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

Beta-adrenoreceptor blocking agents have been used to relieve symptoms mainly in patients with ischemic heart disease. Prophylactic use of beta blockade in patients after acute myocardial infarction has shown a reduction in total mortality and also in sudden death. The overall total mortality reduction amounts to about 30%, whereas the reduction in the sudden death rate is 50%. The mechanisms behind this reduction in sudden death are probably manifold. Antiarrhythmic effects in ischemic myocardium, prevention of new ischemia, and also perhaps other factors may play a role. Apart from the prevention effect in chronic ischemic heart disease, beta blockers have also been able to reduce the sudden death rate in the long QT syndrome and are suggested for use in congestive cardiomyopathy.
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PMID:Prevention of sudden death by beta-blockade. 198 82

We performed a postmortem study on 61 hearts from patients who died of acute ischemic heart disease (IA). Chronic ischemic heart disease (IB) and from hypertensive patients who died of heart infarction (IIA) and other hypertensive complications (IIB). Control group consisted of 16 pts. who died of non cardiac diseases. 4062 coronary artery specimens were estimated. Irrespective of the clinical course of ischemic heart disease the mean percent of coronary artery stenosis was similar in both ischemic groups and significantly higher than in control group. In hypertensive pts. who died of heart infarction it was also significantly higher and similar to ischemic pts. We found the highest percent of segments with critical stenosis in the left anterior descending coronary artery in group IA, IB, IIA. It was also significantly higher in the left main coronary artery in the group of ischemic pts. (IA, IB).
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PMID:[Comparative evaluation of coronary arteriosclerosis in arterial hypertension and ischemic heart disease. Morphometric analysis of 4062 coronary artery specimens]. 205 7

In summary, myocardial perfusion scintigraphy with either thallium or the isonitriles has added substantially to electrocardiographic definition of both myocardial infarction and acute and chronic myocardial ischemia. Using perfusion scintigraphy, one can define infarct zones, risk zones, and the presence of reperfusion following thrombolytic therapy. When perfusion scintigraphy is combined with physiologic or pharmacologic stress, myocardial ischemia can be documented, irrespective of electrocardiographic documentation of the phenomenon. Delayed imaging may be important for defining viability even in the presence of significant Q waves. Myocardial perfusion scintigraphy provides prognostic evaluation of patients with both acute and chronic coronary syndromes. When the current cumulative experience is looked at critically, it is clear that myocardial perfusion scintigraphy has helped in the development of an understanding of the limitations of electrocardiography in the diagnostic and functional categorization of patients with acute and chronic coronary disease.
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PMID:Myocardial perfusion scintigraphy as an aid in understanding electrocardiographic changes of ischemia and infarction. 222 82

Aim of this study was to evaluate the pattern of onset and the characteristics of ventricular arrhythmias (VA) observed during treadmill test (TT) in patients with chronic ischemic heart disease (CIHD). Two groups of patients with CIHD were retrospectively compared: group A consisted of 120 consecutive patients with premature ventricular beats (PVBs) either isolated (greater than 2/min) or repetitive during exercise, or maximal exercise, or recovery; group B consisted of 140 consecutive patients without PVBs during TT. The two groups were comparable in mean age, male/female ratio, incidence of previous myocardial infarction, of previous coronary artery by-pass graft or of percutaneous transluminal coronary angioplasty. There were no significant differences between the two groups regarding the parameters evaluated during TT: duration of exercise, maximal heart rate, heart rate-systolic blood pressure product as well as in the percentage of positive tests for acute myocardial ischemia (51.6% vs 40.7%). In the two subgroups of patients who underwent coronary arteriography and left ventricular angiography (24/120 and 23/140 patients respectively) no differences were found in the number and distribution of critical coronary stenosis and of dyskinetic or akinetic areas. In both groups A and B the QTc interval at maximal exercise was significantly longer than its value at rest (p less than 0.001), but there was no relevant difference between the two groups. In group A patients with VA during maximal exercise (n = 60) showed a higher prevalence of complex VA (class Lown greater than or equal to 3) compared to the others (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hyperkinetic ventricular arrhythmia during the treadmill test in chronic ischemic heart disease]. 223 48

