Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

95 angina patients surgically treated by aortocoronary saphenous vein by-pass, have been studied by comparing the factors limiting the exercise (i.e. muscular exhaustion, angina, electrocardiographic changes), the total work performed, the O2 consumption and the heart rate-arterial pression product. After surgery the incidence of positive effort tests (effort angina and/or ecg evidence of myocardial ischemia) decreased from 79% to 27,4% (p less than 0,001), and the average amount of work performed increased from 2718 to 3504 Kgm (p less than 0,01), the MVO2 from 13,9 to 15,6 cc/min/Kg. (p less than 0,01) and the heart rate-arterial pression product from 206 to 243 (p less than 0,001). The patients who preoperatively were more invalidated (that is able to performe a lasser amount of physical work) presented a more pronounced improvement in comparison with those who had a greater tolerance to exercise. It seems therefore that for these latter patients the bypass grafting surgery should be justified only if a significant increase of life expectancy and reduction of myocardial infarction incidence could be definitely proved. The exercise performance improvement after surgery was statistically significant only in the patients with post infarction or with unstable angina not in those with chronic angina. The perioperative infarction (present in 8,4% of cases) did not show any unfavorable correlation with the result of the late postoperative effort test.
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PMID:[Aorto-coronary by-pass: pre and post-operative ergometric evaluation of 95 patients (author's transl)]. 30 58

We prospectively studied the clinical, biochemical (including creatine phosphokinase (CPK) isoenzymes) and electrocardiographic features of exertional heat stroke in 13 patients (group 1) and severe heat exhaustion in 14 patients (group 2). Despite initial presentations with severe hyperthermia, tachycardia and hypotension, only one patient with heat stroke had myocardial ischemia. The CPK isoenzymes were not indicative of myocardial damage in any patient. The patients with heat stroke were somewhat more dehydrated than those with heat exhaustion as measured by differences in serum creatinine, sodium and osmolality, and the former (group 1) had a significantly lower initial glucose level (P less than 0.05). Although significant differences in potassium were not observed in the pretreatment samples, at 12 hours the serum potassium was significantly lower in group 1 (P less than 0.05). This suggests that this group may have been more potassium-depleted at the time of heat stroke. Prompt recognition and vigorous therapy were successful in rapidly lowering high temperatures and in preventing serious complications.
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PMID:Cardiovascular and metabolic manifestations of heat stroke and severe heat exhaustion. 42 71

In 30 diabetics and their nearest relations (44 persons) the immunoreactive insulin (IRI) was examined and a routine glucose tolerance test was carried out as well as in patients with ischaemic heart disease (more than 100 patients). The control group consisted of 30 healthy volunteers. An analysis of the results was performed taking into consideration the degrees of severity and the duration of the diabetes as well as the age of the patients. A conclusion was drawn that the exhaustion of Langerhans islets occurs relatively early during "juvenile" diabetes. A clear decrease of the IRI corresponding to the degree of severity and to the duration of diabetes can be observed. In the nearest relations of the diabetics a normal IRI-level and in a relatively little percentage latent forms of a diabetes were detected. In patients with ischaemic heart disease however, the non-manifest forms of diabetes were by far more frequent. It is considered that more precise tests should be applied in laboratory diagnosis of latent diabetes mellitus in hereditarily aggravated persons in the mentioned respect.
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PMID:[Latent diabetes mellitus in families with diabetes and ischemic heart disease]. 96 Aug 96

Data covering 177 cases of the atrioventricular block where cardiostimulation was effected by using Soviet-made batch-produced electrocardiostimulators are analyzed. The largest group included patients 50 to 70 years old (71 per cent). In 47 per cent of the cases the atrioventricular block stemmed from ischemic heart disease. As indications for cardiostimulation served the Morgagni-Adams-Stocks syndrome and a well-marked circulatory insufficiency. The hospital lethality comprised 15.8 per cent. The death was caused by acute cardio-pulmonary incompetence, thromboembolism of the pulmonary artery and myocardial infarction. Among complications secondary to cardiostimulation figure suppuration of the operating wound, disturbed integrity of the myocardial electrodes and a premature exhaustion of the cardiostimulators reserves. From among 130 patients kept under observation the duration of cardiostimulation comprised: up to 1-year--in 20.7, from 1 to 3 years--in 26.1, from 3 to 5 years--in 20.7, from 5 to 10 years--in 1m.7 and over 10 years--in 14.8 per cent.
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PMID:[10-year experience with heart stimulation in atrioventricular heart block]. 111 22

