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)

Exercise two-dimensional (2-D) echocardiography was performed in patients with suspected coronary artery disease, and exercise induced left ventricular asynergy was evaluated qualitatively and was compared with the coronary artery stenosis and electrocardiographic ST changes. Subjects were 12 patients with angina of effort, 8 patients with spontaneous angina, 8 patients with chest pain syndrome with the normal coronary artery, and 7 patients with hypertrophic cardiomyopathy (HCM). Cases with myocardial infarction were excluded from this study. 1) Left ventricular asynergy during exercise was observed in 10 and ST depression in 11 of 12 patients with angina of effort. In patients with spontaneous angina, left ventricular asynergy and ST depression during exercise were observed in 2 of 8 patients without anginal pain, and both patients had coronary artery stenosis of 90% or more. 2) Exercise induced asynergy was also observed in 4 of 7 patients with HCM without coronary artery stenosis. It seemed likely that the markedly hypertrophied myocardium and impairment of left ventricular compliance and relaxation may induce relative myocardial ischemia.
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PMID:[Exercise two-dimensional echocardiography: correlation between exercise induced asynergy and coronary artery lesions]. 717 21

Fifteen patients were examined by echocardiography during the atrial stimulation test. The patients were divided into 2 groups: the main group of 8 patients with ischemic heart disease and a control group of 7 persons wit a negative bicycle ergometry test and no changes in the coronary arteries. It is shown that acceleration of the cardiac rhythm leads to a proportional decrease in the left-ventricular end-diastolic diameter and increase in Vcf and diastolic thickness of the myocardium; the ejection fractions, minute volume and index of left-ventricular activity do not change. It was revealed that the development of myocardial ischemia leads to myocardial asynergy, decrease in the ejection fraction. Vcf, index of left-ventricular activity and minute volume and to an increase in the end-diastolic diameter of the left ventricle, which precede the ECG changes and the development of an angina attack.
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PMID:[Intracardiac hemodynamics in heart rhythm acceleration and the development of an angina attack]. 720 26

Homeostasis of cardiac output is maintained by a complex intergration of many physiologic responses, both central and peripheral, including pulse,the contractile state of the ventricle, and pre-and after load. In the abnormal ventricle at rest, any or all of the measurable parameters that define left ventricular function may be normal. However, in disease states, exercise can provoke abnormalities in these parameters indicating a reduction in myocardial reserve. Regional asynergy occurs in patients with significant ischemic heart disease during exercise reflecting a local supply-demand mismatch. Recently, radionuclide ventriculography has been combined with exercise techniques in attempts to elucidate details of the normal and abnormal ventricular response to stress noninvasively. The majority of data describe the response of the ventricle during graded supine bicycle exercise. The normal response is to increase myocardial contractility, reducing end-systolic volume, while end-diastolic volume remains constant. This results in an increase in ejection fraction. In ischemic ventricles, regional asynergy develops and ejection fractions may either fall or fail to rise. This appears to be accomplished by an increase or no change in the end-diastolic volume, with an increase in end-systolic volume, particularly in patients with angina during exercise. Radionuclide methods can be applied to large mumbers of patients providing informaton that is unobtainable by more invasive procedures. This review traces the development of knowledge of the ventricular response to exercise, emphasizing the role of radionuclide ventriculography. Although radionuclide angiography has the capacity for advancing the understanding of the ventricular response to exercise, the technical limitations of this technique in specific diagnostic conditions has yet to be defined adequately.
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PMID:Physiologic Intervention in Cardiovascular Nuclear Medicine. 724 62

Left ventricular wall motion was studied by two-dimensional echocardiography in 11 patients with congestive cardiomyopathy and was compared with the data of the electrocardiogram and cardiac catheterization. A segmental analysis of left ventricular wall motion was performed using 9 segments obtained by short- and long-axis views of the left ventricle. Left ventricular volume and ejection fraction were calculated from the apical long-axis view by area-length method. Asynergy such as dyskinesis or akinesis was detected in 8 of the 11 patients. Two patients with complete left bundle branch block had asynergy in the septal, anterior and apical segments. In 3 patients with abnormal Q waves inI, aVL and V5,6, asynergy was observed in the different area of the left ventricle in addition to the corresponding region with EKG abnormalities. However, in 3 patients, asynergy occurred without any Q waves. The left ventricle with asynergy had an increased left ventricular end-diastolic volume and left ventricular end-diastolic pressure and a decreased ejection fraction as compared to those without asynergy. As congestive cardiomyopathy had high incidence of asynergy, it was difficult to differentiate congestive cardiomyopathy from ischemic heart disease by two-dimensional echocardiography.
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PMID:[Localized disorders of left ventricular wall motion in congestive cardiomyopathy (author's transl)]. 734 28

Asynergia of systolic wave of the apexcardiogram was studied in 54 patients with various forms of ischemic heart disease. The paradoxical protrusions were divided into 4 types. A directly proportionate dependence was disclosed between the magnitude of asynergy and the degree of the pathological condition. The paradoxical protrusion diminished during treatment and rehabilitation in most patients, in some it disappeared, which may point to the functional character of disorders of myocardial contractility.
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PMID:[Apex cardiography in the assessment of the signs of early disorder of myocardial contractile capacity]. 735 3