A study is presented of the morphological changes of the lymphatic circulation in chronic ischemic heart disease (IHD). Examinations were carried out on clinical material: intraoperative cardiac biopsies and on hearts of patients who died of this disease at the age of 36-59 years. Transmission electron microscopy was used. A clinical comparison was realized of changes of intramyocardial and subepicardial regions of the heart lymph circulation and morphological equivalents of disorders of outflow of lymph from the heart in chronic IHD were evaluated. The obtained data indicate the lymph stasis possessing cardiotoxic and sclerogenous properties is an essential pathogenetic factor of myocardial fibrotization in chronic coronary insufficiency.
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PMID:[The morphological characteristics of the cardiac lymphatic bed in chronic coronary failure]. 223 95

Using radionuclide angiography at rest, we studied several parameters of left ventricular systolic and diastolic function in 60 patients divided into three groups, a control group (G1) of 15 patients and two groups of patients with chronic ischemic heart disease and previous anterior wall myocardial infarction but without aneurysm or dyskinetic wall motion, a second group (G2) of 23 patients with no history of heart failure, and a third group (G3) of 22 patients in New York Heart Association (NYHA) class II or III of heart failure. Ejection fraction, peak emptying, and peak filling rates, in addition to times to reach peak rates, were evaluated after constructing a global time-activity curve and its first time derivative. In addition, we computed the first time-derivative curves for each image pixel and obtained functional images (MIN/MAX images) representing the distribution of times to peak emptying or filling rates Using a left ventricular region of interest, time histograms were generated, and indexes of dispersion of times to peak rates, defined as the full width at half maximum of the histograms, were obtained. Significant (p less than or equal to 0.01) differences were observed among all groups for ejection fraction, peak emptying rate, and peak filling rate. The decrease of the peak filling rate still remained significant from group G1 to group G3 even after adjustment for differences in ejection fraction and heart rate. Peak filling rate was linearly correlated with ejection fraction in the population with ischemic heart disease (G2 + G3) (r = 0.68, p less than or equal to 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alterations in left ventricular diastolic function in chronic ischemic heart failure. Assessment by radionuclide angiography. 229 84

To compare the natural history of patients with new onset ischemic heart disease with that of patients with exacerbations of chronic ischemic heart disease, short- and long-term outcomes of 3,465 emergency room patients with acute ischemic heart disease at four community and three university hospitals were evaluated. Acute myocardial infarction was diagnosed in 598 (33%) of the 1,835 patients with a prior history of infarction or angina and 934 (57%) of the 1,630 without such a history (p less than 0.001). Patients with new onset ischemic heart disease with acute myocardial infarction were more likely than patients with infarction and exacerbated chronic ischemic heart disease to have Q wave infarction (57% versus 36%) and to receive thrombolytic therapy (11% versus 5%); they also had higher maximal creatine kinase levels (1,088 +/- 1,299 versus 733 +/- 906 U/liter) (p less than 0.0001 for all three). After adjustment for differences in clinical presentation and initial triage, patients with new onset ischemic heart disease with acute myocardial infarction were less likely than the comparison group to have congestive complications (odds ratio 0.63, 95% confidence interval 0.47 to 0.84, p less than 0.01) but not less likely to have arrhythmic, ischemic or overall complications. Among patients with angina without acute myocardial infarction, patients with new onset ischemic heart disease were less likely to have recurrent ischemic pain and congestive heart failure. In multivariate analysis of long-term follow-up data on 457 patients from one hospital, patients with new onset ischemic heart disease had better cardiovascular survival rates.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of the natural history of new onset and exacerbated chronic ischemic heart disease. The Chest Pain Study Group. 219 11