Evaluation of the concentration of atrial natriuretic peptide, angiotensin P, renin activity in the blood of the coronary sinus and aorta in 18 patients with IHD and hypertrophy of the left ventricle during development of induced ischemia revealed that in left ventricular hypertrophy secretion of atrial natriuretic peptide by the myocardium is reduced. The level of this reduction depends on the kind of hypertrophy. Dilatation of the left ventricle cavity furthers exhaustion of the secretory function of the ischemic myocardium.
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PMID:[The interrelation of the secretory activity of the myocardium with its hypertrophic characteristics in patients with ischemic heart disease]. 129 16

The aim of this study was to evaluate the effects of the transdermal application of nitroglycerin (NGT) on exercise tolerated and regional myocardial perfusion, as evaluated by 201 thallium stress scintigraphy, in patients with stable effort angina. We studied 20 patients, 15 men and 5 women, aged between 43 and 68 years, with average age of 55 +/- 8 years, suffering from effort angina, whose angina threshold was stable in 3 stress testing performed in the week before the study started. The patients, after a pharmacological washout of 1 week, underwent 2 exercise testing 20 hours after the application of a patch containing placebo or 10 mg NGT, with an interval of 7 days. 60-90 s before stress testing was interrupted, 2 mCi of thallium 201 were injected in an antecubital vein of the arm. The scintigraphic images were obtained soon in the 0, 45 and 90 degree views and after 4 hours reperfusion. Under placebo patch all patients interrupted ergometer test for angina, while under the patch containing active NGT angina was present in 11/20 patients and 9 patients stopped the test because of muscular exhaustion. NGT induced an increase of the ergometer test duration (+26%); this difference was statistically significant. The ST segment downsloping decreased significantly both at maximal common work and at exercise peak after NGT application in comparison with placebo. The perfusional defects observed on the scintigraphic images obtained soon after the exercise (and reversible after 4 hours of reperfusion) on placebo patch, diminished significantly after NGT and the captation index lung/heart decreased also significantly (from 49 to 41%), showing so an improvement of cardiac performance. In conclusion the transdermal application of NGT, in patients with effort angina, demonstrated to have antianginal and antiischemic effect, reducing the number of patients interrupting the stress testing for angina, increasing the exercise tolerated and diminishing the ST segment downsloping, objective demonstration of myocardial ischemia. This antianginal and antiischemic effect might follow to the reduction of the preload induced by nitrates, in part also the reduction of the afterload, factors determining a decrease of the wall tension and so of MVO2, but also to a redistribution of the subendocardial flow as demonstrated by 201-Tl scintigraphic images. These effects induce also a global improvement of the left ventricular function as demonstrated by the reduction of the lung/heart index of thallium captation.
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PMID:[Acute effects of transdermal administration of nitroglycerin on effort tolerance and myocardial perfusion, evaluated by Tl-201 scintigraphy, in patients with stable effort angina]. 180 93

Exposure of human body to high altitude environment initiate reaction which could be result whether of adaptation or of exhaustion. The purpose is to establish the human body environment which enables regeneration of own cells. Therefore, mechanism of reestablishment of prevention and recognition of symptoms and signs of insufficient adaptability on high altitude are of great interest for clinical and other medical investigators. Special position in research refers on cardiovascular system. Results show, according to effect of only one factor-catecholamines, that in course of physical training on high altitude, could be expected, cardiac muscle hypertrophy. It is proved, that under special circumstances catecholamines stimulate synthesis of proteins what enables faster regeneration of the cells. However, under conditions of myocardial ischemia, uncontrolled loading of these patients could lead to deterioration of heart function appearance of cardiac insufficiency.
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PMID:[Aspects of acclimatization of the human body to acute and chronic high-altitude hypoxia]. 209 85