On examination of 56 persons, 4 were found to have no abnormalities of the cardiovascular system, in all of the others the diagnosis of ischemic heart disease was confirmed. The cardiac output was determined by means of a thermodiluter. The stroke work index, the total peripheral resistance, and the segmental contraction of the left-ventricular wall were calculated. Changes in the stroke volume in response to a stress test, left ventriculography, were studied. It was found that changes in the stroke volume do not correlate with the clinical and coronarographic manifestations of the disease and the condition of the contractility of segments of the left-ventricular wall in the absence of clinical symptoms of circulatory insufficiency. The trend of stroke volume changes recorded during the stress test showed a dependence on the volume and degree of left-ventricular asynergy. Changes in the stroke volume were determined by the initial value of the cardiac output. High sensitivity of the left-ventricular function curve in detecting dysfunction of the left ventricle as well stroke volume-total peripheral resistance feedback were revealed.
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PMID:[Interrelationship of cardiac output and myocardial contractility]. 737 84

Single-chamber echocardiography and B-scanning provide for evaluation of the local and total left ventricular function in patients with ischemic heart disease. In cases with zones of asynergy, B-scanning may be applied for quantitative evaluation of left ventricular volumes, the diagnosis of left ventricular aneurysm, appraisal of the extent of the zone of myocardial affection, and the contraction geometry and overall function of the left ventricle; the data yielded by echocardiography in the M-method are less accurate and less reliable.
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PMID:[Diagnostic potentials of echocardiography and ultrasonic scanning in ischemic heart disease]. 737 87

Radionuclide angiocardiography was utilized for the measurement of left ventricular dynamics and the analysis of its segmental wall motion. Left ventricular performance was measured by the first pass method and gated equilibrium method in patients with ischemic heart disease. The left ventricular wall motion was also examined by the analysis of computer-drawn outlines of radioactivity counts of the left ventricular chamber. These measurements were well correlated with those obtained by invasive methods such as contrast cine-ventriculography and thermodilution method in the resting state. The patients with effort angina often showed an almost normal left ventricular performance and wall motion in the resting state without ischemic episodes. However, at the time when anginal attack was provoked with exercise testing, an asynergy and a reduced performance of left ventricle were observed. The extent and localization of this asynergy well corresponded with the defect of myocardial scintigrams determined by 201-Tl stress myocardial imaging. From above findings we conclude that the myocardial ischemia with asynergy is a cause of decreased left ventricular hemodynamics during anginal attack. Although further evaluation is necessary to know limitations and to avoid inaccuracy, these techniques were shown to have a significant usefullness in evaluating ischemic heart disease.
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PMID:Evaluation of the left ventricular performance in patients with ischemic heart disease using radionuclide angiocardiography. 745 99

Acoustic quantification (AQ: the real-time automated boundary detection system) allows instantaneous measurement of cardiac chamber volumes. The feasibility of this method was evaluated by comparing the left ventricular (LV) volumes obtained with AQ to those derived from ultrafast computed tomography (UFCT), which enables accurate measurements of LV volumes even in the presence of LV asynergy, in 23 patients (8 with ischemic heart disease, 5 with cardiomyopathy, 3 with valvular heart disease). Both LV end-diastolic and end-systolic volumes obtained with the AQ method were in good agreement with those obtained with UFCT (y = 1.04 x - 16.9, r = 0.95; y = 0.87x + 15.7, r = 0.91; respectively). AQ was reliable even in the presence of LV asynergy. Interobserver variability for the AQ measurement was 10.2%. AQ provides a new, clinically useful method for real-time accurate estimation of the left ventricular volume.
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PMID:[Feasibility of the left ventricular volume measurement by acoustic quantification method: comparison with ultrafast computed tomography]. 787 1

The aim of this study is to try to evaluate the relationship between arterial hypertension and ischemic heart disease (IHD) in the light of the physiopathologic response pattern to the dipyridamole echocardiography test (DET) in hypertensive patients, in pharmacologic washout, without any electrocardiographic ST segment depression during exercise tests or at rest. Sixty patients affected by mild to moderate asymptomatic essential arterial hypertension were studied: the subjects had a sitting diastolic blood pressure > or = 95 < or = 114 mmHg; there were 38 men and 22 women with a mean age of 49.8 +/- 7.6 years (range twenty-nine to sixty-eight). All patients had undergone high-dose DET (0.84 mg/kg in ten minutes). No patients developed side effects or asynergy in cardiac contractility during the test. In the absence of any significant coronary artery obstruction assessed angiographically, 18 patients (30%) showed ST segment depression > 1.0 mV during DET, sometimes with the presence of ventricular and/or supraventricular extrasystoles. In this group of patients the left ventricular mass index (LVMI) and duration of hypertension (in months) were higher as compared with those of the other 42 patients (respectively: 160.2 +/- 5.1 vs 129.2 +/- 9.2 g/m2, P < 0.02; and 30 +/- 4.8 vs 9 +/- 5.4 months, P < 0.007). In conclusion it is reasonable to speculate from these data that the ischemic-like" dipyridamole-induced ST segment depression, like that shown by patients affected by Syndrome X, might involve a worse prognosis in hypertensive patients. This may be because of increased coronary resistance due to structural modification or anatomic background.
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PMID:Hypertension and ischemic heart disease. Role of dipyridamole echocardiography test. 797 8


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