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

Echocardiography was used in the examination of 51 patients with chronic ischemic heart disease (IHD) without accompanying hypertension and congestive circulatory insufficiency. With gradual advancement of the disease, a significant increase in left-ventricular volumes during the systole and diastole was recorded as well as a decrease in the ejection fraction (IF) and velocity of circulatory shortening of the myocardial fibres (Vch) in slight variations of the stroke volume. The IF and Vch were the most characteristic indices for appraising the early manifestations of myocardial contractility disorders. The index of left-ventricular structure functioning intensity (SFI) was used to characterize the functional state of the heart muscle. In patients with a severe course of the disease, SFI was found to be reduced because of an increase in the myocardial mass. The developing damage hypertrophy, however, did not provide for full compensation of left-ventricular function and was attended by a reduction of the indices of contractility and pump function of the heart. This provides the grounds for the assumption that the reduction of SFI in patients with severe IHD is associated with exclusion of part of the myocardium involved in the pathological process from effective functioning.
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PMID:[Intracardiac hemodynamics and myocardial contractile function indices in chronic ischemic heart disease]. 726 33

During the years 1971-1974, ambulatory ECG monitoring (AEM) during everyday activities was done in 888 consecutive subjects. Half of them were patients who suffered from chronic ischemic heart disease (IHD), while in the others no symptoms or signs of this disease were found. Ventricular arrhythmias (VA) were detected in 196 subjects of the former and in 190 of the latter group. The Bureau of Statistics provided information concerning the individuals who died before December 31, 1976, the cause of their death and whether or not the death occurred in hospital or was 'sudden'. We found that during the follow-up period, the rate of sudden cardiac death among the patients with IHD in whom AEM detected VA was higher than in subjects without VA. In the former group, there were 12 sudden cardiac deaths among 196 patients, while in the latter there were only 4 out of 248, a statistically significant difference. Sudden cardiac death was more frequent in individuals without IHD if AEM disclosed VA (4 sudden cardiac deaths among 190 subjects), as compared to individuals without VA (no sudden cardiac deaths among 254 subjects).
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PMID:Relationship between ventricular arrhythmias detected by ambulatory ECG monitoring and subsequent sudden cardiac death. 727 42

Certain categories of cardiovascular disease have significantly declined recently as causes of death. In the present investigation we describe the variation in cardiovascular mortality in Texas by ethnicity, age and sex during 1970--1975 using age-standardized proportional mortality ratios. Specifically, the question of whether the three major ethnic groups in Texas have shared equally in any changes in cardiovascular mortality is examined. Several subcategories of cardiovascular mortality are considered. Among the sex-ethnic groups both ischemic heart disease and acute myocardial infarction mortality declined less among Spanish-surnamed males and females than in their other white and black counterparts. Chronic ischemic heart disease increased in relative importance for all groups except Spanish-surnamed females, in whom it decreased. There was no significant decrease in cerebrovascular disease mortality among Spanish-surnamed males or females as there was in the other groups. These results suggest that important differences in cause-structure of mortality are occurring in the ethnic subpopulations of Texas.
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PMID:Trends in cardiovascular mortality in Spanish-surnamed, other white, and black persons in Texas, 1970--1975. 727 73

Algesimetry was used to study the pain sensitivity in 143 subjects (21 healthy individuals, 20 cases with neurocirculatory dystonia, 62 with chronic ischaemic heart disease and 40 with subacute myocardial infarction). The tests were performed for the tactile threshold, pain threshold, threshold of pain endurance and the interval of pain endurance. In a part of patients indices of pain sensitivity were correlated with tolerance to physical exertion. In neurocirculatory dystonia high pain sensitivity was due to the lowering of the pain threshold. In patients with ischaemic heart disease there were three types of pain threshold (low, medium, high) and two variants as concerns the interval of pain endurance (low and high). Low interval of pain endurance corresponded to low tolerance of physical exertion, hence algesimetry can serve as an additional method of objective interpretation of the bicycle ergometry tests.
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PMID:[Algesimetry in ischemic heart disease and neurocirculatory dystonia]. 732 24

Total cholesterol and triglycerides as well as their distribution among the different hyperlipoproteinemia types were studied in three patients groups: 47 normotensive patients with myocardial infarction, 35 normotensive patients with cardiosclerosis (chronic ischemic heart disease), 29 hypertensive patients without symptoms or signs of clinical atherosclerosis. Their results were compared to those of 45 normal controls. There was no decrease in HDL cholesterol nor increase in LDL cholesterol in patients with chronic or acute ischemic heart disease. A large percentage of patients from these groups had normolipoproteinemia. The most prominent lipidic changes were observed in hypertensive patients: no patient had a HDL cholesterol level above normal values, thirty three per cent had a HDL cholesterol level below 35 mg/dl. A high percentage of patients with acute myocardial infarction or hypertension exhibited atypical lipoproteinemia anomalies (hyper HDL triglyceridemia, hyper LDL triglyceridemia, hyper VLDL cholesterolemia) when they could have normolipoproteinemia. This suggested lipoproteinic metabolism disturbances in such cases.
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PMID:[Changes in serum lipid levels, lipid composition and lipoprotein fractions in patients with ischemic cardiopathies or arterial hypertension]. 733 37

