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

Although prolongation of QTc interval has been shown to increase the risk of sudden death after recent myocardial infarction, no data exist on the relationship between sudden death and QTc duration in patients with chronic ischemic heart disease. Furthermore, it is not known whether patients with long QTc intervals (greater than or equal to 440 units) have more prevalent coronary risk factors. Thus 141 nonsurvivors (128 with coronary death and 13 with noncoronary death) representing the follow-up deaths of a cohort of 1157 medically treated patients with ischemic heart disease over a four-year period were compared to 141 consecutive long-term survivors of the same cohort. Thirty-one patients were excluded because of drug interactions, bundle-branch block or atrial fibrillation. QTc duration was calculated on the ECG immediately prior to angiography in 62 patients with sudden death, 36 with intermediate death, 13 with noncoronary death and 140 long-term survivors with chronic ischemic heart disease. In addition, in 64 nonsurvivors (58%) in whom more than one yearly follow-up ECG was available, QTc was calculated in the last ECG preceding death (mean of four months before death). These data were compared to those obtained in 140 long-term survivors at the time of last ECG (mean 48 months after enrollment). At the time of angiography, mean QTc intervals were similar in patients who later died of ischemic heart disease and in long-term survivors (423 +/- 35 vs 421 +/- 25 units). No difference in QTc duration was apparent among nonsurvivors with ischemic heart disease. All study patients were divided into normal and long QTc subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prediction of sudden death from QTc interval prolongation in patients with chronic ischemic heart disease. 374 47

We dual coded 2,268 deaths due to heart disease occurring in Maryland, using the 8th and 9th revisions of the International Classification of Diseases (ICDA-8, Adapted for Use in the United States, and ICD-9). Certifier preference was for generalized cardiovascular terms rather than terms specific to the heart, resulting in an artifactual change in chronic ischemic heart disease death (IHD) rates in Maryland between 1978 and 1979 because the 8th and 9th ICD revisions classified these terms differently. Medical examiners were more likely to use these generalized cardiovascular terms as were physicians who went to certain medical schools in the state. The physician's terminology preference was associated with the sex and race of the decedent and was related to aspects of the patient's medical care. The ICD should be modified in the 10th revision to allow for the separate classification of generalized cardiovascular terminology within the ischemic heart disease category.
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PMID:The effect of physician terminology preference on coronary heart disease mortality: an artifact uncovered by the 9th revision ICD. 379 55

In a group of patients with chronic ischaemic heart disease whose diagnoses were ascertained by the clinic, by the electrocardiogram after resting and after work, by the coronarography and/or by the complication of the ischaemic heart disease (myocardial infarction), we compared the findings of the classical ECG with those ones of the ST-mapping. In 32% the ST-mapping brought an increased evidence. A correspondence of 100% we found in the certainly normal and certainly pathological findings. The maxima of the repolarisation disturbances withdrew from the proof of the Wilson derivations at rest at 54.8% and under submaximal strain at 79.3%, changed in 25.8% their position under load and during the load the emigrated in 16.5% out of the precordial leads after Wilson. The evaluated sums of the partial surfaces of the ST-mapping have a higher correlation to the severity of the ischaemic heart disease, permit a better differentiation between the individual degress of severity and render possible an exacter judgment of the prephase of the ischaemic heart disease than it is possible with the usual ECG. In 25.8% of all examinations after work repolarisation disturbances limited to small myocardiac areas could be proved only by means of the mapping. The localisation of lesions of the myocardium is better possible by means of the ST-mapping above all dorsally/caudally than by means of the classical ECG.
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PMID:[Comparison between classical ECG and ST mapping]. 399 30

In 158 patients with chronic ischaemic heart disease (IHD), the state of microcirculation was investigated, using local 133Xe clearance. With growing severity of the disease, muscular blood flow decreased. Local disturbances were accompanied also by changes in central haemodynamics (decrease in cardiac index, slow-down of blood flow in the pulmonary and systemic circulations, increased peripheral resistance), which were established by radiocardiography using 131I-labelled albumin. A distinct relationship was found between muscular blood flow and the intensity of intravascular microcirculatory disturbances (microthrombosis, intravascular thrombocyte aggregation, arteriolo-venular anastomoses). The authors recommend the use of 133Xe clearance for microcirculation study in patients with chronic IHD.
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PMID:Clearance of radioactive xenon in evaluating microcirculation in patients with ischaemic heart disease. 399 94

This study addresses the question of whether the rise in ischemic heart disease mortality has been just "a paper epidemic" as asserted in an earlier issue of this journal. Age-standardized death rates, proportions expected to die, mean ages at death, and cause specific contributions to changes in overall life expectancies were calculated for acute and chronic ischemic heart disease and for males and females for the years 1931 to 1980 using published vital statistics data. These multiple analyses reveal: a true epidemic of acute ischemic heart disease has occurred, affecting males exclusively or to a greater degree than females and it is now on the decline, fairly stable and more nearly comparable mortality for both males and females for chronic ischemic heart disease, and continuing problems of classification obscure the true levels of mortality for both the acute and chronic entities.
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PMID:Ischemic heart disease: footprints through the data. 402 3

In 40 patients suffering from chronic ischemic heart disease (16 with history of myocardial infarction, 10 with unstable angina and 14 with stable angina) and in an equal number of sex-and age-matched control subjects, we have determined plasma and blood viscosity according to RAND et al. using a Wells-Brookfield Micro-Viscometer, shear rate 230 sec-1, and red cell filterability according to REID et al. Significant differences were found in patients suffering from ischemic heart disease, in comparison with the control group, for blood viscosity (p less than 0.01), plasma viscosity (p less than 0.001) and red cell filterability (p less than 0.001). The changes of hemorheological parameters in ischemic heart disease, especially in patients suffering from unstable angina and in those with history of myocardial infarction, point to the opportunity of a pharmacological treatment aiming at improving the district microcirculation.
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PMID:[Evaluation of blood viscosity and erythrocyte filterability in chronic ischemic heart disease]. 403 13

