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Sample records for angina inestable como

  1. Clinical Practice Guidelines for Unstable Angina Treatment. Guía de práctica clínica para el tratamiento de la angina inestable.

    Directory of Open Access Journals (Sweden)

    Claudio Manuel González Rodríguez

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Unstable Angina Treatment. It has been defined as the oppressive pain or uneasiness mainly thoracic, which is caused by a transitory myocardial ischemia. This document includes important aspects as classification, diagnosis, treatment (aimed at its principal strategies and risk stratification. It includes assessment guidelines focused on the most important aspects to be accomplished.Guía de práctica clínica para el tratamiento de la angina inestable. Definida como el dolor opresivo o malestar generalmente torácico atribuible a isquemia miocárdica transitoria. La guía enfoca aspectos principales como clasificación, diagnóstico, tratamiento dirigido a sus estrategias principales y estratificación de riesgos. Concluye con su guía de evaluación, enfocada en los aspectos más importantes a cumplir.

  2. Ectasia coronaria, angina inestable e insuficiencia aórtica

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    Róger A Lanzas Rodríguez

    2009-12-01

    Full Text Available Se presenta el caso de una paciente femenina de 79 años, conocida portadora de cardiopatía hipertensiva, insuficiencia aórtica y dislipidemia, que se hospitalizó con un síndrome coronario agudo. Durante su evolución presentó cambios electrocardiográficos de isquemia subepicardica anterior extensa e inferior, por lo que se le realizó una coronariografia selectiva bilateral, detectándose ectasia de la arteria coronaria derecha, con flujo lento y retención del medio de contraste. Se refirió el caso para cirugía de reemplazo valvular.Coronary artery ectasia, unstable angina and aortic insufficiency The case of a 79 year old female patient, who was hospitalized with acute coronary syndrome (ACS, is presented. She had known hypertensive heart disease, aortic insufficiency and dyslipidemia. During the evolution of her ACS, she presented electrocardiographic changes of ischemia. Selective coronary angiography detected ectasia of the right coronary artery with slow flow and retention of contrast medium. The patient was referred for aortic valve replacement surgery.

  3. Variabilidad de la frecuencia cardíaca en pacientes con angina inestable: correlación con otros marcadores pronósticos

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    Oswaldo Gutiérrez Sotelo

    2004-01-01

    Full Text Available Introducción: La importancia del análisis de la variabilidad de la frecuencia cardíaca (VFC está bien establecida como marcador pronóstico en pacientes que han tenido infarto agudo de miocardio y en otras cardiopatías. El objetivo de este estudio es establecer la correlación entre las variables de VFC y los índices pronósticos tradicionales en angina inestable Materiales y Métodos: Se reclutaron prospectivamente pacientes con diagnóstico de angina inestable. Se consignaron indicadores de riesgo cardiovascular clínicos (angor de reposo refractario, hipotensión arterial, insuficiencia cardíaca, presencia de cambios dinámicos en el ST-T, fracción de eyección =40% y los hallazgos angiográficos (2 ó más vasos, conformándose entonces dos grupos, de alto riesgo y de bajo riesgo. A todos los pacientes se les realizó un registro electrocardiográfico de 5 minutos y se analizaron diversas variables de VFC en dominio de tiempo y de frecuencia mediante un programa de computadora. Estas variables se compararon entre ambos grupos. Resultados: Se reclutaron 63 pacientes (44 hombres, 70% con edad promedio de 63 + 10.4 años (35-90; 46 se consideraron de alto riesgo por cambios electrocardiográficos dinámicos y la fracción de eyección disminuida y 17 de bajo riesgo. En el primer grupo, el poder espectral total fue significativamente menor que en el grupo de bajo riesgo (p=0.04. La banda de baja frecuencia mostró diferencia pero sin alcanzar significancia estadística (p=0.07 y otras variables como el SDNN, el NN50 y la banda de baja frecuencia, mostraron sólo tendencia de ser menores en el grupo de alto riesgo. Conclusión: En pacientes con angina inestable de alto riesgo, la presencia de indicadores pronósticos tiene correlación con una menor VFC en dominio de frecuencia.Introduction: The usefullness of heart rate variability (HRV analysis is well known in myocardial infarction as in other cardiac diseases as a prognostic tool. The

  4. Troca de gases prejudicada em pacientes com angina instável Deterioro del intercambio gaseoso en pacientes con angina inestable Impaired gas exchange in patients with unstable angina

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    Dayane Horta Rocha

    2009-09-01

    Full Text Available A identificação do diagnóstico de enfermagem "troca de gases prejudicada na assistência aos pacientes com angina" é visualizada rotineiramente, porém faz-se necessário um aprofundamento desta temática. Com o objetivo de analisar a ocorrência deste diagnóstico, realizamos um estudo transversal, de caráter descritivo-exploratório, com pacientes internados em um hospital especializado. Os dados foram obtidos por meio de entrevista, exame físico e consulta ao prontuário. O diagnóstico "troca de gases prejudicada" foi ausente em nossa amostra; entretanto, as variáveis profundidade da respiração, pressão arterial sistólica, sonolência e sódio sérico estiveram comprometidas, o que indica risco de agravamento. Visualizamos alguma relação entre os resultados obtidos e características do estilo de vida dos pacientes avaliados, o que reforça a importância de medidas preventivas para a obtenção de um melhor prognóstico na assistência aos pacientes com angina.La identificación del diagnóstico realizado por parte de la enfermería del Deterioro del intercambio gaseoso en el cuidado de pacientes con angina es comúnmente percibida, sin embargo es necesario profundizar esta temática. Con el objetivo de analizar la ocurrencia del diagnóstico del Deterioro del intercambio gaseoso en portadores de Angina Inestable desarrollamos un estudio transversal, de carácter descriptivo-exploratorio, con pacientes ingresados en un hospital especializado. Los datos fueron recolectados por medio de entrevistas, examenes físicos y consultas a los registros médicos. Este diagnóstico no fue identificado en nuestra muestra, sin embargo, las variables profundidad de la respiración, presión arterial sistólica, somnolencia y sodio sérico presentaron alteraciones , lo que indica riesgo de agravación del cuadro clínico. Se identificó una relación entre los resultados obtenidos y las características del estilo de vida de los pacientes

  5. Diferencias en las características clínicas y en la evolución intrahospitalaria entre la angina inestable primaria y secundaria en ancianos

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    Mariano A. Giorgi

    2007-01-01

    Full Text Available IntroducciónLa angina inestable (AI se clasifica en primaria (AP y secundaria (AS sobre la base de la presencia o no de causas secundarias de isquemia. Estas condiciones son frecuentes en los ancianos y podrían influir en su pronóstico.ObjetivoEl presente trabajo se llevó a cabo con el objetivo de evaluar las características clínicas y la evolución intrahospitalaria de ancianos con AI primaria y secundaria.Material y métodosSe registraron 298 ancianos (edad ≥ 75 años con diagnóstico final de AI. La muestra se dividió, según la presencia de causas secundarias de isquemia (anemia, taquicardia, hipertensión no controlada, infección, hipertiroidismo, en dos grupos: AS y AP. Secompararon antecedentes, características clínicas al ingreso, tratamientos, procedimientos y la ocurrencia de muerte y muerte o infarto en la fase intrahospitalaria. Se identificaronpredictores univariados de mala evolución.ResultadosCincuenta y dos pacientes (17,45% tenían AS y 246 (82,5% padecían AP. Los pacientes con AS eran más añosos y tenían mayores registros de tensión arterial y de frecuencia cardíaca al ingreso. El tratamiento médico, la cinecoronariografía y la revascularización se utilizaron menos en el grupo AS. La mortalidad (7,7% versus 6,9% [p = 1,00; OR (IC 95 = 1,12 (0,36-3,48] AS y AP, respectivamente y la combinación de muerte o infarto (7,7% versus 9,7%[p = 0,79; OR (CI 95 = 0,77 (0,25-2,32] AS y AP, respectivamente fueron similares. Los predictores univariados de muerte o infarto fueron infradesnivel del ST y desarrollo de insuficiencia cardíaca para ambos grupos y la refractariedad y necesidad de coronariografía y revascularización para el grupo AP. ConclusiónLa AS es una causa común de isquemia en los ancianos y, pese a que requiere un manejo diferente, orientado a su etiología, tiene un pronóstico similar al de la AP.

  6. Comparação de biomarcadores inflamatórios entre pacientes diabéticos e não-diabéticos com angina instável Comparación de biomarcadores inflamatorios entre pacientes diabéticos y no-diabéticos con angina inestable Comparison of inflammatory biomarkers between diabetic and non-diabetic patients with unstable angina

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    Marçal de Oliveira Huoya

    2009-04-01

    concentração de marcadores inflamatórios de fase aguda, independentemente do estado metabólico.FUNDAMENTO: Pocos estudios compararon la actividad inflamatoria entre pacientes diabéticos y no-diabéticos con síndrome coronario agudo, y todavía no se publicó ninguno que investigara solamente a los portadores de angina inestable (AI. OBJETIVO: Este estudio tuvo dos objetivos. En primer lugar, comparar los niveles séricos de proteína C reactiva (PCR y interleuquina-6 (IL-6 en pacientes diabéticos y no-diabéticos con angina inestable (AI para determinar si la diferencia en la actividad inflamatoria justifica el empeoramiento pronóstico en los pacientes diabéticos. En segundo, evaluar la correlación entre los marcadores inflamatorios y el perfil metabólico en pacientes diabéticos y entre la respuesta inflamatoria y los desenlaces hospitalarios, como muerte, infarto agudo de miocardio, insuficiencia cardiaca congestiva y tiempo de hospitalización. MÉTODOS: Estudio de cohorte prospectiva de 90 pacientes consecutivos, ingresados a la Unidad de Dolor Torácico con angina inestable. Se dividieron a los pacientes en dos grupos: diabéticos y no-diabéticos. Los niveles séricos de PCR e IL-6, el perfil metabólico y el conteo de leucocitos se obtuvieron al ingreso al hospital. RESULTADOS: De todos los pacientes analizados, 42 (47% eran diabéticos (edad 62 ± 9 y 48 (53% no eran diabéticos (edad 63 ± 12. No se encontraron diferencias entre la mediana de la PCR (1,78 vs. 2,23 mg/l, p = 0,74 y de la IL-6 (0 vs. 0 pg/ml, p = 0,31 entre los dos grupos. Hubo una correlación positiva entre la PCR y el colesterol total (rs = 0, 21, p = 0, 05, la PCR y el colesterol LDL (rs = 0,22, p = 0,04 y la PCR y el conteo de leucocitos (rs = 0,32, p = 0,02 en los dos grupos. No se encontró ninguna asociación entre los marcadores inflamatorios y los desenlaces hospitalarios. CONCLUSIÓN: No encontramos diferencia en la actividad inflamatoria entre los pacientes diabéticos y no

  7. Solitones embebidos: estables, inestables, continuos y discretos

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    J. Fujioka; R. F. Rodríguez; A. Espinosa-Cerón

    2006-01-01

    En 1997 se descubrió un nuevo tipo de solitones, bautizados en 1999 como solitones embebidos . Estas peculiares ondas no lineales son interesantes porque existen bajo condiciones en las que hasta hace poco se creía que la propagación de ondas solitarias era imposible. En este trabajo se explica qué son los solitones embebidos, en qué modelos se han encontrado, y qué variantes existen(estables, inestables, continuos, discretos, etc.).

  8. Solitones embebidos: estables, inestables, continuos y discretos

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    J. Fujioka

    2006-01-01

    Full Text Available En 1997 se descubrió un nuevo tipo de solitones, bautizados en 1999 como "solitones embebidos". Estas peculiares ondas no lineales son interesantes porque existen bajo condiciones en las que hasta hace poco se creía que la propagación de ondas solitarias era imposible. En este trabajo se explica qué son los solitones embebidos, en qué modelos se han encontrado, y qué variantes existen(estables, inestables, continuos, discretos, etc..

  9. Ecuador: una democracia inestable

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    Juan J. Paz y Miño Cepeda

    2009-12-01

    Full Text Available En 1979, tras una década de dictaduras militares, se inició la fase constitucional más larga en la historia del Ecuador. Ésta se levantó sobre las herencias del pasado y se caracterizó, de manera fundamental, por el tránsito desde un modelo estatal-desarrollista hacia uno de tipo empresarial, por el aparecimiento de nuevos agentes sociales, el multipartidismo político, la regionalización nacional, la presencia multicultural y la inserción del país en nuevas relaciones internacionales. Pero esos procesos trajeron como consecuencias centrales: la edificación de una economía inequitativa, una sociedad tensionada, la desestructuración institucional, la precarización del trabajo y la debilidad con la que la nación ha enfrentado el nuevo mundo unipolar. Todo ello ha configurado un cuadro de riesgos para la incipiente democracia. El Ecuador contemporáneo tiene, por tanto, una serie de desafíos económicos, sociales y políticos para escapar a la inestabilidad que ha acompañado a la construcción de su modernización democrática.___________________ABSTRACT:In 1979, after one decade of military dictatorships, the longest constitutional phase in the history of Ecuador was initiated. It was built upon the inheritance of the past and can be fundamentally characterized by the transition from a model that focused on the state as developing the economy (State-model to a model that focused on private business (enterprise-model. The appearance of new social agents, a multiparty system, national regionalization, multicultural presence and the country´s new international relationships are processes which show some important consequences: the establishment of an unequal economy, a society under tension, the breakdown of institutional structures, the vulnerability of working conditions and the weakness with which the nation faced the new polarized world. All this might put into danger this incipient democracy. And this is why Ecuador in these

  10. Angina Pectoris (Stable Angina)

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Angina Pectoris (Stable Angina) Updated:Sep 19,2016 You may have heard the term “angina pectoris” or “stable angina” in your doctor’s office, but ...

  11. Problemas de adaptación fisiológica en personas con angina

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    Nóbrega Fortes, Allyne; Martins da Silva, Viviane; Lopes,Marcos Venícios de Oliveira

    2006-01-01

    En este artículo fueron identificados los problemas comunes de adaptación fisiológica presentados por pacientes con angina inestable teniendo como base el Modelo de la Adaptación de Callista Roy. Estudio descriptivo desarrollado en un hospital de servicio especializado en enfermedades cardíacas. La muestra para el estudio fue de 20 pacientes. Para caracterización y discusión, utilizamos las definiciones presentadas por Roy para cada problema de adaptación fisiológic...

  12. DIAGNÓSTICO DE ENFERMAGEM RISCO DE QUEDAS EM PACIENTES COM ANGINA INSTÁVEL

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    ALLYNE FORTES VITOR

    2010-01-01

    Full Text Available El riesgo de caídas puede ser considerado como fenómeno o diagnóstico de enfermería. Investigaciones han relacionado directamente isquemias de miocardio, como la angina inestable y el riesgo de caer. La meta de este estudio fue analizar el diagnóstico de enfermería Riesgo de caídas en casos de angina inestable a través de estudio transversal realizado en 57 individuos internados en un hospital académico, mediante examen físico y cuestionario. Para el análisis estadístico se utilizaron test de chi cuadrado, test exacto de Fisher, Mann-Whitney, test-t y Coeficiente Phi (p <0,05. El Riesgo de caídas fue el diagnóstico de enfermería más preponderante (87,71%, especialmente en los hombres, mayores, con menos años de estudio y renta inferior. Presencia de angina inestable, hipertensión arterial, remedios contra hipertensión, enfermedad vascular, dificultades visuales e insomnio presentaron asociación con el diagnóstico de enfermería Riesgo de caídas. Se concluye que es imprescindible el desarrollo de parámetros claros y objetivos para medir con más precisión el riesgo de caídas en el ámbito de un hospital.

