular wall "resistance"--is introduced for the cases of extended atherosclerosis of the coronaries with distinct calcification and impaired mobility of the vessels, as shown by cineradiography. Intravital diagnosis of atherosclerosis of distal branches of the coronaries was found to be possible only in cases of stenosis exceeding 40--50%.
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PMID:[State of the coronary vessels in patients with ischemic heart disease according to findings from angiographic and morphologic studies]. 101 81

Pending the long-term solution of the problem of coronary atherosclerosis, and considering the unlikelihood of a universally effective, nontoxic, anti-arrhythmic regimen, it seems likely that ambulatory real-time monitoring is a promising avenue of approach for attacking the largest share of IHD mortality, namely the 2/3 who currently die before any medical attention.
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PMID:The role of ambulatory real-time monitoring in ischemic heart disease. 104 10

The studies on natural history of ischemic heart disease are reviewed and the major predictors of mortality identified. The severity of the coronary atherosclerosis and the status of ventricular function are found to be more important predictors of survival than the clinical presentation. The objectives of therapy in patients with ischemic heart disease are (1) to improve the quality of life by reducing symptoms, (2) to improve ventricular function, and (3) to increase survival time. The results of surgical therapy are examined in relation to these three objectives. Symptomatic improvement is present in 85 to 95 percent of patients after surgery, but convincing evidence for improved ventricular function is lacking and controlled studies of natural history have failed to show that surgery increases survival time. Analysis of the mechanism of symptomatic improvement after surgery suggests that increased blood flow to the ischemic area as well as infarction of ischemic myocardium and the nonspecific effects of surgery may account for the improvement. The prevention of coronary atherosclerosis is viewed as an attainable long-term solution to the problem of ischemic heart disease.
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PMID:Ischemic heart disease: an overview. 110 3

The autopsy findings in a White man aged 59 years are presented; he underwent heterotopic cardiac transplantation with left ventricular bypass for irreversible left ventricular failure caused by severe ischaemic heart disease. Microscopically, the donor heart showed mild signs of chronic rejection with negligible loss of functional myocardium, and no complications attributable to the surgical technique. Severe, generalised atherosclerosis had resulted in fibrous replacement of the recipient left ventricular myocardium and intra-operative atheromatous embolisation to the brain, the latter being the main contributory factor in the patient's death. Other significant findings were bilateral femoral vein thrombosis with recurrent pulmonary infarction, Aspergillus granulomata of the right lung, cytomegalovirus infection of lungs and oesophagus, Herpes simplex infection of the tongue and oesophagus, and duodenal ulceration with haemorrhage.
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PMID:The autopsy findings in a case of heterotopic cardiac transplantation with left ventricular bypass for ischaemic heart failure. 110 21

In a series of male survivors of ischaemic heart disease there were fewer patients belonging to the risk-factor blood group (group A) before than after age 55 who were either non-infarction patients in light work or infarction patients in active or heavy work. Conversely, there were more A's before than after age 55 who were either non-infarction patients in active or heavy work or infarction patients in light work.
Atherosclerosis
PMID:ABO blood groups, age and work in ischaemic heart disease. 114 37

This review summarizes previously unpublished and recently published autopsy findings of prehospital sudden coronary death (SCD) in four different counties (Olmsted, Minnesota; Albany, New York; Dade, Florida; and San Francisco Bay Area, California), totaling 868 patients. The prevalence of cardiomegaly and significant coronary atherosclerosis, and the relative infrequency of acute coronary thrombosis in prehospital SCD, well documented in the past, have been reaffirmed in current studies. Differences in the patient populations and laboratory techniques notwithstanding, these independent autopsy studies showed that 62% to 74% of cases of SCD had either acute or old myocardial infarction (MI); the incidence of acute MI ranged from 12% to 47%, and that of old MI from 22% to 53%. The prospective autopsy study of 120 Olmsted County SCD cases showed that among those with established acute MI, subendocardial lesions outnumbered transmural lesions by the ratio of 2:1, and the infarcts ranged in histological age from less than 24 hours to 4 weeks. Evidence of acute myocardial ischemia, as determined by the histological criteria of myofibrillar degeneration, sinuous fibers, and positive HBFP staining, was present in 52% to 81% of patients. Such high incidence of myocardial ischemia is compatible with the proposed mechanism of the terminal event in SCD, namely ventricular fibrillation or asystole, and underscores the importance of presymptomatic diagnosis of coronary heart disease. The lack of specific or acute anatomical lesions in the conduction system in SCD, however, does not preclude the possibility of bradyarrhythmias occurring shortly before death.
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PMID:Pathology of the myocardium and the conduction system in sudden coronary death. 118 81

