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)

The effect of nitroglycerin, digoxin and inderal on myocardial asynergy was studied in 108 patients with ischemic heart disease by means of echocardiography. The effect of nitroglycerin was studied in 32 patients; myocardial contractions were restored in the areas of asynergy in 15 patients, in 17 the character of myocardial asynergy did not change. The effect of digoxin was studied in 42 patients; intensification of myocardial contractions in the asynergic areas was noted in 18 patients in 16 the character of asynergy of the myocardium did not change, and in 8 paradoxical protrusion of the cardiac wall increased. Prescription of inderal for 34 patients did not lead to the development of additional areas of myocardial asynergy; proportionate decrease of the amplitude of the systolic myocardial movement in healthy areas and in areas with hypo-and dyskinesia was noted in such cases. The study showed changeability of the character of myocardial asynergy under the effect of the drugs investigated, which should be taken into account when these drugs are given to patients with ischemic heart disease.
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PMID:[Effect of nitroglycerin, digoxin and inderal of myocardial asynergy in ischemic heart disease]. 10 Jun 46

A comparison was performed between the echocardiographic (EchoC) indices for the pump and contraction function of left ventricle and the stage of left-ventricle insufficiency, determined according to clinical criteria of 82 patients with ischemic heart disease (IHD)--old myocardial infarction and (or stable angina pectoris without left-ventricle infarction and for stable angina pectoris without left-ventricle aneurysm. With IHD, regardless of the considerable asynergy of left ventricle, some of the functional EchoC-indices were established to preserve their diagnostic values and definitely to differentiate the majority of the cases with, from those without, cardiac insufficiency, objectivizing the determination of initial left-ventricle insufficiency. The most significant diagnostic value of EchoC-assessment of left-ventricle function in IHD has the following complex of EchoC-indices: diastolic extent, left ventricle index resp, expulsion fraction (EF), shortening fraction (FS), average velocity of circumferential fibres (VCF), distance between point E of mitral echogram and interventricular septum (S-E distance), telediastolic interval A-C of mitral echogram and extent, index of left auricle, resp.
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PMID:[Echocardiographic evaluation of left ventricular function in ischemic heart disease (IHD)]. 52 71

In 120 P. with ischemic heart disease, left ventricolar wall motion was analyzed from the left ventriculogram in a regular sinus beat as compared to the first beat following one or more premature ventricular contractions (PExP). The response of asynergic segment to PExP was determined with a qualitative as wall as a quantitative technique. Of a total of 225 asynergic segments, 62% showed a positive response to PExP. In the absence of pathologic Q waves in the electrocardiogram, the response was positive in 77% and negative in 23% of the cases. In the presence of Q waves, PExP was present only in 33% of the cases (p less than 0.001). In respect to the severity of asynergy, 68% of 145 hypokinetic segments and 52% of 80 akinetic-dyskinetic segments responded to PExP; in the presence of pathologic Q waves, the number of positive responses decreased to 36% in the case of segmental hypokinesis, and to 31% in the case of more severe asynergy. The study of PExP has appeared as an useful diagnostic technique, capable of detecting a residual myocardial function in left ventricular asynergic segments, even in the presence of electrocardiographic signs of infarction.
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PMID:[Post-extrasystolic potentiation for the study of regional left ventricular asynergy (author's transl)]. 54 Jul 3

The left ventricular systolic ejection phase was cineangiographically analyzed in an attempt to evaluate left ventricular performance. Forty-eight patients were classified into five groups: (1) 9 controls; (2) 5 patients with PMD (congestive type) (COCM); (3) 9 patients with PMD hypertrophic type) (HCM), (4) 9 patients with ischemic heart disease (IHD); and (5) 16 patients with mitral stenosis (MS). The rate of volume change (deltaV/deltat) and the volume change as a percentage of stroke volume (deltaV/SV) in patients with COCM and IHD were lower in the early systole and higher in the mid-systole as compared with the control group. Normalized systolic ejection rate (NSER) and velocity of circumferential fiber shortening (Vcf) for the early and late systole were significantly lower in patients with COCM and IHD than in the control group. In two patients with IHD in whom normal indices of left ventricular performance and no asynergy were observed, NSER and Vcf were normal in the late systole but were significantly lower in the early systole. In all 48 patients, deltaV/deltat, deltaV/SV, NSER and Vcf were compared statistically with conventional ejection phase indices and isometric phase indices. delthV/SV for the midstystole showed a negative correlation with EF, MNSER and mVcf. NSER and Vcf for all three phases showed a good correlation with Vmax, max dp/dt and R-max dp/dt but a better correlation with EF, MNSER and mVcf. It was concluded that NSER and Vcf for the early systole were sensitive indices of left ventricular performance and may be utilized to detect subtle depression of left ventricular performance.
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PMID:Quantitative analysis of left ventricular ejection phase by means of left ventricular cineangiography. 59 71