  13. TROMBO GIGANTE DE AURÍCULA DERECHA COMO CAUSA DE ANGINA Y SÍNCOPE / Giant thrombus in right atrium as a cause of angina and syncope

    OpenAIRE

    José L. Aparicio Suárez; Mario E. Nápoles Lizano; Roberto Bermúdez Yera; Jean L. Chao García; Roger Mirabal Rodríguez; Yuri Medrano Plana

    2012-01-01

    ResumenLas tumoraciones intracardíacas son poco frecuentes, y pueden ser de tipo neoplásicas y no neoplásicas. De estas últimas, los trombos, constituyen las masas más frecuentes. Se presenta un paciente joven, operado en el Cardiocentro "Ernesto Che Guevara" de Villa Clara, Cuba, con antecedentes de trastornos hematológicos desde la infancia, que comienza con episodios de disnea progresiva, angina y síncope; con diagnóstico preoperatorio de tumoración gigante en aurícula derecha que resultó ...

  14. Estudio de eficacia y coste en la electroestimulación medular como tratamiento de la angina refractaria Cost-effectiveness study of medullary electrostimulation for the management of refractory angina

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    M. Mayo

    2004-07-01

    Full Text Available Objetivo: Valorar la evolución de los pacientes, de nuestro hospital, diagnosticados de angina refractaria y tratada con estimulación eléctrica medular (EEM cervical desde 1994-2002, además de valorar los costes asociados a dicho tratamiento y su relación coste/beneficio. Material y métodos: Estudio retrospectivo de 12 pacientes observando su evolución a lo largo de 8 años con controles clínicos periódicos, objetivándose tanto en la historia previa como posterior al implante, las siguientes variables: fracción de eyección del ventrículo izquierdo (FEVI, estadio funcional NYHA, frecuencia de ingresos hospitalarios, frecuencia de episodios anginosos e ingesta de cafinitrinas, sensación subjetiva de mejora del dolor anginoso, exitus, costes hospitalarios previos y posteriores a la colocación del EEM. Resultados: El electrodo de EEM fue implantado a nivel cervical siendo más frecuente la localización C2-C3 (58,3%. No se presentó ninguna complicación intraoperatoria. En el postoperatorio inmediato tuvimos como única complicación un desplazamiento del electrodo. No hubo ninguna complicación a largo plazo. Comprobamos que existió una disminución del número de anginas por semana (14 vs 4 p = 0,005 asociada a una disminución del número de tomas de nitroglicerina de acción rápida (15,7 vs 3,8 p = 0,002 y a una disminución en el número de ingresos hospitalarios/año (2,62 vs 0,84 p = 0,003. La mejoría subjetiva por parte del paciente tras la colocación del neuroestimulador fue del 70%. En cuanto al coste hospitalario quinquenal (conformado sólo por el coste del ingreso sin pruebas complementarias fue de 37.921,85 e en los pacientes con angina refractaria que no portaban EEM, frente a los 15.150,25 € de los pacientes portadores EEM.Objective: To assess the evolution of patients in our hospital with diagnosis of refractory angina treated with cervical medul-lary electrostimulation (MES over the period 1994-2002, and to

  15. Cervical Angina

    Science.gov (United States)

    Sussman, Walter I.; Makovitch, Steven A.; Merchant, Shabbir Hussain I.

    2015-01-01

    Cervical angina has been widely reported as a cause of chest pain but remains underrecognized. This series demonstrates the varied clinical presentation of patients with cervical angina, the delay in diagnosis, and the extensive cardiac examinations patients with this condition typically undergo prior to a definitive diagnosis. Recognition of this condition in patients with acute chest pain requires a high index of suspicion and an awareness of the common presenting features and clinical findings of cervical angina. PMID:25553225

  16. Efectos del entrenamiento en superficies inestables sobre el equilibrio y funcionalidad en adultos mayores

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    Juan C. López S

    2015-02-01

    Full Text Available Objetivo: determinar los efectos de un programa de ocho semanas de entrenamiento en superficies inestables con y sin trabajo de fuerza, sobre el equilibrio y la capacidad funcional en adultos mayores de 60 años, pertenecientes al programa “Escuelas populares del deporte” del inder Medellín. Metodología: se llevó a cabo un estudio experimental simple, ciego y enmascarado con asignación al azar de 34 sujetos a dos grupos de intervención con y sin trabajo de fuerza sobre superficies inestables; se midió el equilibrio unipodal, bipodal con ojos abiertos y cerrados, además de pruebas funcionales como Up and Go, arm curl y chair test. Resultados: las intervenciones con y sin trabajo de fuerza mejoraron el equilibrio total en 57,0 y 69,5 segundos respectivamente, sin diferencias estadísticamente significativas en la comparación entre los grupos (p = 0,13. Se mejoró la velocidad de la marcha con ambas intervenciones sin diferencias intragrupos estadísticamente significativas (p = 0,33 pero importantes para la práctica. Conclusión: ambas intervenciones mejoran el equilibrio, sin embargo existen diferencias importantes para la práctica a favor del programa sobre superficies inestables sin trabajo de fuerza, pues la intervención tiene un mejor efecto sobre el equilibrio unipodal y bipodal tanto con ojos abiertos como con cerrados.

  17. [Ludwig's angina].

    Science.gov (United States)

    De Bast, Y; Appoloni, O; Firket, C; Capello, M; Rocmans, P; Vincent, J L

    2000-06-01

    Ludwig's angina is a rare infectious condition originating in the oropharyngeal region, most commonly from the teeth. The principal symptoms consist of cervical pain, dyspnea, dysphagia, symmetrical neck swelling and fever. Serious complications include respiratory collapses, mediastinitis, pleural empyema, pericarditis and pericardial tamponade, and may result in the death of the patient. The most useful investigations in patients with suspected Ludwig's angina are clinical assessment, a cervico-thoracic CT-scan to determine the extent of the lesions, microbiological examination and panoramic radiography to detect possible dental focuses of infection. Treatment consists of ensuring adequate ventilation by securing the upper airways, broad spectrum antibiotic therapy, eradication of the source of infection, and often early surgical decompression may be necessary. Rapid diagnosis and appropriate treatment can reduce the mortality rate to 10%.

  18. TÓRAX INESTABLE, EVOLUCIÓN SIN OSTEOSINTESIS: PRESENTACIÓN DE UN CASO

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    Elbert Oberto Reyes Graterol; Jhonelly Jhoselyn Narváez Rodríguez; Héctor Alonso Moreno Parra; Willington René Zapata Salazar

    2011-01-01

    El trauma torácico cerrado suele ser el resultado de un impacto directo a alta velocidad o caídas siendo responsable de fracturas costales. Se define tórax inestable como la fractura de tres o cuatro costillas en más de dos segmentos de su longitud, ocasionando un fenómeno paradójico en la caja torácica durante la respiración, colapsándose en inspiración y expandiéndose en espiración. Los de localización anterior o lateral son los más graves, dada su repercusión fisiopatológica. El diagnóstic...

  19. Terapia celular associada à revascularização transmiocárdica laser como proposta no tratamento da angina refratária Cell therapy plus transmyocardial laser revascularization: a proposed alternative procedure for refractory angina

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    Luís Alberto Oliveira Dallan

    2008-03-01

    Full Text Available OBJETIVO: É descrita uma proposição cirúrgica para o tratamento de pacientes com doença arterial coronária (DAC terminal, não mais passíveis de revascularização miocárdica convencional. Constitui-se na revascularização transmiocárdica com raios laser (RTML, associada ao emprego de células progenitoras hematopoiéticas autólogas (CPH. MÉTODOS: Nove pacientes (oito homens, 65±5 anos, com as características supracitadas foram submetidos ao procedimento combinado. Além da avaliação clínica, o protocolo incluiu o estudo da perfusão miocárdica através da ressonância cardíaca (RMC sob estresse farmacológico, antes e seis meses após a intervenção cirúrgica. Procedeuse à RMTL através de minitoracotomia esquerda e utilização de laser de CO2, com média de 11±3 tiros por paciente. As CPH foram obtidas por punção medular, seguindo-se sua injeção direta (1,9±0,3x10(8 células/paciente em múltiplas áreas do miocárdio isquêmico. RESULTADOS: Não ocorreram óbitos ou complicações imediatas decorrentes dos procedimentos. Um paciente faleceu no segundo ano de pós-operatório, de causa não cardíaca (choque séptico. O seguimento clínico pós-operatório desses pacientes revelou redução significativa da classe funcional de angina de 3,7±0,2 para 1,3±0,2 (pOBJECTIVE: We tested the hypothesis that TMLR combined with intramyocardial injection of BMC is safe, and may help increase the functional capacity of patient with refractory angina. METHODS: Nine patients (eight men, 65±5 years old, with refractory angina for multivessel disease and previous myocardial revascularization procedures (CABG/PCI, not candidates for another procedure due to the extension of the disease were enrolled. TMLR (11±3 laser drills was performed via a limited thoracotomy using a CO2 Heart Laser System. BMC were obtained immediately prior to surgery, and the lymphomonocytic fraction separated by density gradient centrifugation. During

  20. Bloqueo de Ganglio Estrellado en el tratamiento de angina de pecho refractaria: un posible tratamiento coadyuvante

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    Isaías Salas Herrera

    2002-04-01

    Full Text Available El presente trabajo corresponde una revisión bibliográfica de los estudios clínicos realizados en síndromes anginosos refractarios al tratamiento convencional, utilizando como tratamiento el bloqueo de ganglio estrellado. Se realizó una búsqueda de literatura publicada entre los años 1.900 al 2.000 en las bases de datos MDConsult, Medline y ProQuest. A su vez se revisaron las publicaciones en la Biblioteca del Hospital Rafael Ángel Calderón Guardia y en la Biblioteca del BINASSS (Biblioteca Nacional de Salud del Seguro Social. De acuerdo a los estudios analizados el bloqueo de ganglio estrellado se describe como posibilidad terapéutica para el control de dolor de la angina de pecho refractaria . La descripción clásica de la inervación cardíaca consiste en tres nervios simpáticos mayores originados de los ganglios cervicales superior, medio e inferior. Esta inervación simpática en conjunto con diversos nervios parasimpáticos, se describen como el plexo cardíaco. En contraste Jane et. al. (1986 en un estudio anatómico de 23 cadáveres describe que la inervación cardiopulmonar en el hombre se origina en el ganglio estrellado y las mitades caudales de las cadenas simpáticas cervicales junto con nervios que se originan del nervio recurrente laríngeo o del vago. De estas estructuras derivan los dos plexos cardiopulmonares. De estos plexos derivan tres nervios cardíacos mayores que se proyectan hacia el corazón. Se estima que determinado porcentaje de los pacientes diagnosticados con angina inestable progresará a desarrollar una angina refractaria al tratamiento. El bloqueo de ganglio estrellado podría ser un nuevo método terapéutico para controlar el dolor de dicha condición. Sin embargo se necesitan estudios clínicos randomizados a doble ciego para obtener resultados concluyentes.

  1. Tórax inestable, evolución sin osteosíntesis: presentación de un caso.

    OpenAIRE

    Elbert Oberto Reyes Graterol; Jhonelly Jhoselyn Narváez Rodríguez; Héctor Alonso Moreno Parra; Willington René Zapata Salazar

    2012-01-01

    El trauma torácico cerrado suele ser el resultado de un impacto directo a alta velocidad o caídas siendo responsable de fracturas costales. Se define  tórax inestable como la fractura de tres o cuatro costillas en más de dos segmentos de su longitud, ocasionando un fenómeno paradójico en la caja  torácica durante la respiración, colapsándose en inspiración y expandiéndose en espiración. Los de localización anterior o lateral son los más graves,  dada su repercusión fisiopatológica. El diagnós...

  2. Efectos del entrenamiento en superficies inestables sobre el equilibrio y funcionalidad en adultos mayores

    OpenAIRE

    2015-01-01

    Objetivo: determinar los efectos de un programa de ocho semanas de entrenamiento en superficies inestables con y sin trabajo de fuerza, sobre el equilibrio y la capacidad funcional en adultos mayores de 60 años, pertenecientes al programa “Escuelas populares del deporte” del inder Medellín. Metodología: se llevó a cabo un estudio experimental simple, ciego y enmascarado con asignación al azar de 34 sujetos a dos grupos de intervención con y sin trabajo de fuerza sobre superficies inestables; ...

  3. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

    OpenAIRE

    Eduardo Contreras Zuniga; Juan Esteban Gomez Mesa; Sandra Ximena Zuluaga Martinez; Vanesa Ocampo; Cristian Andres Urrea

    2009-01-01

    Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacie...

  4. TÓRAX INESTABLE, EVOLUCIÓN SIN OSTEOSINTESIS: PRESENTACIÓN DE UN CASO

    Directory of Open Access Journals (Sweden)

    Elbert Oberto Reyes Graterol

    2011-01-01

    Full Text Available El trauma torácico cerrado suele ser el resultado de un impacto directo a alta velocidad o caídas siendo responsable de fracturas costales. Se define tórax inestable como la fractura de tres o cuatro costillas en más de dos segmentos de su longitud, ocasionando un fenómeno paradójico en la caja torácica durante la respiración, colapsándose en inspiración y expandiéndose en espiración. Los de localización anterior o lateral son los más graves, dada su repercusión fisiopatológica. El diagnóstico se establece con el examen físico, radiografías y tomografías de tórax, así como también estudios de fisiología respiratoria. El tratamiento se basa en la estabilización neumática interna mediante ventilación mecánica y osteosíntesis. Se presenta el caso de paciente femenino de 18 años de edad quien ingresa al Hospital General del Sur por presentar trauma toraco-abdominal cerrado complicado, con neumotórax derecho, hemoneumotórax izquierdo que ameritó colocación de drenaje torácico e intubación, lesión hepática grado IV de segmentos II y III y lesión del ángulo esplénico del colon, ingresando a UCI donde permaneció durante doce días bajo ventilación mecánica asistida. Se destaca la consolidación costal en ausencia de osteosíntesis o fijación con una evolución observable en estudios de imágenes de control periódico.

  5. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

    Directory of Open Access Journals (Sweden)

    Eduardo Contreras Zuniga

    2009-08-01

    Full Text Available Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacientes, é uma manifestação de distúrbio vasoespástico e está associado à migrânea, fenômeno de Raynaud ou asma induzida por aspirina. Apresentamos um caso associado com depressão transitória do segmento ST.Este síndrome es causado por un espasmo focal de una arteria coronaria epicárdica, llevando a isquemia miocárdica grave. Aunque frecuentemente se crea que el espasmo ocurra en arterias sin estenosis, muchos pacientes con angina de Prinzmetal presentan espasmo adyacente a placas ateromatosas. La causa exacta del espasmo no está bien definida, pero puede estar relacionada a la hipercontractilidad del músculo liso vascular debido a mitógenos vasoconstrictores, leucotrienos o serotonina. En algunos pacientes, es una manifestación de disturbio vasoespástico y está asociado a la migraña, fenómeno de Raynaud o asma inducida por aspirina. Presentamos un caso asociado con depresión transitoria del segmento ST.This syndrome is due to focal spasm of an epicardial coronary artery, leading to severe myocardial ischemia. Although it is frequently thought that the spasm occurs in arteries without stenosis, many Prinzmetal patients have spasm adjacent to atheromatous plaques. The exact cause of the spasm has not been well defined, but it may be related to the hypercontractility of the vascular smooth muscle due to vasoconstrictor mitogens, leukotrienes, or serotonin. In some patients, it is a manifestation of a vasospastic disorder and it

  6. Un sistema internacional inestable con dominio de los Estados Unidos

    Directory of Open Access Journals (Sweden)

    Pierre Gilhodes

    2004-11-01

    Full Text Available Con la imposición de la agenda única de terrorismo y la invasión a Iraq ¿se consolidó Estados Unidos como potencia mundial? o con el ascenso de China y los avances constitucionales europeos podríamos avanzar hacia una nueva división del mundo sobre bases diferentes de las de la Guerra Fría. En este caso ¿dónde se situaría AméricaLatina?

