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)

In 11 patients (2 female, 9 male) suffering from angiographically proven CHD (age 45-60 years; 54.3 years on an average) the efficacy of a once-daily oral medication with 120 mg ISDN/50 mg ISMN and diltiazem (D) each in a long-acting preparation was examined in a placebo-controlled study. Each period lasted for 3 days; 2 capsules were given at 0700 a.m. one capsule at 5 p.m. Long-term ECG-recordings for 24 hrs (Tracker recorder, Pathfinder III) were performed twice under placebo and once during the third day of ISDN or ISMN, ISDN/ISMN + D in the morning and JSDN or ISMN in the morning and D in the afternoon. The rate of ischemic events declined from 10.4 to 4.7, 3.3 and 2.2; the duration of ischemia in 24 hours declined from 128 min to 43 min, 44 min and 34 min. The product of ST-depression (mV) and time of duration (min) showed an equivalent course. A more than 80% reduction of ischemia (duration and frequency) was achieved by a combination therapy in 72% of the patients. Minimal increase of heart rate at the beginning of ST-depression increased significantly during all periods of therapy, maximal increase of heart rate at that time showed a decrease only during combination therapy with D, the mean value did not change significantly. The once-daily application of ISDN/ISMN (50 mg) in a long-acting preparation (120 mg) led to a significant reduction of silent myocardial ischemia. The efficacy of ISDN/ISMN can be improved by D (120 mg, long acting preparation) up to a greater than 80% reduction in frequency and duration of ischemic events.
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PMID:[Combination therapy with slow release isosorbide nitrate and diltiazem in silent myocardial ischemia]. 268 57

In the Warsaw Pol-MONICA area, which is inhabited by 274,000 people of ages 25-64, trends in total mortality showed increases similar to those for the whole of Poland. In Warsaw, mortality from cardiovascular disease in men and from ischaemic heart disease (IHD), myocardial infarction (MI), and cerebrovascular disease in both sexes decreased from 1976 to 1986, whereas trends for these diseases were increasing for the whole of Poland. Within the last 11 years, the MI attack rate and case-fatality rate increased in Warsaw. In the Warsaw male population, an increase in the majority of CHD risk factors was also observed. Age-adjusted mortality rates, MI attack and incidence rates, and stroke attack rates in Warsaw were all higher in men than in women. The mean values of HDL cholesterol and LDL cholesterol, Quetelet's index, and prevalence of hypercholesterolaemia in Warsaw were higher in women than in men, whereas the mean values of triglycerides, diastolic blood pressure, and number of cigarettes smoked as well as prevalence of hypertriglyceridaemia, hypertension, and smoking were higher in men.
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PMID:Epidemiology of cardiovascular diseases in Warsaw Pol-MONICA area. 280 93

Myocardial ischemia without symptoms (= silent ischemia = Sl) has become a well known clinical entity in subjects with heart disease and in apparently healthy subjects. Detection of Sl is easiest and least expensively done with exercise ECG-testing (X-ECG). Data on the significance of Sl in the present report is derived from long-term follow-up of 2014 men aged 40-59 yrs, studied 1972-75, restudied in 1979-81 and 1986-88. The sources of information are: 1) 50 men with Sl detected with X-ECG/coronary angiography in 1972-75; 2) subjects with positive X-ECG in 1979-81 (but not in 1972-75); 3) preliminary data from the last follow-up study; and 4) complete data on cardiovascular mortality by Aug. 1987. The survey data indicate: a) Sl detected with X-ECG, confirmed with angiography is an indicator of later severe CHD-complications over 12-15 yrs; b) positive X-ECGs (not validated invasively) increase the risk of future CHD events and death from CHD 2-4 fold compared with subjects with normal X-ECG of similar age; c) limited isotope studies from the 1986-88 study indicate a very high specificity of a positive X-ECG in CHD, and d) cardiovascular mortality is very accurately predicted by factors known to be associated with the development of CHD. In accordance with the world literature, Sl is frequently observed in apparently healthy middle-aged and old men, and increases the risk of future CHD considerably when encountered.
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PMID:Coronary heart disease without angina pectoris: silent ischemia. 322 15

Catheterization of the coronary sinus, the atrial stimulation test with repeated ventriculographies and investigation of myocardial metabolism of lactate, and coronary ventriculography were performed in 25 CHD patients. The absence of interrelationships between the gravity of affection of the coronary arteries and changes in left ventricular contractility in the atrial stimulation test, a limited role of quantitative determination of myocardial extraction of lactate and the absence of direct interrelationships between metabolic and mechanical symptoms of myocardial ischemia were established.
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PMID:[Regional contractility of the left ventricle during the performance of an atrial stimulation test in patients with ischemic heart disease]. 336 51

Clinical use of the quantitative method of evaluation of myocardial perfusion reserve capacities was analysed in patients with ischaemic heart disease, dilating cardiomyopathy and essential hypertension. Using Tl(201) myocardial scintigraphy, the indicator accumulation in the myocardium was quantitatively evaluated and the interrelationship between the myocardial mass, myocardial perfusion and its reserve capacities in patients with dilative cardiomyopathy was established. It was noted that myocardial perfusion changes in patients with CHD and essential hypertension depend on changes in the cardiac pump function.
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PMID:[Clinical aspects of the quantitative evaluation of the accumulation of Tl-201 in the myocardium]. 342 8