The medicamentous therapy of the angina pectoris vera and of the chronic ischaemic heart disease is at present based on three groups of medicaments: nitrate compounds, beta-blocking agents and calcium antagonists. The underlying therapeutic principle which is common for them consists in the reduction of the oxygen requirement of the myocardium so that an improvement of the complaints and a larger load capacity may be achieved. The improvement may be objectified also at the behaviour of the haemodynamics and the ECG under load. The so-called coronary dilating remedies and the beta-stimulators did not prove clinically. In the acute attack rapidly acting nitroglycerin compounds remain the remedies of choice. Also the permanent treatment should at first again use longer acting nitrate preparations. When despite a sufficient dosage no satisfying improvement takes place an additional prescription of beta-blocking agents is recommended. Calcium antagonists are suitable particularly for the vasospastic form of the angina pectoris. They can be used also as basis medicaments, however, according to the hitherto yielded experiences they do not possess any advantages in contrast to the proved nitrates and beta-blocking agents. When apart from the ischaemic heart disease a hypertension exists, the beta-blocking agents are particularly indicated. This is further important for certain forms of tachycardiac disturbances of rhythm, which partly also well response to calcium antagonists. In patients with disturbances of conduction (sinus node and atrioventricular nodes, bifascicular block) beta-blocking agents are contraindicated. If there are no signs of cardiac decompensation and radiologically the heart proves to be normally large, so there is no indication for the prescription of glycosides.
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PMID:[Actual and theoretical points of view in the application of coronary therapeutic agents]. 610 22

The author discusses the results of examination conducted by means of continuous ECG recording for many hours, intracardiac electrography, and programmed electric stimulation of the heart in patients with ischemic heart disease and arrhythmias. It was established that ventricular extrasystoles, including the so-called precursors of ventricular fibrillation, are recorded in most patients suffering from chronic ischemic heart disease and acute myocardial infarction, in 66 and 95% of those examined, respectively. The article gives the electrophysiological criteria of the diagnosis of sino-atrial, atrial, nodal atrio-ventricular, supraventricular in additional paths of stimulation conduction, and ventricular paroxysmal tachycardia.
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PMID:[New study methods and their significance for the diagnosis of heart rhythm disorders]. 616 Feb 79

We observed 70 male patients with a seriously proceeding Chronic myocardial ischemia. They were hospitalised because of frequent, permanent and serious attacks of stenocardia at rest and in stress situations. More than 2/3 of these patients had suffered from a myocardial infarct. In the course of two weeks an intensive therapy with all modern preparations for vasodilatation was made. This therapy proved to be unsuccessful. Nearly all patients were administered more than 10 tables of nitroglycerin per day and, in addition, they were injected analgetics as a compensation of attack. The ultraviolet own blood irradiation (UVB) had a positive therapeutic effect in all patients. There was a good success in 46 patients, in all patients satisfactory results could be registered. The effect of therapy was evident by the decrease of administration of nitroglycerin required, by an increase in the degree of stress capacity, and by an easier treatment of stenocardia attacks. The observation time for patients amounted to 2-8 months. The success of therapy remained in 38 patients. After this time the success of therapy could partially be regained by a repeated number of irradiation series. Then, it remained positive in 9 of 22 patients who had been followed-up for 10 months. The half decay period of eliminating 131I from an intradermal depot could be normalised under the influence of ultraviolet own blood irradiation. This ultraviolet own blood irradiation had no significant influence on the fibrinogen level, fibrinolytic activity, and erythrocyte aggregation (examined in 11 patients). A 2 1/2-fold diminution of monomer fibrin complexes in the blood could be observed. The titre of antistreptolysin-O was increased in all patients who had got over the infarct. It had completely normalised a week after finishing the ultraviolet own blood irradiation. Spectroscopic examinations of the blood and plasma made after ultraviolet own blood irradiation revealed that this irradiation will not only affect the properties of Hb, but will also cause a photochemical transformation accompanied by a destruction of some plasma proteins, of the membrane of formed blood elements, and a photosynthesis of biochemically active compounds. The mechanism of action of ultraviolet own blood irradiation is complicated and requires further exact investigations. Even today, however, this method can be recommended as a complex therapy in patients with severe myocardial ischemia.
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PMID:[Therapy of severe stenocardia with ultraviolet blood irradiation (UVB) and various action mechanisms of this therapy]. 618 67

In 40 patients with chronic ischaemic heart disease [IHD) and 10 healthy subjects the total and local myocardial contractility was assessed during threshold-level exercise. The patients were subjected to radionuclide ventriculography in a modification recording the first passage of the radioindicator through the heart cavities. In the control subjects the exercise induced a 27% increase in the total ejection fraction, with increased contractility of all left ventricular segments. In the patients with IHD the reactions to exercise varied. In 40% of the patients the total ejection fraction increased adequately, in 17.5% the increase was nonadequate, in 20% no increase was observed, and in 22.5% the ejection fraction decreased. The most marked reduction in myocardial contractility was found in patients who had sustained myocardial infarction and reacted positively to the exercise test. In 34 patients there were observed left ventricular segments showing a paradoxical response of contractility to exercise--a decrease in the local ejection fraction. This pathological local reaction occurred rather in a normal function at rest than in a myocardium with hypokinetic segments at rest.
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PMID:Changes in total and local contractility of the left ventricle, imaged by radionuclide ventriculography, in patients with ischaemic heart disease during submaximal exercise. 627 65


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