  7. Fronteras inestables : lo fantástico en Eternal Darkness

    OpenAIRE

    Zermeño Vargas, Carlos Gerardo

    2015-01-01

    En el videojuego "Eternal Darkness: Sanity’s Requiem", el jugador controla a diversos personajes inmersos en un universo narrativo similar al del autor norteamericano H. P. Lovecraft. Al enfrentarse a presencias monstruosas, los personajes experimentan “efectos” sobre su salud mental. Extradiegéticamente, estos aparecen como interpelaciones al jugador (efectos de sonido y video, simulación de errores en el juego, aparición de objetos que no están allí) que también son percibidos por los perso...

  8. Valor del BNP y de la proteína C reactiva en el diagnóstico diferencial entre angina primaria y secundaria por hipertensión arterial

    Directory of Open Access Journals (Sweden)

    Enrique P. Gurfinkel

    2006-01-01

    Full Text Available Introducción A los episodios de inestabilidad anginosa precipitados por causas secundarias que, no infrecuentemente, no pueden discernirse de razones primarias se les concede poca atención. El presente trabajo intenta responder si algunos biomarcadores pueden contribuir a identificar a aquellos individuos con angina IIIb de los conocidos como anginosos IIIa de la clasificación de Braunwald. Material y métodos En total, participaron del ensayo 64 pacientes seleccionados. De éstos, 33 tuvieron diagnóstico final de angina inestable secundaria a hipertensión arterial y 21 de angina primaria, en tanto que 10 enfermos anginosos estables, referidos para la práctica de un estudio angiográfico diagnóstico, sirvieron de control. En todos ellos, en el momento de la admisión se obtuvieron alícuotas de sangre venosa para la determinación del péptido natriurético auricular tipo B (BNP y de proteína C reactiva ultrasensible (hs-CRP, y luego se realizó un estudio angiográfico invasivo a fin de analizar la carga aterosclerótica con puntajes (scores angiográficos. Resultados Los pacientes con angina primaria tuvieron una extensión aterosclerótica mayor en la angiografía (p < 0,025, más vasos comprometidos (p = 0,029 y un porcentaje mayor de estenosis (p < 0,001 que los anginosos secundarios. Los pacientes controles presentaron valores de BNP de 133 pg/mL (41; 224 [mediana (percentiles 25 y 75] y de 1,6 mg/L (0,4; 3,6 de hs-CRP. Los anginosos primarios no difirieron de los controles: 129 (95; 231 y 4,0 (2,0; 5,6 para BNP y hs-CRP, respectivamente. Los anginosos secundarios tuvieron valores de 73 (19; 325 y de 4,5 (2,2; 9,0, respectivamente. No hubo diferencias significativas entre ambos cuadros anginosos: p = 0,458 para BNP y p = 0,552 para hs-CRP. Conclusiones Independientemente de la carga aterosclerótica elevada en los anginosos primarios, el BNP y la hs-CRP no reconocieron con precisión la inestabilidad clínica inducida por un

  9. Angina de Prinzmetal

    OpenAIRE

    Contreras Zuniga,Eduardo; Gomez Mesa,Juan Esteban; Zuluaga Martinez,Sandra Ximena; Ocampo,Vanesa; Andres Urrea,Cristian

    2009-01-01

    Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacie...

  10. Comparación de un entrenamiento propioceptivo sobre base estable y base inestable

    OpenAIRE

    Gonzalez Jurado, J.A.; Romero Boza, S.; Campos Vázquez, M.A.; Toscano Bendala, F.J.; Otero Saborido, F.M.

    2016-01-01

    El objetivo de este estudio fue comparar dos programas de entrenamiento propioceptivo sobre base estable (G1) y base inestable (G2). Durante 5 semanas, 18 jugadores de fútbol profesional se sometieron a un programa de entrenamiento propioceptivo, 9 formaron el G1 y 9 G2. Se aplicó el Standard Excursion Balance Test (Test de Estrella) antes y después de la intervención. Los resultados intragrupo mostraron diferencias significativas en las variables ANT.IZDO; ANTLAT.IZDO; POST...

  11. Angina de Ludwig. Reporte de 2 casos

    OpenAIRE

    Antonio Fabbio Gagliardi Lugo; María Gabriela Contreras Ravago; Ronar Alejandro Gudiño Martinez; Rafael José Zeballos Peltrini

    2014-01-01

    La angina de Ludwig (AL) es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, orig...

  12. Angina pectoris efter sumatriptan (Imigran)

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Christiansen, B D

    1992-01-01

    Developed for the treatment of migraine, sumatriptan is an agonist of 5-hydroxytryptamine-1-receptors. Though a pressure sensation is a common complaint, significant ECG changes have not been reported after subcutaneous administration of sumatriptan. A case history is given where angina pectoris...... after sumatriptan self-administration was experienced on two occasions by a 61-year old man with a history of minor myocardial infarction--without post-infarction angina--two years previously. The angina after sumatriptan was accompanied on both occasions by significant ST-segment depression on ECG...

  13. Tórax inestable, evolución sin osteosíntesis: presentación de un caso.

    Directory of Open Access Journals (Sweden)

    Elbert Oberto Reyes Graterol

    2012-09-01

    Full Text Available El trauma torácico cerrado suele ser el resultado de un impacto directo a alta velocidad o caídas siendo responsable de fracturas costales. Se define  tórax inestable como la fractura de tres o cuatro costillas en más de dos segmentos de su longitud, ocasionando un fenómeno paradójico en la caja  torácica durante la respiración, colapsándose en inspiración y expandiéndose en espiración. Los de localización anterior o lateral son los más graves,  dada su repercusión fisiopatológica. El diagnóstico se establece con el examen físico, radiografías y tomografías de tórax, así como también estudios  de fisiología respiratoria. El tratamiento se basa en la estabilización neumática interna mediante ventilación mecánica y osteosíntesis. Se presenta el  caso de paciente femenino de 18 años de edad quien ingresa al Hospital General del Sur por presentar trauma toraco-abdominal cerrado complicado,  con neumotórax derecho, hemoneumotórax izquierdo que ameritó colocación de drenaje torácico e intubación, lesión hepática grado IV de segmentos  II y III y lesión del ángulo esplénico del colon, ingresando a UCI donde permaneció durante doce días bajo ventilación mecánica asistida.  Se destaca la consolidación costal en ausencia de osteosíntesis o fijación con una evolución observable en estudios de imágenes de control periódico.

  14. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... pain and reduce your risks from heart disease. Heart Disease and Angina CHD is a narrowing of the ...

  15. Bradycardiac angina: haemodynamic aspects and treatment.

    Science.gov (United States)

    Fowler, P B; Ikram, H; Maini, R N; Makey, A R; Kirkham, J S

    1969-01-11

    A patient with a sinus bradycardia and angina is described who was unable to increase his heart rate on vigorous exercise by more than a few beats. His severe angina was attributed to the bradycardia. Atrial pacing of his heart abolished his angina and increased his exercise tolerance. Circulatory changes at rest, on exertion, and with atrial pacing are described. The cause of angina in this patient is discussed.

  16. Menstruation angina: a case report

    Directory of Open Access Journals (Sweden)

    Choo Wai Kah

    2009-03-01

    Full Text Available Abstract Introduction Menstruation is commonly associated with migraine and irritable bowel but is rarely correlated with angina or myocardial ischaemia. Only a small number of cases have been reported suggesting a link between menstruation and myocardial ischaemic events. Case presentation A case of menstruation angina is reported in order to raise awareness of this association. A 47-year-old South Asian woman presented with recurrent chest pains in a monthly fashion coinciding with her menstruations. Each presentation was associated with troponin elevation. Angioplasty failed to resolve her symptoms but she eventually responded to hormonal therapy. Conclusions The possibility of menstruation angina should always be taken into account in any female patients from puberty to menopause presenting with recurrent chest pains. This can allow an earlier introduction of hormonal therapy to arrest further myocardial damage.

  17. Statine bei instabiler Angina pectoris

    Directory of Open Access Journals (Sweden)

    Marschang G

    1999-01-01

    Full Text Available Die Statine stellen die derzeit wirksamsten cholesterinsenkenden Medikamente dar, deren Effektivität und Verträglichkeit bereits durch große Primär- und Sekundärpräventionsstudien an zahlreichen Patienten gesichert ist. Subanalysen einiger dieser Interventionsstudien (AFCAPS/TexCAPS, 4S, CARE, LIPID haben eine signifikante Reduktion von Episoden instabiler Angina pectoris und damit verbundener Krankenhausaufenthalte ergeben. In der LIPID-Studie wurde weiters gezeigt, daß Patienten mit einer Anamnese von instabiler Angina pectoris mindestens ebenso wie Postinfarktpatienten von einer Therapie mit einem Statin profitieren. Von zwei derzeit noch nicht publizierten Studien (AVERT, MIRACL wird die Klärung weiterer Fragestellungen (hochdosierte Statintherapie im Vergeich zu Angioplastie, aggressive Cholesterinsenkung als Akuttherapie der instabilen Angina pectoris erwartet.

  18. Klinik der instabilen Angina pectoris

    Directory of Open Access Journals (Sweden)

    Auer J

    1999-01-01

    Full Text Available Die instabile Angina pectoris wird zu den akuten Koronarsyndromen gerechnet und weist als pathophysiologisches Substrat ein thrombotisches Ereignis auf dem Boden einer koronaren Endothelläsion auf. Aufgrund der Anamnese und unter Zuhilfenahme von EKG und serologischen Markern kann eine Risikostratifizierung von Patienten mit instabiler Angina pectoris vorgenommen werden. Je nach Risikoeinstufung und der damit möglichen prognostischen Abschätzung der klinischen Situation kann das weitere therapeutische Management stratifiziert werden. Im Rahmen der folgenden Übersicht werden anamnestische Kriterien für Definition und Klassifikation der instabilen Angina pectoris abgehandelt und darüber hinaus versucht, den Stellenwert der klinischen Untersuchung, der Echokardiographie und serologischer Tests für Risikoabschätzung und Therapieplanung dieser Patienten anzugeben.

  19. How Can Angina Be Prevented?

    Science.gov (United States)

    ... can help prevent or delay angina and heart disease. To adopt a healthy lifestyle, you can: Quit smoking and avoid secondhand smoke ... a healthy diet Be physically active Maintain a healthy ... and controlling heart disease risk factors, visit the Diseases and Conditions Index ...

  20. Las políticas habitacionales destinadas a los habitantes de villas inestables durante la década de los ´90: el caso del municipio de Guaymallén, Mendoza, Argentina

    Directory of Open Access Journals (Sweden)

    Sonia Roitman

    2001-01-01

    Full Text Available El presente trabajo pretende analizar cuáles han sido las políticas estatales en materia habitacional destinadas a solucionar las carencias de las familias que habitan en villas inestables. Se estudia cuáles han sido las acciones realizadas durante la década de los noventa tendientes a mejorar la situación habitacional de los grupos sociales de escasos recursos económicos, poniendo especial énfasis en el punto de inflexión que significó la descentralización de la política de vivienda desde el ámbito nacional hacia las provincias y desde estas a los municipios, ocurrida en Argentina en 1992. A partir de esto, el gobierno local se ha transformado en el responsable directo de la satisfacción de las demandas ciudadanas. Por otra parte, el gobierno provincial (a través del Instituto Provincial de la Vivienda ha puesto en marcha programas que buscan solucionar el déficit de viviendas de los sectores más carenciados, como es el caso del programa “Municipios y Desarrollo Comunitario”, que cuenta con un subprograma específico para familias residentes en villas inestables. Se toma como caso de estudio el municipio de Guaymallén, el cual forma parte del Area Metropolitana de Mendoza. En 1991 había en su territorio siete villas inestables, donde habitaban casi 7 mil personas (el 3 por ciento de la población del municipio. En el presente trabajo se analiza cuáles han sido las respuestas por parte del Estado a esta población y en qué medida sus expectativas de tener un terreno propio, con infraestructura de servicios básicos y obras de urbanización, y de poseer una vivienda en buenas condiciones de habitabilidad, han sido satisfechas.

  1. [Exercise tests in unstable angina suspects].

    Science.gov (United States)

    2012-01-01

    The review is devoted to exercise tests (ET) potential in patients with different forms of coronary heart disease (CHD) exacerbation and suspected unstable angina. It is well known that unstable angina untreated pharmacologically is a contraindication for ET. Of interest in clinical practice is diagnosis, risk assessment and treatment policy in patients with chest pain. The main focus is on ET conduction in unstable angina suspects with low and intermediate risk, on safety and validity of ET conduction in these patients.

  2. Angina de Ludwig. Reporte de 2 casos

    Directory of Open Access Journals (Sweden)

    Antonio Fabbio Gagliardi Lugo

    2014-10-01

    Full Text Available La angina de Ludwig (AL es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, origen, vías de diseminación, manejo terapéutico y posibles complicaciones. Se reportan 2 casos que acuden a Emergencias del Hospital General del Oeste «Dr. José Gregorio Hernández» (HGO en Los Magallanes de Catia (Caracas, Venezuela con diagnóstico de AL. Se presenta el manejo clínico y la relevancia del rol que adquiere el cirujano maxilofacial en el diagnóstico en aras de la preservación de la vida del paciente.

  3. Angina

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  4. Interpreting angina: symptoms along a gender continuum

    Science.gov (United States)

    Crea-Arsenio, Mary; Shannon, Harry S; Velianou, James L; Giacomini, Mita

    2016-01-01

    Background ‘Typical’ angina is often used to describe symptoms common among men, while ‘atypical’ angina is used to describe symptoms common among women, despite a higher prevalence of angina among women. This discrepancy is a source of controversy in cardiac care among women. Objectives To redefine angina by (1) qualitatively comparing angina symptoms and experiences in women and men and (2) to propose a more meaningful construct of angina that integrates a more gender-centred approach. Methods Patients were recruited between July and December 2010 from a tertiary cardiac care centre and interviewed immediately prior to their first angiogram. Symptoms were explored through in-depth semi-structured interviews, transcribed verbatim and analysed concurrently using a modified grounded theory approach. Angiographically significant disease was assessed at ≥70% stenosis of a major epicardial vessel. Results Among 31 total patients, 13 men and 14 women had angiograpically significant CAD. Patients describe angina symptoms according to 6 symptomatic subthemes that array along a ‘gender continuum’. Gender-specific symptoms are anchored at each end of the continuum. At the centre of the continuum, are a remarkably large number of symptoms commonly expressed by both men and women. Conclusions The ‘gender continuum’ offers new insights into angina experiences of angiography candidates. Notably, there is more overlap of shared experiences between men and women than conventionally thought. The gender continuum can help researchers and clinicians contextualise patient symptom reports, avoiding the conventional ‘typical’ versus ‘atypical’ distinction that can misrepresent gendered angina experiences. PMID:27158523

  5. [Panic disorder and angina pectoris].