The purpose of this study was to compare the in vitro metabolic changes in mouse peritoneal macrophages exposed to sera of CHD patients and healthy donors. Oxidative (metabolic) burst was estimated by the activity of one of the limiting enzymes of hexose monophosphate shunt--glucoso-6-phosphate dehydrogenase. Pronounced enhancement of glucoso-6-phosphate dehydrogenase activity accompanied the exposure of macrophages to sera of patients with acute myocardial ischemia during the first two days after the onset of anginal pains. The correlation was established between the activity of creatine kinase in the sera of patients with acute myocardial infarction and the ability of these sera to enhance glucoso-6-phosphate dehydrogenase activity in mouse peritoneal macrophages.
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PMID:[Activation of glucose-6-phosphate dehydrogenase in mouse peritoneal macrophages by sera from patients with ischemic heart disease]. 373 May 42

The isoprenaline test was performed in 89 patients with CHD and cardialgias of various origins. The diagnosis was verified by coronarography and bicycle ergometry in 60 patients. Isoprenaline was administered via intravenous drip, with the initial rate of 2-3 micrograms/min eventually increased until clinical or electrocardiographic signs of myocardial ischemia emerged, or the heart rate reached 130 beats per minute. When compared with coronarographic and bicycle-ergometric results, the isoprenaline test was shown to be highly sensitive and specific (64.3 and 95.2%), as evidenced by the electrocardiographic positive-result criteria, and superior to bicycle ergometry in its diagnostic possibilities. The isoprenaline test is recommended for the diagnosis of coronary heart disease in cardiologic and therapeutic hospital units. The test can be a method of choice in cases where rationed exercise tests are impossible to achieve.
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PMID:[Importance of the intravenous isoprenaline test in diagnosing ischemic heart disease]. 408 72

From an urban Swedish population, samples of 25 and 55 year old men and women were examined with questionnaires, oesophageal manometry including acid perfusion test. An exercise ECG was performed in 55 year old men with anginalike pain. Oesophageal dysfunction (OD) defined as either a hiatal hernia, severe dysmotility or a positive related acid perfusion test was found in 12% of the younger population and in 29% of the older one. The frequency of angina pectoris according to the Rose questionnaire was 5% in the 25 year olds and 13% in the 55 year olds. OD was found in 44% of the older male group with angina pectoris at history. In the angina group objective signs of ischemic heart disease was found in 32%. At interview by a cardiologist in connection with exercise ECG, the angina pectoris diagnosis as assessed by questionnaire was reduced to 4% in the 55 year old men. In this group objective signs of ischemic heart disease or a history of myocardial infarction (CHD) were found in 94%. The others, classified by a physician as possible or no angina pectoris had a lower rate of CHD of 25% and 13% respectively. The angina pectoris group diagnosed according to Rose questionnaire contains more people with OD than with CHD. The diagnosis angina pectoris as ischemic heart disease should therefore not be set on the history alone.
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PMID:Oesophageal dysfunction and angina pectoris in a Swedish population selected at random. 694 50

In the recently reported Scandinavian Simvastatin Survival Study (4S), 4,444 men and women between 35 and 70 years of age who had coronary heart disease and plasma total cholesterol concentrations of 212 to 310 mg per deciliter (5.5 to 8.0 mmol/l) received simvastatin or placebo for 5.4 years; in the treatment group, mortality from coronary heart disease was 42 percent lower and mortality from all causes was 30 percent lower. Further analysis of the relation between the risk of major coronary events and baseline cholesterol levels in patients randomised to placebo or simvastatin therapy in the study showed that simvastatin significantly reduced the risk of major coronary events in all quartiles of baseline total, high-density-lipoprotein, and low-density-lipoprotein cholesterol, by a similar amount in each quartile. Clearly, cholesterol-modifying interventions can substantially improve the outlook for patients with coronary heart disease and should be considered in identification and treatment of patients with established coronary heart disease. The available data from secondary intervention trials indicates that all patients with documented ischemic heart disease should be offered a reliable assessment of plasma total cholesterol. However, since the impact of simvastatin on CHD seems to begin after about one year of therapy it would be reasonable to exclude very old persons and patients with serious disease with a limited life-expectancy. As a consequence of the 4S data it should be recommended that all the patients in question, who after lifestyle modifications and non-pharmacological risk factor modification still have total cholesterol levels above 200 mg per deciliter (5.2 mmol) should be offered treatment with a HMG-CoA reductase inhibitor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The Scandinavian Simvastatin Survival Study: the clinical consequences]. 749 39

The relationship of dyslipidemia, particularly hypercholesterolemia to coronary heart disease is now well established. Although ischemic heart disease and stroke share many of the same risk factors, the relationship of cholesterol to stroke remains controversial. The 6-year and 12-year follow-up of the MRFIT study showed that elevated cholesterol significantly increased the risk for fatal nonhemorrhagic stroke. Atkins found no evidence that lowering plasma cholesterol influenced the incidence of fatal or nonfatal stroke and regression analysis showed no statistical association between the magnitude of cholesterol reduction and the risk for fatal stroke. We cannot preclude the possibility that more effective cholesterol lowering over a longer period of time might be effective. Hypertension is the most powerful risk factor for stroke. The San Antonio Heart Study reported a clustering of cardiovascular risk factors in individuals who developed hypertension during an eight-year follow-up period (higher levels of BP, fasting TC and LDLC, TG, glucose and insulin, and BMI, less favourable fat deposition, and lower HDL). Insulin resistance may be the unifying factor that results in those phenomena, the so-called syndrome X. The important factor underlying syndrome X may be central or visceral obesity, suggesting that maintenance or attainment of ideal weight would be a powerful preventive factor against both CHD and nonhemorrhagic stroke. There is evidence from the Treatment of Mild Hypertension Study that nutritional/hygienic measures can reduce the syndrome X risk factors and hence the risk of coronary heart disease and stroke.
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PMID:Dyslipidemia and metabolic factors in the genesis of heart attack and stroke. 791 92


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