The use of 1C-14 acetate for biosynthesis of lipids and their fractions (cholesterol, phospholipids, triglycerides and nonesterified fatty acids) in the heart, liver, adrenals, lipoid tissue and blood serum was studied in experimental myocardial infarction on the 5th to the 30th day of the experiment. It was concluded that disturbances of lipid metabolism did not always precede myocardial infarction and acute myocardial ischemia could induce changes in lipid metabolism characteristic of atherosclerosis.
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PMID:[Use of Na1C14 acetate for biosynthesis of serum and organ lipid components in the early periods of experimental myocardial ischemia]. 124 74

Several recent autopsy reports indicate an increased prevalence of coronary atherosclerosis in ischemic heart disease temporally associated with cocaine abuse. The objective of this study was to conduct a retrospective analysis of sudanophilic lesions in young asymptomatic individuals who abused cocaine. Twenty-six cases (15-34-year-old black males) were examined from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. Sixteen subjects (mean age 25 +/- 1 years) had a positive toxicologic screen for cocaine and/or its major metabolites at autopsy and were confirmed habitual cocaine abusers. The remaining 10 cases (mean age 24 +/- 2 years) were subjects with a negative toxicologic screen at autopsy and no history of illicit drug abuse. Post-mortem blood was collected for lipoprotein analysis and determination of smoking status. The aorta and right coronary arteries were stained with Sudan IV and the degree and extent of sudanophilia was quantitated by image analysis. Multiple linear regression analysis of cocaine, age, smoking status, VLDL+LDL-C/HDL-C ratio and HDL-C as predictor variables of percentage intimal surface involvement, revealed an association between cocaine abuse and the extent of sudanophilia in both the thoracic and abdominal aorta (P = 0.002 and 0.049, respectively). Analysis of risk factors or of cocaine abuse as predictors of sudanophilia did not achieve statistical significance in the right coronary artery. These preliminary results suggest that habitual use of cocaine, through unknown mechanism(s), increases aortic sudanophilia independent of traditional risk factors.
Atherosclerosis 1992 Nov
PMID:Cocaine: an independent risk factor for aortic sudanophilia. A preliminary report. 128 Jan 44

The reduction in cardiovascular mortality and morbidity observed over the last decade may be considered to be largely the result of the prevention of lipid disorders. The beneficial effects of diet and increased consumption of unsaturated fatty acids on ischaemic heart disease is a generally accepted concept. The low death rate from coronary artery disease amongst Greenland eskimos who eat a lot of fish has been confirmed by epidemiological studies of other large fish eating populations like the Japanese. The results reported by Bang and Dyerberg have been confirmed by the Zutphen study undertaken by Kromhout in the Netherlands. Fish oil act by the intermediary of the omega-3 fatty acids. Fish oil is rich in high unsaturated omega-3 fatty acids, the most important one being eicosapentaenoic (EPA) and docosahexaenoic acids (DHA). On the basis of epidemiological studies and clinical and experimental observations, it would appear that the consumption of marine polyunsaturated fatty acids has at least a preventive effect on phenomena of atherosclerosis and thrombosis. Their efficacy on the regression or stabilisation of the atheromatous plaque has not been demonstrated. The sites of action are multiple: decreased platelet aggregation; inhibition of thromboxane A2 production; reduction of triglyceride and VLDL concentration; improved blood rheology; action on the endothelium and proliferation of the intimal cells, vascular tone and vasomotricity. The importance of cardiovascular mortality and the hopes raised by clinical and epidemiological trials justify the pursuit of complementary studies on the efficacy and modes of action of marine polyunsaturated omega-3 fatty acids.
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PMID:[Atheroma and fish oils]. 128

Homozygous familial hypercholesterolaemia is characterized by cutaneous xanthoma development from infancy, precocious and accelerated atherosclerosis with clinical signs of ischemic heart disease and frequent involvement of left heart valves resulting in stenosis and/or incompetence. Two cases are described of this condition, both associated with aortic stenosis. In one case mitral incompetence and thromboembolic pulmonary hypertension were also found. The mitral valve is involved in the atherosclerotic process at the level of the cusps. These become thickened and stiff. Aortic stenosis is mainly due to atheromas infiltrating the Valsalva sinuses and the ascending aorta. Pulmonary hypertension, never reported before in this disease, is probably due to concomitant atheromatosis involving the pulmonary artery with secondary fatty embolism.
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PMID:[Involvement of the heart valves and great vessels in homozygote familial hypercholesterolemia]. 129 17


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