    Science.gov (United States)

    Prenninger, Markus; Giefing, Georg; Auer, Johann; Windhager, Elmar; Eber, Bernd

    2004-02-01

    Panic attacks are a frequently cited cause of noncardiac chest pain. A strict separation of the internist's job (i. e., ruling out an "organic" cause of the patient's complaints) from the psychiatrist's job (e. g., diagnosing and treating panic disorder if present) may not always be the most efficient way of diagnostic work-up. We present the case of a 56-year-old female referred to our institution for elective coronary arteriography. Significant cardiovascular risk factors and symptoms compatible with unstable angina illustrate the common problem of a high probability of cardiac pathology in a patient with possible psychiatric symptoms. A modified SCID-interview complementing the coronary angiography results finally led to the definite diagnosis in this patient after symptoms had been present for over 20 years.

  6. Microvascular angina in postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Alexander Valdés Martín

    2011-10-01

    Full Text Available Fundamento: la angina microvascular es frecuente en mujeres posmenopáusicas. La isquemia miocárdica ha sido inducida mediante pruebas de estrés, en las que se ha comprobado una relación entre la disfunción endotelial y los defectos de perfusión miocárdica. Objetivo: determinar si la isquemia miocárdica puede evidenciarse por anormalidades de la perfusión y de la función detectadas por gammagrafía miocárdica en mujeres con angina típica, angiografía coronaria normal y disfunción endotelial. Métodos: estudio descriptivo realizado en el Instituto de Cardiología y Cirugía Cardiovascular de La Habana que incluyó 59 mujeres. Se les realizó lipidograma, se les midió función endotelial de la arteria braquial mediante ultrasonido, y estudio electrocardiográfico de 24 horas (Holter. Se aplicó un protocolo de estrés-reposo durante la gammagrafía. Las pacientes fueron divididas en dos grupos, acorde a la presencia (grupo I o ausencia (grupo II de defectos de perfusión miocárdica. Resultados: mostraron defectos de la perfusión 21 pacientes. El 57 % de las pacientes del grupo I exhibió más disfunción endotelial. Sólo doce pacientes mostraron defectos reversibles de la perfusión y en el 75 % de los casos se asoció a una reducción de la fracción de eyección ventricular izquierda postestrés mayor de un 5 % y a anormalidades regionales de la motilidad de la pared. Tres pacientes en el grupo I mostraron evidencia de isquemia comparado con cuatro en el grupo II. Conclusiones: la isquemia inducida por estrés se asocia a una reducción de la fracción de eyección ventricular izquierda postestrés y a una vasodilatación anormal dependiente del endotelio.

  7. Instabile Angina pectoris: nichtinvasive und invasive Diagnostik

    Directory of Open Access Journals (Sweden)

    Benzer W

    1999-01-01

    Full Text Available Patienten mit instabiler Angina pectoris befinden sich grundsätzlich in einer lebensbedrohlichen Situation, die eine notfallmäßige sofortige Klinikeinweisung und Einleitung einer maximalen medikamentösen Therapie unter intensivmedizinischer Überwachung nötig macht. Trotz moderner diagnostischer Möglichkeiten ist der Nachweis einer tatsächlich instabilen Angina pectoris nicht immer einfach. In der Beurteilung des klinischen Schweregrades der Symptomatik und der daraus abzuleitenden Prognose einer instabilen Angina pectoris hat sich zuletzt hauptsächlich die Braunwald-Klassifikation durchgesetzt. Die leichteste Form der instabilen Angina pectoris ist die Klasse IA1, die schwerste Form die Klasse IIIC3. Wenn eine EKG-Registrierung während einer Episode von Angina pectoris eine akute ST- Streckenveränderung zeigt, muß mit einem höheren Schweregrad der Erkrankung gerechnet werden. Das EKG ist darüber hinaus ein wichtiger prognostischer Marker für den Langzeitverlauf der Patienten über 6 Monate bis 1 Jahr. Die Bestimmung der kardialen Troponine ist heute ein unerläßlicher Eckpfeiler der Diagnostik und Risikostratifizierung von Patienten mit instabiler Angina pectoris. Wie in großen Studien gezeigt wurde, haben Patienten mit instabiler Angina pectoris und positivem Troponin T eine schlechtere Prognose als jene ohne Anstieg. Ist das Troponin I bzw. das Troponin T 6 Stunden nach Schmerzbeginn negativ, haben die Patienten ein sehr geringes Risiko ( 1% für ein folgendes kardiales Ereignis in den nächsten 30 Tagen. Bei den Troponin-positiven Patienten liegt die ereignisfreie Überlebensrate hingegen bei lediglich etwa 80%. Das C-reaktive Protein ist kein Prädiktor für die Prognose, gerade wenn die kardialen Troponine normal sind. Deshalb sollte dieser Parameter nicht als alleinstehender prognostischer Marker zur Abklärung der instabilen Angina pectoris verwendet werden. Das prognostische Gesamtbild der instabilen Angina pectoris

  8. Angina crónica estable. Consideraciones actuales

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-03-01

    Full Text Available La angina de pecho crónica estable es un síndrome clínico caracterizado por dolor o malestar precordial secundario a isquemia miocárdica y sin características clínicas de inestabilidad. El debate actual sobre esta entidad clínica incluye tres aspectos fundamentales: diagnóstico, prevalencia e impacto socioeconómico, y tratamiento médico frente a revascularización miocárdica. En los últimos cuatro años se han dado a conocer los resultados de varios estudios multicéntricos de gran importancia que compararon tratamiento médico con revascularización miocárdica y cirugía de revascularización frente a intervención coronaria percutánea; además, han mejorado las técnicas de revascularización y existe abundante información sobre la eficacia de nuevos fármacos antiisquémicos. El presente trabajo tiene como objetivo hacer una revisión de los aspectos actuales más importantes relacionados con la angina de pecho estable y su tratamiento, publicados en la literatura especializada.

  9. A case of reninoma with variant angina

    Directory of Open Access Journals (Sweden)

    Hyung Ah Jo

    2014-06-01

    Full Text Available Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia because of hypersecretion of renin. We present a case of a 29-year-old female patient with reninoma and concomitant variant angina. The patient had uncontrolled hypertension and elevated plasma renin activity and aldosterone levels. Imaging studies revealed a mass in the left kidney, which was further confirmed as a renin-producing lesion via selective venous catheterization. During the evaluation, the patient had acute-onset chest pain that was diagnosed as variant angina after a provocation test. After partial nephrectomy, the plasma renin activity and plasma aldosterone levels decreased and blood pressure normalized. We report a case of reninoma with variant angina.

  10. Identidades inestables: el síndrome borderline y la condición postmoderna

    Directory of Open Access Journals (Sweden)

    Enric J. Novella

    2015-03-01

    Full Text Available Partiendo de un análisis de las profundas transformaciones sociales y culturales que justifican lo que se describe como la nueva subjetividad expresiva propia de la modernidad tardía, el presente ensayo trata de mostrar su afinidad constitutiva con la patología de la identidad que numerosos autores consideran central no solo en el síndrome borderline o narcisista, sino también en buena parte de los trastornos mentales más frecuentes y representativos de nuestro tiempo.

  11. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    OpenAIRE

    de Feyter, Pim; Heuvel, P.; Unger, Felix; Beyar, R; Lindeboom, Wietze; de Valk, Vincent; Milo, S; Simon, Rudiger; Tyers, Frank; Regensburger, D.; Crean, Peter; Penn, Ian; McGovern, E; Cauwelaert, C.; Serruys, Patrick

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or ...

  12. Coronary angioplasty for early postinfarction unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); A. Soward; M.J.B.M. van den Brand (Marcel); E. Bos (Egbert); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractCoronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had

  13. Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    José Marconi Almeida de Sousa

    2004-05-01

    Full Text Available OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS. MÉTODO:As pressões, assim como os fatores de risco para doença arterial coronariana (DAC foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariografia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001 e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002, enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003. Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave.OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB 2 times greater than the standard value used in the hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI. METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI underwent cinecoronariography

  14. Association of interleukin-6 gene polymorphism with angina pectoris.

    Science.gov (United States)

    Amorim, Fernanda Gobbi; Campagnaro, Bianca Prandi; Tonini, Clarissa Loureiro; Norbim, Ana Paula Capua; Louro, Iuri Drummond; Vasquez, Elisardo Corral; Arruda, Jose Airton; Meyrelles, Silvana Santos

    2011-10-01

    In this study, we investigated the role of the -174G>C polymorphism of interleukin-6 (IL-6) as a predisposing factor to angina pectoris. Patients were separated into 2 groups: angina (N = 72) and nonangina (N = 71). There were no statistical differences between groups for all cardiovascular risk factors evaluated. The GG genotype frequency was 18% lower in the angina than in the non-angina group, whereas GC + CC was 18% higher in the angina group (P = .036). The frequency of G allele was 11% lower in the angina than in the nonangina group and C allele was 11% higher in the angina group (P = .043). Patients carrying the C allele showed a 2-fold increased risk for angina pectoris (P = .036). Our study demonstrates a high incidence of the -174G>C polymorphism of the IL-6 gene in patients with angina pectoris compared with those carrying the G allele, reinforcing the contribution of genetic factors to the symptoms of angina pectoris.

  15. Treating angina pectoris by acupuncture therapy.

    Science.gov (United States)

    Xu, Lixian; Xu, Hao; Gao, Wei; Wang, Wei; Zhang, Hui; Lu, Dominic P

    2013-01-01

    Acupuncture therapy on PC 6 (Neiguan) has a therapeutic effect on cardiac and chest ailments including angina pectoris. Additional beneficial acupuncture points are PC 4 (Ximen), HT 7 (Shenmen point), PC 7 (Daling point), PC 5 (Jianshi point), PC 3 (Quze point), CV 17 (Danzhong point), CV 6 (Qihai point), BL 15 (Xinshu point), L 20 (Pishu point), BL 17 (Geshu point), BL23 (Shenshu point), BL18 (Ganshu point), HT 5 (Tongli point), and ST36 (Zusanli point). Acupuncture not only quickly relieve the symptoms of acute angina pectoris, but also improve nitroglycerine's therapeutic effects. Therefore, it is an efficient simple therapeutic method used for emergency and for regular angina treatment. Review of studies on acupuncture therapy has shown effectiveness were between 80% to 96.2% that are almost as effective as conventional drug regimen. When compared with conventional medical treatment, the acupuncture therapy shows the obvious advantage of lacking, adverse side effects commonly associated with the Western anti-anginal drugs such as 1) Nitroglycerine (headache--63% with nitroglycerine patch and 50% with spray; syncope--4%; and dizziness--8% with patch; hypotension--4% with patch; and increased angina 2% with patch). 2) Isosorbide mononitrate (dizziness--3 to 5%; nausea/vomiting--2 to 4% and other reactions including hypotension, and syncope even with small doses). 3) Propranolol (bradycardia, chest pain, hypotension, worsening of AV conduction disturbance, Raynaud's syndrome, mental depression, hyperglycemia, etc.). Many conventional anti-anginal medications cause inter-drug reactions with other medications the patients taking for other diseases. Whereas, acupuncture therapy does not pose such an interference with patient's medications. Nevertheless, surgery is still the treatment of choice when acupuncture or conventional drug therapy fails. Combination of conventional drug therapy and acupuncture would considerably decrease the frequency and the required dosage

  16. Angina pectoris: current therapy and future treatment options.

    Science.gov (United States)

    Parikh, Raj; Kadowitz, Philip J

    2014-02-01

    Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

  17. A rare cause of Ludwig's angina by Morganella morganii.

    Science.gov (United States)

    Ho, Min-Po; Tsai, Kuang-Chau; Yen, Szu-Lin; Lu, Cheng-Lin; Chen, Chia-Hung

    2006-10-01

    Ludwig's angina is a rapidly spreading and potentially lethal infection involving the floor of the mouth and neck. We present a rare case of Ludwig's angina caused by an unusual microorganism, Morganella morganii, and the group D alpha-hemolytic streptococcus. To our knowledge, this is the first case of Ludwig's angina and deep neck infection caused by Morganella morganii. Adequate airway maintenance, appropriate use of antibiotics and surgical drainage resulted in survival of the patient without complications.

  18. Use of ranolazine in patients with stable angina pectoris.

    Science.gov (United States)

    Khera, Sahil; Kolte, Dhaval; Aronow, Wilbert S

    2014-01-01

    The current American Heart Association/American College of Cardiology guidelines for patients with stable angina pectoris recommend β-blockers as the initial drug therapy for prevention of angina pectoris (class I B indication). Long-acting nitrates or calcium channel blockers should be prescribed for prevention of angina when β-blockers are contraindicated or not tolerated secondary to side effects (class I B indication). Long-acting nitrates or calcium channel blockers in combination with β-blockers should be prescribed for angina prevention when initial treatment with β-blockers is unsuccessful (class I B indication). Only sublingual nitroglycerin or nitroglycerin spray should be used for immediate relief of angina pectoris (class I B indication). Ranolazine with β-blockers can be used for prevention of angina when initial treatment with β-blockers is not successful (class IIa A indication). If angina persists despite treatment with β-blockers, long-acting nitrates and calcium channel blockers, we recommend the addition of ranolazine for prevention of stable angina pectoris. This editorial discusses the contemporary role of ranolazine in the management of patients with stable angina pectoris.

  19. Effectiveness of Ivabradine in Treating Stable Angina Pectoris.

    Science.gov (United States)

    Ye, Liwen; Ke, Dazhi; Chen, Qingwei; Li, Guiqiong; Deng, Wei; Wu, Zhiqin

    2016-04-01

    Many studies show that ivabradine is effective for stable angina.This meta-analysis was performed to determine the effect of treatment duration and control group type on ivabradine efficacy in stable angina pectoris.Relevant articles in the English language in the PUBMED and EMBASE databases and related websites were identified by using the search terms "ivabradine," "angina," "randomized controlled trials," and "Iva." The final search date was November 2, 2015.Articles were included if they were published randomized controlled trials that related to ivabradine treatment of stable angina pectoris.Patients with stable angina pectoris were included.The patients were classified according to treatment duration (ivabradine and control groups, respectively. The ivabradine group had significantly longer exercise duration when they had been treated for at least 3 months, but not when treatment time was less than 3 months. Ivabradine significantly improved time to angina onset regardless of treatment duration. Control group type did not influence the effect of exercise duration (significant) or time to angina onset (significant).Compared with beta-blocker and placebo, ivabradine improved exercise duration and time to onset of angina in patients with stable angina. However, its ability to improve exercise duration only became significant after at least 3 months of treatment.

  20. Una palabra inestable

    OpenAIRE

    2012-01-01

    Cuando mi generación estaba en la escuela primaria, la palabra “nacionalista” tenía una connotación diferente a la de hoy. En los libros de lectura y en la orientación familiar, correspondía en primer lugar a un orgullo patriótico de fondo militarista, nutrido de la expulsión de los franceses, guerra holandesa y sobre todo de Paraguay. En segundo lugar, venía el extraordinario tamaño del país, con el inmenso territorio, el río más grande del mundo, los paisajes más hermosos, la suavidad del c...

  1. Ludwig's angina after severe thrombocytopenic purpura associated with dengue fever

    Directory of Open Access Journals (Sweden)

    Maria Antonia Campos

    2014-01-01

    Full Text Available Here, we report a case of Ludwig's angina, which required surgery because of toothache. The patient had dengue and severe thrombocytopenia as confirmed by clinical and laboratory diagnoses. However, dengue is not included among the predisposing factors for Ludwig's angina.

