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

The antiarrhythmic action of disopyramide (1.5 mg/Kg) administered i.v. as a bolus was assessed in 30 patients with ischemic heart disease and different arrhythmias. In 75% of supraventricular parossistic tachycardia and in 75% of parossistic atrial fibrillation, arrhythmia was interrupted within few minutes from drug injection; in 90% with premature ventricular contractions (PVC) and in 100% of ventricular tachycardia, disopyramide was capable to interrupt the arrhythmias. The hemodynamic effects of the same dose of disopyramide were evaluated in other 17 patients, 9 of which in I-II class NYHA and 8 in III-IV class. We used STI's as parameters of cardiac performance. In all patients following the injection of disopyramide, a significant increase of PEP, ICT and PEP/LVET ratio and a significant decrease of LVETc were observed. Thus, the disopyramide impaired cardiac performance and its effect appeared more evident in patients in III-IV class NYHA. In conclusion, disopyramide showed to be effective in interrupting different arrhythmias; however, its depressant action on cardiac performance suggests that caution should be used in patients with severely impaired myocardial function.
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PMID:[Clinical and hemodynamic effects of disopyramide phosphate administered i.v. in cardiopathic subjects (author's transl)]. 52 Jul 46

The response to exercise during increasing workloads (supine bicycling), was studied in 105 men, of whom 70 had ischemic heart disease and 35 did not, clinically classed into 6 groups. Heart rates, blood pressures and systolic time intervals (STI) were measured in relation to exercise tolerance and capacity. The ischemic heart disease (IHD) subjects differed from the nonischemic by an increased PEP/LVET ratio at rest and by a tendency of the diastolic blood pressure to increase upon exercise. Two main types of abnormal reaction of STI to workload were ascertained: (1) prolonged LVETc with respect to controls (prevailing in angina pectoris), and (2) prolonged PEPEc together with shorter LVETc (typical for left ventricular failure). The dominant feature appears to be the depressed contractility in the latter and a decreased compliance (or rate of relaxation) in the former. Estimation of STI may contribute to the evaluation of the exercise tolerance test in long-term examination of ischemic patients.
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PMID:A noninvasive study of the response of ischemic heart to exercise. 59 Feb 97

A large series of 306 patients with ischemic heart disease was studied with automated systolic time intervals and left ventricular ejection fraction as determined by the angiocardiographic method. It was found the pre-ejection period, left ventricular ejection time, delta values, and PEP/LVET ratio all were related to the ejection fraction. However, in all instances the correlation was too low and the scatter of the data was too large to warrant the use of the systolic time intervals for predicting left ventricular function as indicated by the ejection fraction.
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PMID:The use of the systolic time interval for predicting left ventricular ejection fraction ischemic heart disease. 84 40

Systolic time intervals and the a/H ratio were recorded in 20 patients with uncomplicated acute myocardial infarction over a period of five days. The initial high heart rate and systolic blood pressure and the short PEP and ICT indicating a sympathetic overactivity were spontaneously normalized during the first week of infarction. LVET was reduced indicating a fall in stroke volume and the a/H ratio was unchanged at the high levels suggestive of elevated preload or LVEDP. In 10 patients with acute myocardial infarction and recurrent chest pain recordings on noninvasive parameters were made before and 30 min after intravenous injection of practolol. In addition, 7 patients with chest pain, classified as acute myocardial infarction, were given practolol. The average dose of practolol was 17.9 mg ranging from 5 to 30 mg. An almost immediate and pronounced relief of pain was observed in all patients and no signs of impaired left ventricular function appeared. The product of systolic blood pressure and heart rate was decreased by practolol and the PEP and the ICT were prolonged to normal values while no changes were seen in LVET and a/H ratio. On 126 occasions practolol was given in dosages ranging from 5 to 30 mg (mean 8 mg) to 75 patients with acute myocardial infarction and recurrent chest pain. A satisfactory pain relief was seen on 108 occasions. It is suggested that an inappropriate sympathetic overactivity is an important factor in provoking recurrent chest pain in acute myocardial infarction. Administration of the beta-adrenergic blocking agent practolol resulted in pain relief due to reduction of heart work and in severity of myocardial ischemia. The beta-blocking agent was well tolerated in the present study. Continuous beta-blockade during the whole hospital stay to patients with acute myocardial infarction seems to be a very attractive therapy in order to preserve the ischemic myocardium and limit the size of infarction.
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PMID:Effect of cardioselective beta-blockade on heart function and chest pain in acute myocardial infarction. 106 28

The authors describe differences in behaviour of left ventricular systolic time intervals after isometric exercise between patients with ischemic heart disease and normal control. Isometric exercise consists of tonic hand-grip, which is to be gauged by hand-grip dynamometer for 5 minutes at 30% of the patient's maximum voluntary contraction or for 2-3 minutes at 50%. The parameters referred to are pre-ejection period and left ventricular ejection time index (PEPI, TETI), the PEP/TET ration, heart rate and arterial pressure. The authors conclude that from isometric exercise it is possible to point out the heart failure degree in patients with ischemic heart disease.
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PMID:[Behaviour of left ventricular systolic time intervals after isometric exercise in patients with ischemic heart disease (author's transl)]. 114 63