The appearance of impaired left ventricular diastolic function in chronic ischemic heart disease often precedes systolic dysfunction. Myocardial ischemia and increased calcium loading have been implicated in the genesis of increased left ventricular stiffness. We have assessed the effects of long-term therapy with different classes of calcium channel-blocking drugs on left ventricular peak filling rate in patients with chronic stable angina and congestive heart failure secondary to ischemic heart disease. Therapeutic effects of nicardipine (30 mg t.i.d.), nisoldipine (10 mg b.i.d.), and verapamil (120 mg t.i.d.) (4 weeks) have been assessed on radionuclide left ventricular diastolic filling parameters in patients with chronic stable angina using placebo-controlled studies. All three drugs significantly improved exercise capacity as compared with placebo. Verapamil produced significant improvements in peak filling rate (p less than 0.005), time to peak filling rate (p less than 0.01), and first one-third filling fraction (p less than 0.005), whereas nicardipine only improved peak filling rate (p less than 0.005); neither drug altered the mean ejection fraction (n = 20). Nisoldipine did not significantly alter diastolic filling parameters or ejection fraction (n = 10). Nisoldipine and digoxin were also assessed in congestive heart failure (New York Heart Association [NYHA] classes II and III) associated with ischemic heart disease (n = 26) (open parallel design). Neither produced significant alterations in peak filling rate and ejection fraction after 3 months of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of long-term treatment with calcium antagonists on left ventricular diastolic function in stable angina and heart failure. 240 36

In animal studies, amiodarone has substantial and immediate antiarrhythmic/antifibrillatory action during acute myocardial ischemia. The magnitude of this effect is discordant with the minor degree of prolongation of ventricular action potential duration (APD) and refractoriness which occurs immediately after acute drug administration. However, amiodarone's early onset of antiadrenergic activity and inhibition of inward slow calcium channel currents may be important when arrhythmogenesis is dependent on increased sympathetic tone. Because ventricular arrhythmia substrate may differ in acute and chronic ischemic heart disease, we investigated the acute electrophysiologic and antiarrhythmic/antifibrillatory effects of intravenously (i.v.) administered amiodarone in nine chronically infarcted cats. Amiodarone caused significant decreases (-17%) in mean heart rate (HR) and increases (+10%) in mean ventricular effective refractory period (ERP), which occurred promptly after drug administration. Increases in mean ventricular fibrillation (VF) threshold also occurred (11 +/- 3.4 and 12.5 +/- 2.4 mA for right and left ventricular sites before drug as compared with 45.5 +/- 13.2 and 42 +/- 13.9 mA after drug). Despite these changes, no significant reduction in the incidence of malignant ventricular arrhythmias induced by programmed stimulation was noted (63% of animals with arrhythmia induced before drug were still inducible after drug). In addition, no change in the increased degree of mean dispersion of refractoriness between infarcted and normal myocardial sites occurred following amiodarone (22.8 +/- 3.9 ms before vs. 30.2 +/- 2.5 ms after drug). In chronic myocardial infarction without superimposed acute ischemia, early onset of amiodarone's antiadrenergic and calcium channel blocking activities may play only a minor role in preventing ventricular arrhythmias inducible by programmed stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute electrophysiologic effects and antiarrhythmic/antifibrillatory activity of intravenous amiodarone in a chronic feline infarction model. 247 17

The paper deals with the rheological properties of the blood of 38 male patients affected by ischaemic heart diseases (age: 40-75 years) and 19 healthy test persons of comparable age. The following haemorheological properties were measured. 1. Relative plasma viscosity 2. Erythrocyte aggregation 3. Erythrocyte deformability 4. Thrombocyte aggregation and 5. Whole blood viscosity. For the purpose of representing and assessing the results of measurement obtained a division was made into different groups according to the appearances of ischaemic heart disease (chronic ischaemic heart disease, unstable angina pectoris, acute heart infarct) and risk factors (smoking, diabetes mellitus, blood high pressure and hyperlipidaemia). The methods 1-3 proved to be especially suitable for representing gradual differences in the examined rheological parameters. The results obtained are discussed and evaluated.
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PMID:[Hemorheologic findings in patients with ischemic heart disease]. 248 31


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