  2. Necrotizing fasciitis in association with Ludwig's angina - A case report.

    Science.gov (United States)

    Kavarodi, A M

    2011-07-01

    A 28 year old male diabetic patient developed Ludwig's angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig's angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented.

  3. Preinfarction angina: old story initiates new attention

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo

    2012-01-01

    Since first report by Murry et al1 in 1986,the role of ischemia preconditioning before sustained coronary occlusion in protecting myocardium and reducing infarct size has been identified in animal studies.2-4 The mechanism underlying the endogenous cardioprotective effects of ischemia preconditioning is complex and may involve humoral,neural,or a combination of both,with different signaling pathwaysinvolving adenosine,bradykinin,protein kinases and K(ATP) channels.5,6 In humans,episodes of angina before acute myocardial infarction (AMI) may also confer a preconditioning or protective effect.

  4. Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study (EARL)

    DEFF Research Database (Denmark)

    Andréll, P; Yu, W; Gersbach, P;

    2010-01-01

    To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation.......To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation....

  5. External minifixation in unstable fractures of the metacarpal Minifijación externa en fracturas inestables de los metacarpianos

    Directory of Open Access Journals (Sweden)

    Pablo Oquendo Vázquez

    Full Text Available Background: External fixation is one of the surgical treatment methods more used in traumatology for its versatility and the care it provides to the soft parts. Objectives: To demonstrate that external minifixation allows obtaining a stable fixation that doesn’t limit the hand functionally and facilitates early rehab. Methods: A descriptive study about 42 patients managed at the orthopaedic service in the time period between February 2000 and February 2004, to whom an unstable metacarpal fracture was diagnosed with surgical treatment criteria. All cases were submitted to reduction and stabilizing of the lesion, using an external minifixator RALCA. Hand rehab began in immediate post surgical state. Results: In our series predominated the male sex (83, 3 %, white skinned (92, 8%, with age groups between 31 and 40 years. Lesions in predominant hands were more frequent (80, 9%, and the direct production mechanism (76, 1%, with prevalence of transversal diaphysial pattern (38% and short slanting (35, 1%. Consolidation time was considered inside normal limits in the 88% of the sample. The 52, 3% of the patients incorporated to their social active lives without functional limitations.
    Fundamento: La fijación externa es uno de los métodos de tratamiento quirúrgico más utilizados en traumatología por su versatilidad y el cuidado que provee a las partes blandas. Objetivo: Demostrar que el uso de la minifijación externa permite obtener una fijación estable que no limita funcionalmente la mano y facilita la rehabilitación precoz. Métodos: Estudio descriptivo sobre 42 pacientes atendidos en el Servicio de Ortopedia en el período de tiempo comprendido entre febrero del 2000 y febrero del 2004, a los que se les diagnosticó una fractura inestable de los metacarpianos con criterio de tratamiento quir

  6. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P. van den Heuvel; F. Unger (Felix); R. Beyar; W.K. Lindeboom (Wietze); V. de Valk (Vincent); S. Milo; R. Simon (Rudiger); G.F.O. Tyers (Frank); D. Regensburger; P.A. Crean (Peter); I.M. Penn (Ian); E. McGovern; C. van Cauwelaert; P.W.J.C. Serruys (Patrick)

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the

  7. Frequency of Angina Pectoris After Percutaneous Coronary Intervention and the Effect of Metallic Stent Type.

    Science.gov (United States)

    Gaglia, Michael A; Torguson, Rebecca; Lipinski, Michael J; Gai, Jiaxiang; Koifman, Edward; Kiramijyan, Sarkis; Negi, Smita; Rogers, Toby; Steinvil, Arie; Suddath, William O; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

    2016-02-15

    Although metallic coronary stents significantly reduce angina pectoris compared with optimal medical therapy, angina after percutaneous coronary intervention (PCI) remains frequent. We, therefore, sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents. Metallic stent type was classified as bare metal stent, Cypher, Taxus Express, Xience V, Promus Element, and Resolute. The primary end point was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year. Overall, 8,804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI. Major adverse cardiovascular events, a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6.8% for patients without angina, 10.0% for patients with class 1 or 2 angina, and 19.7% for patients with class 3 or 4 angina (p angina at 1 year after PCI. Baseline Canadian Cardiovascular Society class 3 or 4 angina, history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina. In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI.

  8. Selection of medical treatment in stable angina pectoris

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1995-01-01

    pectoris. BACKGROUND: The characteristics of anginal symptoms and the results of exercise testing are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select...... the best pharmacologic approach in individual patients. METHODS: In this prospective multicenter study, 280 patients with stable angina pectoris were enrolled in 25 European centers. After baseline evaluation, consisting of an exercise test and a questionnaire investigating patients' anginal symptoms....... CONCLUSIONS: The results of a baseline exercise test, but not the characteristics of anginal symptoms, may offer useful information for selecting medical treatment in stable angina pectoris....

  9. Ranolazin--ny behandling af kronisk stabil angina pectoris

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Hansen, Peter Riis

    2009-01-01

    Ranolazine sustained-release tablets were recently approved in the EU for chronic stable angina as add-on therapy when symptoms are not controlled with first-line agents. The mechanism of action is thought to involve inhibition of late sodium influx in the heart, which can reduce abnormalities...... of contractility and repolarisation associated with ischaemia. Ranolazine increases the exercise capacity, reduces angina, and diminishes the use of nitroglycerine. The drug has an excellent safety profile and may be a valuable addition to the treatment of chronic stable angina....

  10. Anipamil prevents ST depression in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Larsen, C T; Sørum, C; Rasmussen, V

    1993-01-01

    . The patients received anipamil 80 mg once daily, anipamil 160 mg once daily, and placebo in a randomized order. At the end of each treatment period the patients underwent 24-hour ambulatory ECG recording. Nineteen patients were included, all with typical stable angina pectoris for at least 2 months, exercise...... test with > or = 0.10 mV horizontal or down-sloping ST-segment depression and limited by angina pectoris, and at least 10 attacks of angina pectoris in the initial single-blind placebo period. During the placebo period, a total duration of transient myocardial ischemia > or = 0.10 mV during the 24-hour...

  11. Angina bullosa hemorrhagica: report of 11 cases

    Directory of Open Access Journals (Sweden)

    Julieta Ruiz Beguerie

    2014-05-01

    Full Text Available Angina bullosa hemorrhagica is a rare and benign disorder, usually localized in the subepithelial layer of the oral, pharyngeal and esophageal mucosa. The lesions are characterized by their sudden onset. They appear as a painless, tense, dark red and blood-filled blister in the mouth that rapidly expand and rupture spontaneously in 24-48 hours. The underlying etiopathology remains ill defined, although it may be a multifactorial phenomenon including diabetes, and steroid inhalers. The condition is not attributable to blood dyscrasias, nor other vesicular-bullous disorders. In this study, eleven patients with such blisters are described. Physical examination of the patients revealed a single blister with hemorrhagic content localized in the oral mucosa. Biopsy of the lesions showed sub epithelial blisters with a mild infiltrate. In general practice, dermatologists could face a blood-filled bullous lesion of the oral mucosa. Recognition is, therefore, of great importance for dermatologists.

  12. Unstable angina of crescendo pattern vs new onset: a clinical, coronary arteriographic and hemodynamic study.

    Science.gov (United States)

    Hussain, K M; Gould, L; Bharathan, T; Abdelsayed, G; Karpov, Y

    1995-06-01

    Unstable angina includes a variety of clinical presentations with a different level of risk for an unfavorable outcome. In this study the authors investigated the prognostic significance of crescendo angina and new-onset angina to discuss management strategies, paying attention to the relevance of baseline clinical characteristics, coronary artery lesions, and left ventricular function, as well as their alterations during atrial pacing. Accordingly coronary arteriographic anatomy and changes in left ventricular volumes and ejection fraction before and during atrial pacing were studied by means of digital subtraction ventriculography in 18 patients with crescendo angina and in 18 patients with new-onset angina. Triple-vessel disease was more frequently observed in crescendo angina (56%; P crescendo angina. The angiographic evidence of intracoronary thrombi was found in 33% (P crescendo angina and in 4% patients with new-onset angina. Compared with the patients with new-onset angina, patients with crescendo angina had higher end-diastolic and end-systolic volumes and lower ejection fraction at rest. At peak pacing, ejection fraction was significantly (P crescendo angina (0.48 +/- 0.06) than in new-onset angina (0.66 +/- 0.04). In crescendo angina, during pacing, the magnitude of velocity of circumferential fiber shortening was significantly decreased as compared with new-onset angina.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Invaliderende angina pectoris behandlet med elektrisk rygmarvsstimulation (ERS)

    DEFF Research Database (Denmark)

    Andersen, C; Clemensen, S E; Henneberg, S W

    1992-01-01

    Thirty patients who had severe incapacitating angina pectoris which had not reacted to the conventional therapeutic measures and which required massive daily opioid consumption were treated with electrical spinal cord stimulation (SCS) by means of a completely implantable stimulation system...

  14. Severe angina pectoris in asthma attack: a case report.

    Science.gov (United States)

    Nabavizadeh, Seyed Hesamedin; Farahbakhsh, Nazanin; Fazel, Ali; Mosavat, Fereshteh; Anushiravani, Amir

    2016-06-01

    Asthma is a chronic inflammatory disorder of the airways related to the obstruction of reversible airflow. Asthma presents as recurrent attacks of cough and dyspnea. Poor control causes recurrent admissions to the ICU, and mortality is related to poor drug compliance and follow-up. Angina pectoris is a syndrome of recurrent chest discomfort related to myocardial ischemia. The presence of these two disorders rarely has been reported. We reported a 12-year-old boy who was referred with exacerbation of asthma and developed angina pectoris during hospitalization. He had labored breathing and diffuse wheezing. During treatment of the asthma, the patient developed severe chest pain due to shunt formation and coronary hypoxia, caused by the sole administration of ventolin, since oxygen had been disconnected. After receiving appropriate therapy, both his asthma and angina recovered, and, to date, he has not experienced angina pectoris again.

  15. Neurostimulation bei refraktärer Angina pectoris

    Directory of Open Access Journals (Sweden)

    Theres H

    2005-01-01

    Full Text Available Trotz großer Fortschritte der katheterinterventionellen und operativen Versorgung der koronaren Herzkrankheit (KHK verbleiben Patienten, bei denen eine Revaskularisierung nicht möglich ist. Besteht eine ausgeprägte Angina pectoris (CCS III–IV, so sprechen wir von einer "refraktären Angina pectoris". Eine Arbeitsgruppe der Europäischen Gesellschaft für Kardiologie führt die Neurostimulation an erster Stelle der alternativen Therapiemöglichkeiten für diese Patienten an. Zahlreiche Studien belegen, daß es sich dabei um eine effiziente und sichere adjuvante Therapie handelt. Sie führt zu einer Abnahme der Angina pectoris-Symptomatik mit konsekutiver Zunahme der körperlichen Leistungsfähigkeit. Ingesamt wird eine entscheidende Verbesserung der Lebensqualität erzielt, die Angina pectoris als Warnsymptom bei Myokardinfarkt wird jedoch nicht maskiert.

  16. The Role of Ivabradine in the Management of Angina Pectoris.

    Science.gov (United States)

    Giavarini, Alessandra; de Silva, Ranil

    2016-08-01

    Stable angina pectoris affects 2-4 % of the population in Western countries and entails an annual risk of death and nonfatal myocardial infarction of 1-2 % and 3 %, respectively. Heart rate (HR) is linearly related to myocardial oxygen consumption and coronary blood flow, both at rest and during stress. HR reduction is a key target for the prevention of ischemia/angina and is an important mechanism of action of drugs which are recommended as first line therapy for the treatment of angina in clinical guidelines. However, many patients are often unable to tolerate the doses of beta blocker or non-dihydropyridine calcium antagonists required to achieve the desired symptom control. The selective pacemaker current inhibitor ivabradine was developed as a drug for the management of patients with angina pectoris, through its ability to reduce HR specifically. The available data suggest that ivabradine is a well-tolerated and effective anti-anginal agent and it is recommended as a second-line agent for relief of angina in guidelines. However, recent clinical trials of ivabradine have failed to show prognostic benefit and have raised potential concerns about safety. This article will review the available evidence base for the current role of ivabradine in the management of patients with symptomatic angina pectoris in the context of stable coronary artery disease.

  17. Performing stable angina pectoris: an ethnographic study.

    Science.gov (United States)

    Somerville, Claire; Featherstone, Katie; Hemingway, Harry; Timmis, Adam; Feder, Gene Solomon

    2008-04-01

    Symptoms play a crucial part in the formulation of medical diagnoses, yet the construction and interpretation of symptom narratives is not well understood. The diagnosis of angina is largely based on symptoms, but a substantial minority of patients diagnosed with "non-cardiac" chest pain go on to have a heart attack. In this ethnographic study our aims were to understand: (1) how the patients' accounts are performed or enacted in consultations with doctors; (2) the ways in which ambiguity in the symptom narrative is managed by doctors; and (3) how doctors reach or do not reach a diagnostic decision. We observed 59 consultations of patients in a UK teaching hospital with new onset chest pain who had been referred for a specialist opinion in ambulatory care. We found that patients rarely gave a history that, without further interrogation, satisfied the doctors, who actively restructured the complex narrative until it fitted a diagnostic canon, detaching it from the patient's interpretation and explanation. A minority of doctors asked about chest pain symptoms outside the canon. Re-structuring into the canonical classification was sometimes resisted by patients who contested key concepts, like exertion. Symptom narratives were sometimes unstable, with central features changing on interrogation and re-telling. When translation was required for South Asian patients, doctors considered the history less relevant to the diagnosis. Diagnosis and effective treatment could be enhanced by research on the diagnostic and prognostic value of the terms patients use to describe their symptoms.

  18. Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

    Directory of Open Access Journals (Sweden)

    José Roberto Tavares

    2002-08-01

    Full Text Available OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females with unstable angina and 46 control patients (19 males, paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 µmol/L than in the control group (8.7±4.4 µmol/L (p<0.05. Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 µmol/L versus 11.9±4.2 µmol/L. Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 µmol/L versus 6.4±2.9 µmol/L (p<0.05 in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 µmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.

  19. Pharmacological Management of Chronic Stable Angina: Focus on Ranolazine.

    Science.gov (United States)

    Rosano, Giuseppe M C; Vitale, Cristiana; Volterrani, Maurizio

    2016-08-01

    Percutaneous coronary intervention and anti-anginal medications have similar prognostic effectiveness in patients with chronic stable angina. The choice of optimal medical therapy for the management of chronic angina is of pivotal importance in patients with stable ischemic heart disease. The most commonly used anti-anginal agents have demonstrated equivalent efficacy in improving patient reported ischemic symptoms and quantitative exercise parameters. With regards to mortality, beta-blockers are beneficial only in the setting of depressed left ventricular systolic function after a recent myocardial infarction. Recent evidence suggests the lack of any benefit of beta-blockers in patients with preserved systolic function, even in the setting of prior myocardial infarction.Ranolazine is a non-haemodynamic anti-anginal agent. It is effective as adjunctive therapy in patients with chronic stable angina whose symptoms are un-adequately controlled by conventional treatment. The clinical development program of ranolazine has shown that the drug improves exercise performance, decreases angina and use of sublingual nitrates, compared to placebo. Ranolazine is well tolerated with neutral effect on haemodynamics. Besides its role in chronic stable angina, ranolazine has the potential for development in a number of other cardiovascular and non-cardiovascular conditions in the future.