The indices of contractility of the left ventricular myocardium were studied by means of ventriculography and catheterization in 84 patients with ischemic heart disease according to the extent of damage to the coronary arteries and the course of the disease. Changes in the coronary arteries were encountered twice as frequently among patients with postinfarction cardiosclerosis as among patients with angina pectoris and no history of infarction. The main cause of disorders of myocardial contractility in patients with ischemic heart disease is post-infarction cardiosclerosis (56% of cases). Signs of impaired functional capacity of the left ventricle appeared in segmental asynergy involving 20 to 25% of its circumference. Changes in the indices of contractility were revealed in 13% of patients with angina pectoris.
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PMID:[Myocardial contraction in ischemic heart disease]. 92 72

Studies were made using ordinary selective coronary angiography and angiography during ischaemia produced by right atrial pacing, on a series of 41 patients with ischaemic heart disease, to examine the response of the collaterals to the ischaemia stimulus. Regional myocardial perfusion was determined under the same circumstances by measuring regional 133Xenon washout curves. No collaterals were found in 8 patients, none of whom demonstrated collaterals when angiography was repeated during ischaemia. Eleven of the 33 patients with prepacing collaterals (33%) responded to ischaemia with an increase in the collaterals, 16 patients (49%) showed no change, 5 patients (15%) showed a decrease in the collaterals, and one patient exhibited a bidirectional change. Regional myocardial perfusion responses closely paralleled the angiographic changes, yielding suggestive evidence that the collaterals were intimately involved in the enhancement of the flow. Despite different collateral and flow responses to ischaemia, the data on exercise tolerance, left ventricular end-diastolic pressure, ejection fraction, prevalence of left ventricular asynergy, and the topographic relation between synergy and collaterals, were largely similar. The data show that in some patients the collateral circulation reacts to ischaemia by enhancement, but the functional significance of this response is obscure.
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PMID:Analysis of coronary collaterals in ischaemic heart disease by angiography during pacing induced ischaemia. 125 32

Many patients with ischemic heart disease and depressed left ventricular (LV) function have asynergic zones with sustained microcirculatory perfusion and myocardial metabolic activity that exhibit improved systolic function after coronary revascularization. The 2 predominant noninvasive techniques used to determine myocardial viability in patients with severely depressed LV function are thallium-201 (201Tl) scintigraphy and positron emission tomography (PET). Myocardial extraction of 201Tl is unaltered under experimental conditions of myocardial stunning or short-term hibernation (characterized by decreased flow and ischemic dysfunction). Akinetic or dyskinetic LV wall segments can exhibit normal or near normal 201Tl uptake as long as some residual flow is present. 201Tl scintigraphy can identify viable asynergic segments when performed on patients with severe coronary artery disease who are in the resting state. Many of these patients have initial resting defects that demonstrate delayed redistribution, or mild persistent defects that show improved perfusion and function after revascularization. There is a direct correlation between the extent of 201Tl uptake in zones of severe regional myocardial asynergy and the magnitude of improvement in resting LV ejection fraction after coronary bypass surgery. Rest 201Tl scintigraphy may help in the selection of patients with coronary artery disease and severely depressed LV function who would benefit the most from revascularization.
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PMID:Myocardial thallium-201 scintigraphy for assessment of viability in patients with severe left ventricular dysfunction. 144 67