The aim of the study was to evaluate the value of analysis of left ventricular systolic intervals during Isuprel test in diagnosis of ischemic heart disease. 30 patients with ischemic heart disease without myocardial infarction in the past (group I) and after myocardial infarction (group II) as well as 15 healthy persons (group III) underwent the study. Electrocardiograms and polycardiograms were analyzed by means of Weissler's method. In patients with CAD during Isuprel test decrease of QS2I, LVETI, LVETI/S1S2 and increase of Q-1, ICT, PEPI, PEP/LVET were stated in comparison with healthy persons. Sensitivity of Isuprel test estimated by ST segment analysis was 80%, specificity 100%, predictive value for CAD confirmation 100% and for its exclusion 71.4%. Diagnostic value of Q-1, QS2I and LVETI intervals and PEP/LVET index did not statistically significantly differ from ST segment diagnostic value. Sensitivity of Isuprel test estimated by means of these intervals analysis was 63.3%, specificity 93.3-100%, predictive value for CAD confirmation 95-100%, and for its exclusion 56-57.7%. Analysis of left ventricular systolic intervals during Isuprel test is a valuable complement of an ECG examination.
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PMID:[Value of the analysis of left-ventricular systolic time intervals in the diagnosis of ischemic heart disease provoked by intravenous infusion of isoproterenol]. 262 7

48 patients with chest pain or unexplained heart failure were examined with exercise test, systolic time intervals, apexcardiogram and left- and right-sided heart catheterization including coronary arteriography. The 23 patients with ischemic heart disease (IHD) and 19 patients with congestive cardiomyopathy (COCM) could as groups be separated by several of the parameters. Two major patterns of change were present when using the whole range of parameters, probably reflecting that the heart and circulation had compensated for left ventricular dysfunction in different ways in IHD and COCM. Comparing patients with the same ejection fraction (EF), preejection-period index (PEPI) pre-ejection-period/left ventricular ejection time (PEP/LVET) and systolic blood pressure/left ventricular end systolic volume index (SBP/LVESVI), were all more abnormal in patients with COCM than with IHD at most EF levels. The best separation between the diseases was obtained using exercise capacity in combination with PEP/LVET. The correlations between invasive and noninvasive parameters underlined that no single parameter can satisfactorily characterize the circulatory function in patients with individual differences in preload, afterload, pulse rate, cardiac volumes, compliance and contractility. No or poor correlations were found between exercise capacity and the different function parameters used.
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PMID:Different patterns of hemodynamic abnormalities in patients with ischemic heart disease compared with patients with congestive cardiomyopathy. 371 97

The effect of long-term treatment with alprenolol on left ventricular function was investigated in a controlled double-blind study of 15 patients with ischaemic heart disease (alprenolol 6, placebo 9), by measurement of systolic time intervals (STI). Significant prolongation of QS2I was observed in patients treated with alprenolol (p less than 0.05), while changes in PEPI, LVETI and PEP/LVET were all insignificant. The heart rate x systolic blood pressure product (RPP) was significantly reduced in the alprenolol group (p less than 0.05). The data suggest that long-term treatment with alprenolol did not impair left ventricular function as evaluated by STI, and that myocardial oxygen demand, assessed by RPP, was reduced during the treatment.
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PMID:Systolic time intervals during long-term beta-blockade with alprenol in ischaemic heart disease. 665 45

The effect of spironolactone on cardiac contractility indices was studied by externally recording systolic time intervals in four digitalized and four non-digitalized patients with ischaemic heart disease. A negative inotropic effect was found after spironolactone 100mg b.i.d. in all eight patients, as measured by an increase in pre-ejection period index PEPI (p less than 0.01), and the ratio between pre-ejection period and left ventricular ejection time PEP/LVET (p less than 0.001), while pre- and afterload remained constant. As expected, digoxin exerted a positive inotropic effect, as a decrease was observed in PEPI (p less than 0.01), and PEP/LVET (p less than 0.001). It was not possible to ascertain whether the observed effect was caused by a pharmacological interaction at receptor level between spironolactone and digoxin, or indirectly to changes in endogenous substances e.g. aldosterone. The results suggest that spironolactone may have unintended side effects in patients with severe heart failure and that its use be reevaluated.
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PMID:Systolic time intervals during spironolactone treatment of digitalized and non-digitalized patients with ischaemic heart disease. 705 70

The echocardiographic and clinical study was performed in six patients (three acute pulmonary embolism, one for each hypertensive cardiomyopathy, ischemic heart disease and primary pulmonary hypertension) who had a diastolic monophasic triangular pattern of the tricuspid valve echogram. Left-sided and right-sided IRT / square root R-R, ICT / square root R-R, PEP, Q-Mc and Q-Tc, and PEP / ET (IRT; isovolumic relaxation time, ICT; isovolumic contraction time, PEP; preejection time, Q-Mc or Q-Tc; interval of the Q wave of the ECG to the closing point of the mitral or tricuspid valve, and ET; ejection time) were measured from echocardiograms, and the comparisons of these parameters were made between two kinds of echogram with or without triangular pattern of the tricuspid valve. There were no significant differences in the left-sided parameters between the two kinds of echocardiograms. The mitral valve echogram showed a persistent M-shaped pattern irrespective of the pattern of the tricuspid valve. Right-sided IRT / square root R-R and ICT / square root R-R were significantly prolonged and Q-Tc was significantly shortened in the echogram with a triangular pattern of the tricuspid valve. Right ventricular (RV) catheterization was performed using a Swan-Ganz catheter in four patients with the triangular pattern of the tricuspid valve echogram. The mean pulmonary artery pressure ranged from 24 to 96 mmHg (40 mmHg on an average) and RV end-diastolic pressure from 8 to 17 mmHg (12 mmHg on An average). The possible explanation for the production of the triangular tricuspid valve echogram was an impaired early diastolic relaxation and increased stiffness of the RV due to the acute pressure overloading, resulting in a delayed opening and an early closing of the tricuspid valve. We conclude that a diastolic monophasic triangular pattern of the tricuspid valve echogram is a reflection of an impaired early diastolic relaxation and an increased end-diastolic stiffness of the RV.
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PMID:[Echocardiograms of a monophasic triangular wave of the tricuspid valve]. 718 4


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