  20. Incidence and follow-up of Braunwald subgroups in unstable angina pectoris

    NARCIS (Netherlands)

    A.J.M. van Miltenburg-van Zijl (Addy); M.L. Simoons (Maarten); R.J. Veerhoek (Rinus); P.M.M. Bossuyt (Patrick)

    1995-01-01

    textabstractObjectives. This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. Background. Among many classifications of unstable angina, the Braunwald classification is frequently used. However, the incidence and

  1. ["Persistent" angina: rationale for a metabolic approach].

    Science.gov (United States)

    Marzilli, Mario

    2004-03-01

    Despite increasing pharmacological and mechanical treatment options, ischemic heart disease continues to be associated with considerable patient mortality and morbidity. The estimates of the direct and indirect costs associated with chronic stable angina amount to billions of dollars. Given the epidemiological and economic magnitude of the problem, the need for more effective therapies is self-evident. Based on current guidelines, the management of ischemic heart disease has progressively broadened to include risk factor modification, patient education, and pharmacological therapy. The latter includes i) classic antianginal agents such as beta-blockers, calcium antagonists, and nitrates, and ii) drugs for secondary prevention, such as aspirin, clopidogrel, statins, and angiotensin-converting enzyme inhibitors. Tailoring therapy to individual needs has become even more challenging because of the marked changes in the clinical profile of patients with chronic ischemic heart disease. Compared with the past, today's patients tend to be older, to have undergone revascularization procedures, and to frequently have associated illnesses, including heart failure and diabetes. Significant progress has been made in recent years in understanding the role of cardiac energy metabolism in the pathogenesis of myocardial ischemia. A better understanding of metabolic derangements associated with ischemia and reperfusion is translating into innovative therapeutic approaches. Optimization of cardiac energy metabolism is based on promoting cardiac glucose oxidation. This has been proved to enhance cardiac function and protect myocardial tissue against ischemia-reperfusion injury. A new class of metabolic agents, known as the 3-ketoacyl coenzyme A thiolase inhibitors (trimetazidine), is able to elicit an increase in glucose and lactate combustion secondary to partial inhibition of fatty acid oxidation, producing clinical benefits in patients with ischemic heart disease.

  2. Gambaran Angiografi Koroner Pasien Angina Pektoris Tidak stabil Berjenis Kelamin Wanita di RSUP H. Malik Medan

    OpenAIRE

    Hutagalung, Adit Muhammad Prasetya

    2016-01-01

    Unstable angina pectoris are commonly diagnosis in women who have a heart attack with non spesific symptoms. Angina pectoris in women commonly show chest pain symptom but normal coronary arteries imaging. This study aims to determine the characteristics of the location of the blockage of the coronary arteries in patients with unstable angina pectoris in women and to determine the severity of coronary artery blockages in patients with unstable angina pectoris in women in RSUP. H...

  3. High probability of disease in angina pectoris patients

    DEFF Research Database (Denmark)

    Høilund-Carlsen, Poul F.; Johansen, Allan; Vach, Werner

    2007-01-01

    BACKGROUND: According to most current guidelines, stable angina pectoris patients with a high probability of having coronary artery disease can be reliably identified clinically. OBJECTIVES: To examine the reliability of clinical evaluation with or without an at-rest electrocardiogram (ECG......) in patients with a high probability of coronary artery disease. PATIENTS AND METHODS: A prospective series of 357 patients referred for coronary angiography (CA) for suspected stable angina pectoris were examined by a trained physician who judged their type of pain and Canadian Cardiovascular Society grade...... of pain. Pretest likelihood of disease was estimated, and all patients underwent myocardial perfusion scintigraphy (MPS) followed by CA an average of 78 days later. For analysis, the investigators focused on the approximate groups of patients with more severe disease, ie, typical angina (n=187), Canadian...

  4. Blood blisters of the oral mucosa (angina bullosa haemorrhagica).

    Science.gov (United States)

    Deblauwe, B M; van der Waal, I

    1994-08-01

    Angina bullosa haemorrhagica is a benign phenomenon that is characterized by the sudden appearance of a blood blister on the oral mucosa in the absence of an identifiable cause or systemic disorder; local trauma has been suggested to be the most likely contributory factor. No treatment is required. Angina bullosa haemorrhagica affects mainly middle-aged and elderly people. There is no strong predilection for either men or women. In this article nine patients with such blisters are described. Blood blisters apparently are more common than has been suggested in the literature.

  5. LUDWIG’S ANGINA AND ANAESTHETIC DIFFICULTIES: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sarda Devi

    2015-04-01

    Full Text Available Patients with deep neck infections present challenging airways for an anesthesiologist . Ludwig’s angina is potentially lethal, rapidly spreading cellulitis involving the floor of the mouth and neck. Without aggressive management it often results in life th reatening upper airway obstruction. Securing the airway remains the top priority in treatment of Ludwig’s angina. Although awake fibreoptic intubation remains the ideal method for securing the airway, but it is not available in every set up, so all feasibl e options of securing the airway should be prepared. We present a case successfully managed at our hospital with a brief review of airway management options.

  6. The sensitivity of the symptom angina pectoris as a marker of transient myocardial ischaemia in chronic stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1987-01-01

    Therapeutic decisions in patients with angina pectoris are traditionally based on the history reported by the patient, since objective evidence of myocardial ischaemia during daily life is often not available. In this study, ambulatory ST segment monitoring was performed in 60 patients...... with a history of chronic stable angina pectoris, positive exercise test and/or positive coronary angiography, and a correlation was made between the episodes of chest pain and ST segment change. The patients were grouped according to the results of exercise testing and coronary arteriography, and one group...... was studied with and without antianginal medication. Overall, 195 episodes of angina were noted, only 94 of which (48%) were accompanied by ST segment depression. Pain and ST segment changes were best correlated in patients with a positive exercise test, positive angiography and who were not receiving...

  7. The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study.

    Science.gov (United States)

    Kureshi, Faraz; Shafiq, Ali; Arnold, Suzanne V; Gosch, Kensey; Breeding, Tracie; Kumar, Ashwath S; Jones, Philip G; Spertus, John A

    2017-01-01

    Although eliminating angina is a primary goal in treating patients with chronic coronary artery disease (CAD), few contemporary data quantify prevalence and severity of angina across US cardiology practices. The authors hypothesized that angina among outpatients with CAD managed by US cardiologists is low and its prevalence varies by site. Among 25 US outpatient cardiology clinics enrolled in the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) registry, we prospectively recruited a consecutive sample of patients with chronic CAD over a 1- to 2-week period at each site between April 2013 and July 2015, irrespective of the reason for their appointment. Eligible patients had documented history of CAD (prior acute coronary syndrome, prior coronary revascularization procedure, or diagnosis of stable angina) and ≥1 prior office visit at the practice site. Angina was assessed directly from patients using the Seattle Angina Questionnaire Angina Frequency score. Among 1257 patients from 25 sites, 7.6% (n = 96) reported daily/weekly, 25.1% (n = 315) monthly, and 67.3% (n = 846) no angina. The proportion of patients with daily/weekly angina at each site ranged from 2.0% to 24.0%, but just over half (56.3%) were on ≥2 antianginal medications, with wide variability across sites (0%-100%). One-third of outpatients with chronic CAD managed by cardiologists report having angina in the prior month, and 7.6% have frequent symptoms. Among those with frequent angina, just over half were on ≥2 antianginal medications, with wide variability across sites. These findings suggest an opportunity to improve symptom control.

  8. Breath markers of oxidative stress in patients with unstable angina.

    Science.gov (United States)

    Phillips, Michael; Cataneo, Renee N; Greenberg, Joel; Grodman, Richard; Salazar, Manuel

    2003-01-01

    Cardiac chest pain is accompanied by oxidative stress, which generates alkanes and other volatile organic compounds (VOCs). These VOCs are excreted in the breath and could potentially provide a rational diagnostic marker of disease. The breath methylated alkane contour (BMAC), a 3-dimensional surface plot of C4-C20 alkanes and monomethylated alkanes, provides a comprehensive set of markers of oxidative stress. In this pilot study, we compared BMACs in patients with unstable angina pectoris and in healthy volunteers. Breath VOCs were analyzed in 30 patients with unstable angina confirmed by coronary angiography and in 38 age-matched healthy volunteers with no known history of heart disease (mean age +/- SD, 62.7 +/- 12.3 years and 62.5 +/- 10.0, not significant). BMACs in both groups were compared to identify the combination of VOCs that provided the best discrimination between the 2 groups. Forward stepwise entry discriminant analysis selected 8 VOCs to construct a predictive model that correctly classified unstable angina patients with sensitivity of 90% (27 of 30) and specificity of 73.7% (28 of 38). On cross-validation, sensitivity was 83.3% (25 of 30) and specificity was 71.1% (27 of 38). We conclude that the breath test distinguished between patients with unstable angina and healthy control subjects.

  9. Angina pectoris in women: focus on microvascular disease.

    Science.gov (United States)

    Zuchi, Cinzia; Tritto, Isabella; Ambrosio, Giuseppe

    2013-02-20

    Ischemic heart disease (IHD) is the leading cause of death among women in Western countries, and it is associated with higher morbidity and mortality than in men. Nevertheless, IHD in women remains underdiagnosed and undertreated, and the misperception that females are "protected" against cardiovascular disease leads to underestimation of their cardiovascular risk; instead, women with chest pain have a high risk of cardiovascular events. Women suffering from angina pectoris tend to have different characteristics compared to men, with a high prevalence of non-significant coronary artery disease. Angina in women is more commonly microvascular in origin than in men, and therefore standard diagnostic algorithms may be suboptimal for women. This different pathophysiology impacts clinical management of IHD in women. While response to medical therapy may differ in women, they are scarcely represented in clinical trials. Therefore, solid data in terms of gender efficacy of antianginal drugs are lacking, and particularly when angina is microvascular in origin women often continue to be symptomatic despite maximal therapy with classical antianginal drugs. Recently, new molecules have shown promising results in women. In conclusion, women with angina are a group of patients in whom it seems appropriate to concentrate efforts aimed at reducing morbidity and improving quality of life.

  10. NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

    Directory of Open Access Journals (Sweden)

    Y. V. Gavrilov

    2015-12-01

    Full Text Available Aim. To evaluate antianginal and antiischemic efficiency of nebivolol in patients with stable angina pectoris.Material and methods. 100 patients with ischemic heart disease showing stable exertional angina pectoris and having no contraindications to beta-blockers were studied. After 5-7 days of control period 50 randomly selected patients began to take nebivolol in initial dose of 5mg once daily and 50 patients started to take metoprolol in initial dose of 50 mg twice daily. Duration of treatment was 8 weeks. Efficiency of treatment was assessed according to the results of control treadmill assessment and control daily ECG monitoring.Results. 56-day therapy with nebivolol at a dose of 7,5 mg per day results in increase in duration of treadmill test before angina or ST depression (p<0.05. Antianginal and antiischemic effect of nebivolol 7.5 mg once daily is rather similar with that of metoprolol in average daily dose of 175 mg. Nebivolol compared to metoprolol significantly (p<0.05 more effectively reduces the number of silent myocardial ischemia.Conclusion. Nebivolol is an efficient antianginal and antiischemic drug for patients with stable exertional angina pectoris.

  11. [Microvascular angina in women: a diagnostic and therapeutic challenge

    NARCIS (Netherlands)

    Elias-Smale, S.E.; Boer, M.J. de; Maas, A.H.E.M.

    2014-01-01

    Gender differences play an important role in coronary heart disease (CHD). Not only in the presentation of symptoms, but also in their underlying pathophysiology. Women with persistent angina without obstructive coronary artery disease (CAD) pose a diagnostic and therapeutic challenge. Half of these

  12. Unstable angina following intracavernous injection of alprostadil: a case study

    OpenAIRE

    Delongchamps, Nicolas Barry; Legrand, Guillaume; Zerbib, Marc; Peyromaure, Michael

    2009-01-01

    Intracavernous injection of alprostadil is the gold standard treatment for erectile dysfunction following radical prostatectomy. After surgery, low doses of alprostadil can be delivered for the sole purpose of penile rehabilitation. The only reported systemic side effects of such injections are arterial hypotension and headache. In the current report, a case of unstable angina immediately following an intracavernous injection of alprostadil is described.

  13. Cardiac catheterization in patients with unstable angina. Recent onset vs crescendo pattern.

    Science.gov (United States)

    Plotnik, G D; Fisher, M L; Carliner, N H; Becker, L C

    1980-08-01

    Among patients with unstable angina pectoris, those with crescendo angina seem to be at high risk for death and myocardial infarction. We reviewed the clinical, arteriographic, and hemodynamic findings in 218 consecutive catheterized patients with unstable angina. Unstable angina was defined as ischemic cardiac pain at rest associated with transient ECG changes but no evidence for acute myocardial infarction. Patients were divided into two groups according to the duration of symptoms: 134 patients with crescendo angina (new, or increasing, rest pain with previous ischemic symptoms present for more than three months) and 84 with recent onset angina (symptoms present for less than three months). Compared with patients with recent onset symptoms, patients with crescendo angina had more extensive coronary disease and lower ejection fractions, which may explain their poor prognosis.

  14. Emerging clinical role of ranolazine in the management of angina

    Directory of Open Access Journals (Sweden)

    David S Vadnais

    2010-10-01

    Full Text Available David S Vadnais, Nanette K WengerDivision of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USAAbstract: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for angina consists of beta-blockers, calcium channel blockers, and nitrates. These agents decrease myocardial oxygen demand and ischemia by reducing heart rate, lowering blood pressure, and/or optimizing ventricular loading characteristics. Unique in its mechanism of action, ranolazine is the first new antianginal agent approved for use in the US for chronic angina in over 25 years. By inhibiting the late inward sodium current (INa, ranolazine prevents pathologic intracellular calcium accumulation that leads to ischemia, myocardial dysfunction, and electrical instability. Ranolazine has been proven in multiple clinical trials to reduce the symptoms of angina safely and effectively and to improve exercise tolerance in patients with symptomatic coronary heart disease. These benefits occur without reduction in heart rate and blood pressure or increased mortality. Although ranolazine prolongs the QTc, experimental data indicate that ranolazine may actually be antiarrhythmic. In a large acute coronary syndrome clinical trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation, and bradycardic events. Additional benefits of ranolazine under investigation include reductions in glycosylated hemoglobin levels and improved left ventricular function. Ranolazine is a proven antianginal medication in patients with symptomatic coronary heart disease, and should be considered as an initial antianginal agent for those with hypotension or bradycardia.Keywords: chronic angina, myocardial ischemia, ranolazine, pharmacotherapy, antianginal, sodium current

  15. Predicting prognosis in stable angina--results from the Euro heart survey of stable angina: prospective observational study.

    NARCIS (Netherlands)

    Daly, C.A.; Stavola, B. De; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Clemens, F.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    OBJECTIVES: To investigate the prognosis associated with stable angina in a contemporary population as seen in clinical practice, to identify the key prognostic features, and from this to construct a simple score to assist risk prediction. DESIGN: Prospective observational cohort study. SETTING: Pan

  16. Early and six-month outcome in patients with angina pectoris early after acute myocardial infarction (the GISSI-3 APPI [angina precoce post-infarto] study).