There are obviously several causes of myocardial dysfunction but energy deficiency of the myocytes may play a significant role and probably is a common mechanism during the progression of myocardial failure. Theoretically, a poor utilization efficiency of oxygen may be due to exhaustion of the myocardial stores of bioenergetics. In this report the authors review their biochemical results from measurements of coenzyme Q10 (CoQ10) levels in blood and human endomyocardial biopsies using an HPLC method from patients with suspected myocardial disease (n = 45). The levels of CoQ10, which has a key role in the respiratory chain and the synthesis of ATP, was found to be significantly decreased in various groups of patients with myocardial failure (dilated and restrictive cardiomyopathy and alcoholic heart disease) as compared to "normal" myocardium (0.42 +/- 0.04 micrograms/mg dry weight). The deficiency of CoQ10 was more pronounced with increasing symptoms; e.g. patients with dilated cardiomyopathy in NYHA Classes III and IV had lower tissue CoQ10 content than those of Classes I and II (0.28 +/- 0.04 vs. 0.37 +/- 0.06 micrograms/mg, p less than 0.001). Nearly two thirds of a series of 40 patients in severe heart failure (Classes III and IV) treated with CoQ10, 100 mg daily, in an open, controlled design showed subjective and objective improvement. Clinical responders were 69% and 43% of patients with cardiomyopathy and ischaemic heart disease, respectively. The results suggest that CoQ10 is a novel and effective breakthrough in heart-failure therapy and it appears safe, as no adverse reactions were registered. The through in heart-failure therapy and it appears safe, as no adverse reactions were registered.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Coenzyme Q10: clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure. 227 93

For a study of the natural history of coronary artery lesions after Kawasaki disease and their effect on myocardial blood flow reserve with exercise, five such patients underwent exercise testing on a bicycle. Oxygen consumption, carbon dioxide production, minute ventilation, and electrocardiograms were monitored continuously. Thallium-201 scintigraphy was performed for all patients. One patient stopped exercise before exhaustion of cardiovascular reserve but had no evidence of myocardial perfusion abnormalities. Four patients terminated exercise because of exhaustion of cardiovascular reserve; one had normal cardiovascular reserve and thallium scintiscans, but the remaining patients had diminished cardiovascular reserve. Thallium scintigrams showed myocardial ischemia in two and infarction in one. No patient had exercise-induced electrocardiographic changes. These results indicate that patients with residual coronary artery lesions after Kawasaki disease frequently have reduced cardiovascular reserve during exercise. The addition of thallium scintigraphy and metabolic measurements to exercise testing improved the detection of exercise-induced abnormalities of myocardial perfusion.
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PMID:Myocardial performance and perfusion during exercise in patients with coronary artery disease caused by Kawasaki disease. 229 63

During myocardial ischemia high amounts of noradrenaline are released from the sympathetic nerve terminals of the heart and accumulate in the extracellular space of the ischemic area. This increase in local catecholamine concentrations within the still viable myocardium may induce further deterioration of myocardial function during the ischemic process, i.e., acceleration of cell damage and induction of arrhythmias. Three different mechanisms of local catecholamine release have been demonstrated to operate subsequently during the course of myocardial ischemia. Correspondingly, three phases of release must be considered. Phase 1 (ischemia up to 10 min): The release of catecholamines occurs by exocytosis and depends on the activity of the efferent cardiac sympathetic nerves. The extracellular accumulation of noradrenaline is limited by the activity of the neuronal reuptake process and by presynaptic inhibitory effects of adenosine. Phase 2 (10-40 min of ischemia): A massive accumulation of noradrenaline is found in the extracellular space of the ischemic myocardium. The release is determined by local energy exhaustion rather than by centrally originating factors. The release mechanism is different from exocytosis and demonstrates the characteristics of a carrier-mediated efflux using the neuronal uptake carrier in reverse of its normal transport direction. Phase 3 (ischemia longer than 40 min): The release occurs in parallel with the development of structural membrane defects within the ischemic area and the sympathetic neurons progressively deplete from noradrenaline. Among these mechanisms, the carrier-mediated release of noradrenaline appears to be of greatest significance since during Phase 2, extracellular noradrenaline concentrations reach micromolar concentrations capable of producing myocardial necrosis even in the nonischemic heart.
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PMID:Adrenergic mechanisms in myocardial infarction: cardiac and systemic catecholamine release. 246 29


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