The last 20 years have provided an extraordinary amount of data contributing to an improved understanding of the prognosis of chronic ischemic heart disease. However, much remains incompletely understood. The lack of more precise knowledge about prognosis encourages fuzzy clinical thinking and seems to justify the overutilization of a variety of diagnostic and therapeutic modalities. It seems probable that the information available on many individual patients is not fully utilized in assessing prognosis more accurately. An approach is outlined which attempts to utilize clinical and laboratory data in prognosis with particular emphasis on objective information concerning left ventricular function and evidence of myocardial ischemia. The importance of transition phases in the natural history of the patient with ischemic heart disease is emphasized. Table V attempts to summarize areas of clinical research which are important if we are to gain a better understanding of the prognosis of this unusually complex clinical entity, chronic ischemic heart disease.
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PMID:Prognosis in chronic ischemic heart disease. 734 23

The type of hemodynamics correlating with the severity of the disease was determined from the value of the cardiac index in 283 patients with ischemic heart disease. With progression of this index, the incidence of eu- and hyperkinetic types decreases while that of the hypokinetic type of circulation increases. In patients with the hyperkinetic type of circulation, however, there is a disproportion between the clinical course of the disease and its hemodynamic provision. Physical working capacity was highest in patients with the eukinetic type and lower in patients with the hyperkinetic and hypokinetic types of hemodynamics. The reactions of the cardiovascular system to the same physical exercises were found to have specific features in the different groups of patients. Pain in the heart was the most frequent reason for discontinuing the ergometric test in patients with the hyperkinetic type of circulation, in the groups with eu- and hypokinetic types of hemodynamics the ECG changes increased. Signs of ischemic heart disease were recorded most frequently on the ECG at rest in patients with the hypokinetic type of hemodynamics. The author contends that the type of hemodynamics is one of the components which determine the physical working capacity of patients with chronic ischemic heart disease.
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PMID:[Clinical and hemodynamic comparisons and the physical work capacity of ischemic heart disease patients with different types of circulation]. 742 Aug 47

30 patients with chronic ischemic heart disease allocated to controlled treatment and close monitoring, and 30 patients with ischemic heart disease placed under routine dispensary observation, living in rural areas, were examined. Effectiveness of dispensary follow-up of the IHD patients was found to be dependent upon three factors: use of differentiated approach to prescription of drugs, continuity of work in organization of treatment and feasibility of giving therapy under carefully health monitored conditions.
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PMID:[The efficacy of the dispensary observation of patients with ischemic heart disease who live in a rural locality]. 748 29

Aortic cross-clamping with inadequate myocardial preservation has been shown to cause postoperative decreases in myocardial performance following coronary artery bypass graft surgery. We have demonstrated a mild decrement in myocardial beta-receptor function associated with cold cardioplegia in a normal animal model; in normal human hearts, however, response to beta-adrenergic inotropic stimulation was diminished significantly. Beta-receptor dysfunction also is associated with chronic myocardial ischemia that is associated with severe ischemic heart disease. Although the change in beta-receptor function with acute regional myocardial ischemia associated with severe ischemic heart disease is not understood fully, we found that the intensity of regional ischemia significantly affects functional recovery after cardiopulmonary bypass (CPB). Myocardial stunning does not appear to be significant in this dysfunction; however, alterations in beta-receptor density and function may play a critical role in post-CPB ventricular function.
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PMID:Acute regional myocardial ischemia and recovery after cardiopulmonary bypass: effects of intensity of antecedent ischemia. 757 33

Direct evidence from pathologic-anatomical studies in victims of sudden cardiac death has been given for acute ischemia (caused by either an acute thrombus, plaque fissuring or an organizing thrombus) to play a major role in the genesis of sudden cardiac death. Furthermore, indirect data on the effects of drugs in the setting of acute myocardial infarction have demonstrated that treating patients with beta-blocking agents is more beneficial than treating them with a pure anti-arrhythmic drug such as lidocaine. Whereas lidocaine, which also reduces the incidence of ventricular fibrillation in the setting of acute myocardial infarction, may produce an excess of mortality, beta-blockers reduce ventricular fibrillation and are associated with a prolonged survival. Further, indirect evidence on the role of ischemia in ventricular arrhythmias is given in patients with chronic ischemic heart disease by several studies on coronary revascularization and by studies on antiarrhythmic drugs versus beta-blockers in the same situation. In conclusion, there is clear evidence from studies of coronary revascularization and from studies on drug intervention in different patient populations with ischemic heart disease at risk for ventricular arrhythmias and/or for sudden cardiac death that ischemia plays an important role in the genesis of these arrhythmias.
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PMID:Therapeutic consequences of newer studies addressing the problem of myocardial ischemia and ventricular arrhythmias. 763 2


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