A 63 year old female, who was admitted to a psychiatric hospital for schizophrenia, was referred to our emergency room because of sudden loss of consciousness and convulsions. On arrival, she was drowsy and hypoxemic. Her chest X-ray showed cardiomegaly with pulmonary edema. ECG showed marked ST depression in precordial leads and serum chemistry revealed marked elevation of CPK, GOT and LDH along with hyponatremia and hypochloremia. She was immediately admitted to CCU on suspicion of acute non-transmural myocardial infarction complicated with congestive heart failure. After fluid restriction and intravenous infusion of dopamine she passed large amount of urine, and her consciousness level, electrolyte imbalance and ECG change, improved gradually. Although serum CPK level increased as high as 32,307 IU/ml, there were no signs of left ventricular asynergy on UCG and CPK isozyme analysis performed later revealed more than 99% of serum cCPK was MM-type. We concluded that water intoxication was the cause of the ECG change and the elevated serum CPK, GOT and LDH levels. There are few reports on elevated CPK level in association with water intoxication, in which rhabdomyolysis is speculated as the cause of CPK elevation. But there is no report on ECG change complicated with water intoxication. In our case, electrolyte imbalance caused by water intoxication seemed to play a major role in ST depression and QT prolongation. Although water intoxication is a rare disorder in the general population, it is not infrequent among patients with psychiatric diseases. Care must be taken when such patients present ECG change and serum enzyme elevation mimicking ischemic heart disease.
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PMID:[A water intoxication patient who showed remarkable ST depression and suspected ischemic heart disease]. 152 80

Eight cases of transient reversible segmental asynergy of the left ventricle thought not to be related to coronary artery lesions are reported. Three cases were associated with inflammatory reactions of unknown origin, and one each with lactic acidosis, abdominal surgery, hypoglycemia, tetanus and pneumonia. None of the patients had symptoms suggestive of ischemic heart disease before or after these episodes. Electrocardiograms before these episodes were all normal. Two-dimensional echocardiography was performed to evaluate abnormal electrocardiograms. Coronary angiography was performed in 4 of 8 cases and was normal in all 4 cases; 2 done as emergencies and 2 non-emergencies. Two ergonovine tests were negative. Left ventricular wall motion abnormalities, present mainly at the apex of the left ventricle, returned to normal in 1 to 4 weeks. Giant negative T waves in the chest leads during this recovery period were characteristic electrocardiographic features and normalized in 6 weeks on average. We believe that these episodes were not related to ischemia due to coronary artery disease, but to some metabolic humoral factors. An excellent prognosis can be expected if these abnormal metabolic circumstances can be resolved.
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PMID:Transient segmental asynergy of the left ventricle of patients with various clinical manifestations possibly unrelated to the coronary artery disease. 174 67

Doppler assessment of left ventricular filling and ejection during dipyridamole stress may supplement wall motion analysis for detection of myocardial ischemia and coronary artery disease (CAD). Thirty-four patients taking no cardioactive therapy were studied using intravenous dipyridamole (0.6 mg/kg) during 2-dimensional and pulsed Doppler echocardiography. Twelve patients had normal coronary arteries (group 1) and the remainder, who had significant CAD, were divided into groups 2 (n = 11) and 3 (n = 11). Only subjects in group 2 developed myocardial ischemia manifest as reversible regional asynergy and ST-segment depression. Heart rate increased (16 +/- 9 beats/min, p less than 0.01) and mean blood pressure decreased (-5 +/- 8 mm Hg, p = not significant) uniformly across groups. Exaggerated hyperkinesia of normally contracting wall segments was the common response to dipyridamole infusion in patients with CAD. The respective mean percent changes in peak early diastolic velocity, peak atrial velocity, their ratio and ejection peak velocity, and mean acceleration for groups 1 (20, 42, -13, 20 and 23%), 2 (22, 32, -2, 10 and 14%) and 3 (23, 33, -6, 16 and 18%) were similar. Comparisons between normal patients and those with CAD and between groups 2 and 3 revealed no significant differences in the effect of dipyridamole on any variable. However, a decrease in both peak velocity and mean acceleration of left ventricular ejection was seen in 3 of 4 group 2 patients who developed severe ischemia. Dipyridamole-Doppler echocardiography is insensitive for detection of CAD and appears unable to identify myocardial ischemia unless this is severe. Hemodynamic changes and compensatory wall motion induced by dipyridamole may explain these findings.
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PMID:Evaluation of dipyridamole-Doppler echocardiography for detection of myocardial ischemia and coronary artery disease. 187 75


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