    Science.gov (United States)

    1996-12-01

    There is conflicting evidence whether or not early postinfarction angina implies an unfavorable prognosis. This prospective study assessed the significance and natural history of early angina in a broad population of patients conservatively managed after acute myocardial infarction (AMI) and enrolled in the third Gruppo Italiano per lo Studio della Sopravvivenza nel Infarto Miocardico (GISSI-3) trial. Out of 2,363 consecutive patients (age 63 +/- 11; first AMI in 86%; thrombolysis in 74%) admitted in 31 centers lacking on-site revascularization facilities, early angina associated with transient electrocardiographic (ECG) changes was documented in 332 (14%). At multivariate analysis, preinfarction angina, age > or = 70 years, female gender, and history of infarct were significant predictors of early angina. Though the in-hospital course was free from major cardiac events in 78% of patients after the first anginal episode, reinfarction was more common after early angina (7% vs 2% in patients without, RR 3.1, 95% confidence interval [CI] 1.9 to 5.6; p <0.001), and death occurred in 7% of patients with early angina (vs 5% of patients without, RR 1.4, CI 0.9 to 2.4, p = NS). No demographic or clinical characteristics identified patients who suffered nonfatal reinfarction after angina, and neither the ECG location (infarct zone or remote) nor patterns of ECG changes during angina proved significant predictors of in-hospital reinfarction or death. Early angina emerged as the sole independent predictor of 6-month cumulative reinfarction (12% vs 5% of patients without, RR 2.9, CI 2.0 to 4.4; p <0.0001) and an independent predictor of death (13% vs 7% of patients without early angina, RR 2.3, CI 1.6 to 3.3; p <0.0001). Early postinfarction angina is a powerful prognostic marker. Patients with early postinfarction angina had an unfavourable in-hospital outcome, but the prospective identification of patients at greater risk of major events after angina remains elusive

  17. The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: The Euro Heart Survey of Stable Angina set out to prospectively study the presentation and management of patients with stable angina as first seen by a cardiologist in Europe, with particular reference to adherence to existing guidelines and regional variability in patient presentation and ini

  18. Persistent angina: highly prevalent and associated with long-term anxiety, depression, low physical functioning, and quality of life in stable angina pectoris

    DEFF Research Database (Denmark)

    Jespersen, L.; Abildstrom, S. Z.; Hvelplund, Anders;

    2013-01-01

    To evaluate persistent angina in stable angina pectoris with no obstructive coronary artery disease (CAD) compared to obstructive CAD and its relation to long-term anxiety, depression, quality of life (QOL), and physical functioning. We invited 357 patients (men = 191; women = 166; response rate ...

  19. Non-Linear Dynamics In Patients With Stable Angina Pectoris

    CERN Document Server

    Krstacic, G; Vargovic, E; Knezevic, A; Krstacic, A

    2001-01-01

    We investigate the clinical and prognostic significance of fractal dimension and detrended fluctuation analysis by comparing the group of patients with stable angina pectoris without previous myocardial infarction with the group of age-matched healthy controls. The fractal dimension of the R-R series was determined using the rescaled range (R/S) analysis technique. To quantify fractal longe-range-correlation properties of heart rate variability, the detrended fluctuation analysis (DFA) technique was used. The heart rate variability was characterized by a scaling exponent $\\alpha$, separately for short-term ($$ 11 beats) time scales. The results of data sets show the existence of crossover phenomena between short-time scales. The short-term fractal scaling exponent was significantly lower in patients with stable angina pectoris.

  20. Intravenous nitroglycerin for rest angina. Potential pathophysiologic mechanisms of action.

    Science.gov (United States)

    DePace, N L; Herling, I M; Kotler, M N; Hakki, A H; Spielman, S R; Segal, B L

    1982-10-01

    Twenty patients with refractory rest angina pectoris were treated with intravenously (IV) administered nitroglycerin (mean dosage, 72.4 micrograms/min; range, 15 to 226 micrograms/min). There was a considerable reduction or abolition in the number of ischemic episodes in 85% of patients without overall substantial changes in heart rate, mean arterial BP, pulmonary capillary wedge pressure (PCWP), and pulmonary arterial mean pressure. However, those patients with an initial PCWP of more than 12 mm Hg or a systolic pressure of more than 130 mm Hg had a substantial reduction in PCWP and systolic BP following IV nitroglycerin. We conclude that IV nitroglycerin may relieve rest angina by different pathophysiologic mechanisms. In some patients, IV nitroglycerin favorably altered the hemodynamic determinants of myocardial oxygen consumption. In others, however, no change in these determinants occurred, suggesting a direct effect on the coronary circulation.

  1. Treatment of Angina Pectoris Associated with Coronary Microvascular Dysfunction.

    Science.gov (United States)

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-01

    Treatment of angina pectoris associated with coronary microvascular dysfunction is challenging as the underlying mechanisms are often diverse and overlapping. Patients with type 1 coronary microvascular dysfunction (i.e. absence of epicardial coronary artery disease and myocardial disease) should receive strict control of their cardiovascular risk factors and thus receive statins and ACE-inhibitors in most cases. Antianginal medication consists of ß-blockers and/or calcium channel blockers. Second line drugs are ranolazine and nicorandil with limited evidence. Despite individually titrated combinations of these drugs up to 30 % of patients have refractory angina. Rho-kinase inhibitors and endothelin-receptor antagonists represent potential drugs that may prove useful in these patients in the future.

  2. Update on ranolazine in the management of angina

    Directory of Open Access Journals (Sweden)

    Codolosa JN

    2014-06-01

    Full Text Available J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome-TIMI (Thrombolysis In Myocardial Infarction 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. Keywords: ranolazine, chronic stable angina, coronary artery disease

  3. Update on ranolazine in the management of angina

    OpenAIRE

    Codolosa JN; Acharjee S; Figueredo VM

    2014-01-01

    J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of sym...

  4. Ivabradine: the evidence of its therapeutic impact in angina

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2008-12-01

    Full Text Available Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed for the treatment of cardiovascular diseases including SAP. It has an exclusive heart rate reducing effect, without any negative effect on left ventricular function or coronary vasodilatation.Aims: The aim of this paper is to review the evidence concerning the use of ivabradine in the treatment of SAP.Evidence review: Ivabradine is an effective antianginal and antiischemic drug, not inferior to the beta blocker atenolol and the calcium channel antagonist (CCA amlodipine. It decreases the frequency of angina attacks and increases the time to anginal symptoms during exercise. Because of its exclusive chronotropic effect, ivabradine is not associated with the typical adverse reactions associated with beta blockers or other antianginal drugs.Clinical value: Clinical evidence shows that ivabradine is a very good antiischemic and antianginal agent, being as effective as beta blockade and CCA therapy in controlling myocardial ischemia and symptoms of stable angina. Ongoing studies will determine the potential of ivabradine to improve morbidity and mortality in coronary artery disease and heart failure.Key words: evidence, If current, ivabradine, outcomes, stable angina pectoris, treatment

  5. Angina treatments and prevention of cardiac events: an appraisal of the evidence.

    Science.gov (United States)

    Winchester, David E; Pepine, Carl J

    2015-12-01

    Angina pectoris is the symptomatic manifestation of transient myocardial ischaemia. At the most fundamental level, angina arises when myocardial oxygen demand exceeds the ability of the coronary circulation to provide adequate oxygen delivery to maintain normal myocardial metabolic function. In vivo, the balance of oxygen demand and delivery is a complex physiological process that can be altered by a variety of interventions. Lifestyle modification is a cornerstone of cardiovascular disease management, with or without angina. Additional pharmaceutical and physical interventions are usually applied to patients with angina. Mechanisms of action for these interventions include heart rate modulation, vascular smooth muscle relaxation, metabolic manipulation, revascularization, and others. A number of these interventions have overlapping mechanisms that target angina. Additionally, some interventions may directly or indirectly prevent or delay adverse outcomes such as myocardial infarction or death. This review summarizes current evidence for many applied ischaemia treatments documented to modify angina and comments on available evidence relating to improvement in cardiovascular outcomes.

  6. Selection of drug therapy in stable angina pectoris.

    Science.gov (United States)

    Savonitto, S; Ardissino, D

    1998-05-01

    Drug therapy in stable angina has two aims: the prevention of major cardiac events (such as unstable angina, myocardial infarction, or death) and the control of chest pain and transient myocardial ischemia. Given the low incidence of major cardiac events in patients with stable angina, primary preventive studies are scarce because they require a large sample size and long-term follow-up. Thus far, only aspirin and some lipid-lowering agents have been shown to be effective for this purpose. Antiischemic drugs reduce the imbalance between myocardial oxygen demand and supply, either by reducing oxygen consumption or by increasing coronary blood flow. The ideal approach would be to target drug therapy against the ischemia-inducing factor in each patient. The characteristics of anginal symptoms do not seem to help in selecting medical therapy, whereas a standard exercise test and a provocative test of coronary vasoconstriction may provide useful information in order to select patients who will preferentially respond to either a beta-blocker or a calcium antagonist. The combination of two or more anti-ischemic drugs does not seem to be any more effective than an adequately titrated monotherapy in reducing the occurrence of myocardial ischemia in individual patients. Combination therapy in stable coronary artery disease should include an individually selected and optimally titrated anti-ischemic agent and aspirin, with the addition of a lipid-lowering agent in patients with even mild hypercholesterolemia.

  7. Diurnal variation in exercise responses in angina pectoris.

    Science.gov (United States)

    Joy, M; Pollard, C M; Nunan, T O

    1982-01-01

    Thirty caucasian male patients with stable angina were investigated in two groups of nine and one group of 12. Nine normal subjects were also studied. Patients in the first group (on no treatment) underwent symptom-limited exercise electrocardiography at 0800, 1200, and 1600 hours on the same day. Their heart rates and ST segment displacements at 1600 hours were significantly greater than at 0800 hours and the same phenomenon was seen in the second group who had been receiving propranolol 40 mg four times a day. A similar effect was noted for ST segment displacement but not for heart rate in the third group (on no treatment) tested at 0800 hours and 1600 hours on separate days, two to three weeks apart. Normal control subjects showed no diurnal variation in heart rate and their heart rate responses at 1600 hours were reduced by propranolol. The observations show a circadian variation in the ST segment response to exercise in patients with angina and a possible training effect on heart rate with multiple exercise testing on the same day. This variation is associated with a reduction in vagal parasympathetic tone to the heart and should be taken into account in the assessment of patients with angina and in particular when comparing responses to treatment. PMID:7201319

  8. Update on ranolazine in the management of angina

    Science.gov (United States)

    Codolosa, J Nicolás; Acharjee, Subroto; Figueredo, Vincent M

    2014-01-01

    Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome)-TIMI (Thrombolysis In Myocardial Infarction) 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. PMID:25028555

  9. Sexual function in patients with chronic angina pectoris.

    Science.gov (United States)

    Kloner, Robert A; Henderson, Luana

    2013-06-01

    Drugs for erectile dysfunction (ED) may be contraindicated with nitrates commonly used to treat patients with angina pectoris, and certain antianginal therapies may worsen ED. The American Heart Association and the Princeton Consensus Conference panel of experts recommend that patients with coronary artery disease and ED who experience angina pectoris undergo full medical evaluations to assess the cardiovascular risks associated with resuming sexual activity before being prescribed therapy for ED. Current antianginal therapies include β blockers, calcium channel blockers, short- and long-acting nitrates, and ranolazine, a late sodium current inhibitor. Short- and long-acting nitrates remain a contraindication with phosphodiesterase-5 inhibitors commonly used to treat patients with ED, and the benefits of the other antianginal therapies must be weighed against their effects on cardiovascular health and erectile function. In conclusion, patients with coronary artery disease and ED who wish to initiate phosphodiesterase-5 inhibitor therapy and need to discontinue nitrate therapy need treatment options that manage their angina pectoris effectively, maintain their cardiovascular health, and provide the freedom to maintain their sexual function.

  10. ENHANCED PLATELET AGGREGABILITY UNDER HIGH SHEAR STRESS IN CORONARY CIRCULATION OF PATIENTS WITH UNSTABLE ANGINA

    OpenAIRE

    Doi, Naofumi

    2000-01-01

    Mechanical forces, including high shear stress, have been found to cause platelet aggregation. Although increased platelet aggregation is also associated with the pathophysiology of unstable angina, it is not known whether platelet aggregation induced by high shear stress occurs in the coronary circulation of patients with unstable angina. We assayed high shear stress induced platelet aggregation (h-SIPA) in each of 25 patients with unstable angina and a severe stenotic lesion of the left cor...

  11. Effect of Glucose - Insulin - Potassium (Gik) Solution on Short Term Prognosis of Unstable Angina

    OpenAIRE

    A Azimi; Azimi; M Motafakker; M Sadr-Bafghi; A Andishmand

    2007-01-01

    Introduction: Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction (MI) and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium (GIK) solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal o...

  12. Predicting prognosis in stable angina - results from the Euro heart survey of stable angina: prospective observational study

    DEFF Research Database (Denmark)

    Daly, Caroline A.; De Stavola, Bianca; Sendon, Jose L. Lopez

    2006-01-01

    -European survey in 156 outpatient cardiology clinics. Participants 3031 patients were included on the basis of a new clinical diagnosis by a cardiologist of stable angina with follow-up at one year. Main outcome measure Death or non-fatal myocardial infarction. Results The rate of death and non-fatal myocardial...... of outcome to estimate the probability of death or myocardial infarction within one year of presentation with stable angina. Conclusions A score based on the presence of simple, objective clinical and investigative variables makes it possible to discriminate effectively between very low risk and very high...... risk patients and to estimate the probability of death or non-fatal myocardial infarction over one year....

  13. Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.

    Science.gov (United States)

    Yang, Rong-Hsin; Shen, Shu-Huei; Li, Wing-Yin; Chu, Yum-Kung

    2015-01-01

    Ludwig's angina is a life-threatening cellulitis that involves the submandibular and sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We present here a cancer patient exhibiting the sequential features of bisphosphonate related osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights the need for medical practitioners to be alert to these rare combinations in the compromised patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina secondary to osteonecrosis of the jaw has been reported.

  14. A comparative study of dalteparin and unfractionated heparin in patients with unstable angina pectoris

    Directory of Open Access Journals (Sweden)

    Hanmant S Amane

    2011-01-01

    Conclusion : Dalteparin is as effective and safe as unfractionated heparin in the treatment of unstable angina. Dalteparin does not require routine laboratory monitoring as with unfractionated heparin.

  15. Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris.

    Science.gov (United States)

    Xu, Mingzhu; Yang, Xiangjun

    2015-01-01

    Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated.

  16. [Pain perception and peripheral pain localization in angina pectoris].

    Science.gov (United States)

    Droste, C

    1988-01-01

    Cardiac nociceptive afferences are mainly transmitted by sympathetic nervous tracts. After passing the ganglion stellatum and neighbouring ganglia, the nerves enter the dorsal horn of the spinal cord at C8-Th9 (especially Th2-Th6). Here the nerve synapses for the first time, mainly to neurons which run up to the thalamus contralaterally by the tractus spinothalamicus. Apart from atypically localised pain (jaw, head, neck), the nervus vagus is rarely involved in transmitting angina pectoris pain. There is no close relation between peripheral pain localisation and localisation of coronary stenosis or myocardial ischemia areas. The localisation of angina pectoris is decided by viscero-somatic summation (convergence-projection-theory). Almost all the ascending tracts of the tractus spinothalamicus with visceral inflow also receive inflow from somatic afferences, from skin areas of the dermatome from the same segment level, and especially from deep somatic structures such as muscle and ligaments (Head's zones). Additional reflex mechanisms, where the efferent part is probably sympathetic, explain transferred effects in the matching dermatome such as hypothermic skin zones, cutaneous hyperalgesia, higher pressure sensitivity of the muscles and occasionally even dystrophic changes. The amount of spinal visceral afferences is relatively small (only 1.5-2.5% of all somatic spinal afferences). The low amount, the pronounced divergence and, compared to converging somatic afferences, the larger receptive fields in the organ explain the diffuse, barely localisable character of angina pectoris pain. Cardiac afferences are tonically and phasically inhibited at spinal and supraspinal levels, especially by descending tracts. This explains why angina pectoris can be missing in spite of pronounced peripheral nociceptive impulse rates. Patients with silent myocardial ischemia have a higher central pain threshold than patients with symptomatic myocardial ischemia. Endogenous opioids

  17. Angina pectoris em paciente com hipertireoidismo e coronárias angiograficamente normais Angina pectoris in patient with hyperthyroidism and normal angiography coronary

    Directory of Open Access Journals (Sweden)

    Alessandra Ferri Casini

    2006-11-01

    Full Text Available A presença de angina pectoris em mulher pré-menopausa sem outros fatores de risco para doença arterial coronariana, obriga-nos a descartar outras causas de lesão coronariana não aterosclerótica. A relação entre o hipertireoidismo e as alterações no sistema cardiovascular está bem estabelecida, contudo o hipertireoidismo responde por menos de 5% dos casos de dor torácica. Apresenta-se um caso de uma mulher, 47 anos, com sintomas de precordialgia típica e eletrocardiograma (ECG sugestivo de isquemia coronariana, mas sem alteração laboratorial sugestiva de lesão miocárdica. Anamnese, exame físico e resultados laboratoriais permitiram firmar o diagnóstico de hipertireoidismo. Investigação subseqüente com o cateterismo cardíaco não demonstrou lesões obstrutivas. Após tratamento com iodo radioativo e retorno ao eutireoidismo, a paciente manteve-se assintomática e o ECG e a cintilografia miocárdica foram negativos para isquemia. Esses resultados sugerem uma interação entre hiperatividade tireoidiana e isquemia miocárdica, tendo o hipertireoidismo como provável etiologia dos achados clínicos e eletrocardiográficos.In the presence of angina pectoris in a premenopausal woman without significant risk factors for coronary disease, we have to rule out other causes of coronary lesion of non atherosclerotic origin. The relations between hyperthyroidism and the cardiovascular system are well known, but hyperthyroidism is responsable for less than 5% of all causes of chest pain. We present a clinical case of a 47 year old woman with typical chest pain and eletrocardiogram (EKG suggesting coronary ischemia but with normal laboratory data. Anamnesis, clinical and the laboratory data confirmed the diagnosis of hyperthyroidism. Further investigation showed a normal coronary angiography. After treatment with radioiodine and the establishment of euthyroidism, the patient remained asymptomatic and EKG and myocardial scintilography were

  18. Angina de pecho con arterias angiográficamente normales: características epidemiológicas y clínicas

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    Oswaldo Gutiérrez Sotelo

    2002-12-01

    Full Text Available Introducción: Las lesiones obstructivas por arterioesclerosis coronaria genera diversos síndromes coronarios. Sin embargo, un subgrupo de pacientes con angina de pecho y alteraciones electrocardiográficas no presenta dichas lesiones, en el que se incluyen el vasoespasmo coronario, la angina microvascular, los puentes musculares y otras condiciones. En este estudio se evaluaron las principales características clínicas y electrocardiográficas de este grupo de pacientes. Material y métodos: Se incluyeron pacientes con cualquier síndrome coronario y angiografía coronaria sin lesiones obstructivas. Se consignaron los factores de riesgo cardiovascular, los síntomas de presentación, alteraciones electrocardiográficas y ecocardiográficas y los fármacos utilizados. Resultados: Se reclutaron 26 casos, 13 hombres y 13 mujeres con edad promedio de 56.6 años (rango 16 - 78. Se presentó angina microvascular en 16 casos, vasoespasmo coronario en 8, uno con un puente coronario y uno con flujo lento. Como síntomas se observó disnea en 18 pacientes, angor típico en 19 y angor atípico en 7. El electrocardiograma de reposo fue anormal en 18 pacientes, y el de esfuerzo en 13 casos. De 19 ecocardiogramas, 9 fueron anormales. Los fármacos más utilizados fueron los betabloqueadores, los bloqueadores de los canales del calcio y los nitratos. Conclusiones: Los pacientes con síndromes coronarios y angiografía coronaria sin lesiones obstructivas presentan frecuentemente factores de riesgo coronario, no hay diferencia de género y los exámenes auxiliares son anormales lo que motiva la realización de la angiografía.lntroduction: Coronary arteriosclerosis lesions induce several coronary syndromes. Some patients suffer angina pectoris with abnormal electrocardiograms with no obstructive plaques in the angiogram. This group includes coronary vasospasm, micro vascular angina, muscle bridges and others. This study evaluates the most important clinical

  19. Plasma resistin is increased in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    HU Wen-lan; QIAO Shu-bin; HOU Qing; YUAN Jian-song

    2007-01-01

    Background Resistin, a novel adipokine linked to insulin resistance and obesity in rodents, which is derived mainly from macrophages and identified in atheromas in human, has been shown to play a potential role in atherosclerosis.Resistin levels were reported to increase in coronary artery disease (CAD), while data concerning resistin in different stages of CAD in Chinese people are lacking. The aim of this study was to assess whether plasma concentrations of resistin differed between patients with unstable and stable angina pectoris.Methods Plasma resistin levels were determined by means of enzyme-linked immunosorbent assay (ELISA) in 46 patients with unstable angina (UAP), 37 with stable angina (SAP) and 31 control subjects.Results Plasma concentrations of resistin were significantly increased in UAP group (geometric mean (interquartile range) 12.09 ng/ml (8.40, 18.08)) in comparison with SAP (9.04 ng/ml (7.09, 11.44)) and control groups (8.71 ng/ml (6.58,11.56)). No differences in resistin levels were found between patients with SAP and controls. We also found that plasma resistin positively correlated with leukocyte counts (r=0.21, P=0.027), high sensitive C-reactive protein (hs-CRP) (r=0.25,P=0.008), and endothelin-1 (r=0.21, P=0.025) after adjustment for age, sex and BMI.Conclusion Resistin may be involved in the development of CAD by influencing systemic inflammation and endothelial activation.

  20. Gender differences in the management and clinical outcome of stable angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    BACKGROUND: We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. METHODS AND RESULTS: The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angi

  1. Clinical course of isolated stable angina due to coronary heart disease

    NARCIS (Netherlands)

    Poole-Wilson, Philip A.; Voko, Zoltan; Kirwan, Bridget-Anne; de Brouwer, Sophie; Dunselman, Peter H. J. M.; Lubsen, Jacobus

    2007-01-01

    Aims To describe the clinical course of patients with stable angina due to coronary heart disease without a history of cardiovascular (CV) events or revascutarization (isolated angina). Methods and results Of 7665 patients in a trial comparing long-acting nifedipine with placebo, 2170 (28%) had isol

  2. Muscle Fibre Types, Ubiquinone Content and Exercise Capacity in Hypertension and Effort Angina

    DEFF Research Database (Denmark)

    Karlsson, Jan; Diamant, Bertil; Folkers, Karl;

    1991-01-01

    Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone......Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone...

  3. Improving diagnosis and treatment of women with angina pectoris and microvascular disease

    DEFF Research Database (Denmark)

    Prescott, Eva; Abildstrøm, Steen Zabell; Aziz, Ahmed

    2014-01-01

    BACKGROUND: The iPOWER study aims at determining whether routine assessment of coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease is feasible and identifies women at risk. METHODS: All women with angina referred to invasive angiographic assess...

  4. Necrotizing fasciitis in association with Ludwig’s angina – A case report

    OpenAIRE

    Kavarodi, A.M.

    2011-01-01

    A 28 year old male diabetic patient developed Ludwig’s angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig’s angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented.

  5. Necrotizing fasciitis in association with Ludwig’s angina – A case report

    Science.gov (United States)

    Kavarodi, A.M.

    2011-01-01

    A 28 year old male diabetic patient developed Ludwig’s angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig’s angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented. PMID:24151421

  6. A STUDY OF HIGH SENSITIVITY C-REACTIVE PROTEIN IN UNSTABLE ANGINA

    Directory of Open Access Journals (Sweden)

    Satish

    2014-11-01

    Full Text Available BACKGROUND: Unstable angina has a wide variability in its natural history, changing concepts of Pathophysiology, and newer approaches to its management strategies. So, unstable angina still has importance and prime interest in research work. Various ongoing research works has provided newer insights in pathophysiology of unstable angina syndrome and helps in recognition of clinical variability and unpredictability of it. C - reactive protein being the most sensitive acute phase reactant currently held. A recent previous study has estimated the levels and values of high-sensitivity C - reactive protein in both stable and unstable angina pectoris. Data provided by the study indicated need for further studies in this field. With all these facts, the present study is carried out to estimated Hs CRP levels as a marker of inflammation in patient of unstable angina. AIMS AND OBJECTIVES: The present study was carried out with the following Aims and Objectives. To estimate Hs-CRP levels as a marker of inflammation in patients of unstable angina. To compare Hs-CRP levels in cases of unstable angina, with Hs-CRP levels in patients of stable angina and in healthy age and sex matched controls. MATERIAL AND METHODS: This study was carried out at Basaveshwar Teaching and General Hospital, Gulbarga, MRMC Gulbarga. Approximate duration of study was 1 ½ year from June-2008 to November, 2010. OBSERVATION: Following are the conclusions drawn from the present study.

  7. Total occlusion of left main coronary artery without angina pectoris.

    Science.gov (United States)

    DePace, N L; Kimbiris, D; Iskandrian, A S; Bemis, C E; Segal, B L

    1983-05-01

    A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. The patient was initially seen with clinical signs of congestive heart failure but without symptoms of angina pectoris or ECG evidence of myocardial infarction. The patient's extensive right-to-left coronary artery collaterals may have contributed to the absence of chest pain. Because of the severe left ventricular dysfunction and the absence of chest pain, the patient was treated with medical therapy. Six months after the cardiac catheterization, he was alive and well under New York Heart Association functional classification II.

  8. Changes in multifractal properties for stable angina pectoris

    Science.gov (United States)

    Knežević, Andrea; Martinis, Mladen; Krstačić, Goran; Vargović, Emil

    2005-12-01

    The multifractal approach has been applied to temporal fluctuations of heartbeat (RR) intervals, measured in various regimes of physical activity (ergometric data), taken from healthy subjects and those having stable angina pectoris (SAP). The problem we address here is whether SAP changes multifractality observed in healthy subjects. The G-moment method is used to analyse the multifractal spectrum. It is observed that both sets of data characterize multifractality, but a different trend in multifractal behaviour is found for SAP disease, under pronounced physical activity.

  9. Ivabradine: the evidence of its therapeutic impact in angina

    OpenAIRE

    Guillaume Marquis-Gravel; Jean-Claude Tardif

    2008-01-01

    Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP) is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed ...

  10. Angina pectoris during daily activities and exercise stress testing: The role of inducible myocardial ischemia and psychological distress.

    Science.gov (United States)

    Sullivan, Mark D; Ciechanowski, Paul S; Russo, Joan E; Spertus, John A; Soine, Laurie A; Jordan-Keith, Kier; Caldwell, James H

    2008-10-31

    Physicians often consider angina pectoris to be synonymous with myocardial ischemia. However, the relationship between angina and myocardial ischemia is highly variable and we have little insight into the sources of this variability. We investigated the relationship of inducible myocardial ischemia on SPECT stress perfusion imaging to angina reported with routine daily activities during the previous four weeks (N=788) and to angina reported during an exercise stress test (N=371) in individuals with confirmed or suspected coronary disease referred for clinical testing. We found that angina experienced during daily life is more strongly and consistently associated with psychological distress and the personal threat associated with angina than with inducible myocardial ischemia. In multivariable models, the presence of any angina during routine activities over the prior month was significantly associated with age, perceived risk of myocardial infarction, and anxiety when compared to those with no reported angina in the past month. Angina during daily life was not significantly associated with inducible myocardial ischemia on stress perfusion imaging in bivariate or multivariable models. In contrast, angina experienced during exercise stress testing was significantly related to image and ECG ischemia, though it was also significantly associated with anxiety. These results suggest that angina frequency over the previous four weeks is more strongly associated with personal threat and psychosocial distress than with inducible myocardial ischemia. These results lend support to angina treatment strategies that aim to reduce threat and distress as well as to reduce myocardial ischemia.

  11. Stable and unstable angina: Identifying novel markers on circulating leukocytes.

    Science.gov (United States)

    Brown, Angus; Lattimore, Jo-Dee; McGrady, Michele; Sullivan, David; Dyer, Wayne; Braet, Filip; Dos Remedios, Cristobal

    2008-01-01

    There is currently no blood-based test that can rapidly and objectively distinguish between chest pain which is initiated by increased myocardial oxygen demand (stable angina pectoris (SAP)) and chest pain initiated due to decreased coronary blood flow (unstable angina pectoris (UAP)). Since leukocytes play an active role in the progression of coronary artery disease (CAD), we hypothesize these can provide novel markers of SAP and UAP. Here we use a microarray of 82 cluster of differentiation (CD) antibodies (plus controls) to selectively immobilize peripheral blood mononuclear cells. We find that the pattern of leukocyte immobilization from patients with CAD significantly differs from healthy donors. Within the CAD group, 15 SAP patients exhibited significant (p<0.05) changes in 8 of 82 CD antibody spots compared to 19 age-matched healthy blood donors. An additional ten CD antigens differed between healthy donors and patients with UAP (p<0.05). Furthermore, seven CD antibody spots are significantly different between SAP and UAP patients. These preliminary data suggest it is now appropriate to undertake a larger clinical trial to test the hypothesis that these antibody microarrays can monitor the progression from SAP to UAP.

  12. [Unstable angina pectoris in intermittent left bundle branch block].

    Science.gov (United States)

    Albert, S; Flury, G

    1997-11-19

    We present a case report of a 57 year old woman with recurrent chest pain, initially exclusively at exercise and later also at rest. This led to an emergency hospitalization for suspected myocardial infarction. As there were no enzymatic and electrocardiographic signs of acute infarction she was treated, as unstable angina pectoris. Coronary angiography revealed but a modest coronary atheromatosis without significant coronary stenosis. Therefore her symptoms were interpreted as primary manifestation of an intermittant Left Bundle Branch Block (LBBB) with changing heart-rate dependency. A majority of patients with LBBB and chest pain have a relevant Coronary Artery Disease (CAD). There is a small number of reports in literature about patients with intermittant LBBB without significant CAD but with both typical (exercise-induced) and atypical (at rest) chest pain. Special features of our case are presentation of LBBB as unstable angina, documentation of an intermittant LBBB with changing heart-rate dependency and heart-rate-dependent supranormal conduction in the left bundle branch. We review some important aspects of LBBB with regard to this case.

  13. Angina monocitica con sovrainfezione da Prevotella denticola: caso clinico

    Directory of Open Access Journals (Sweden)

    Maria Teresa Allù

    2005-06-01

    Full Text Available Monocytic angina with superinfection of Prevotella denticola: clinical case Monocytic angina is a clinical sindrome caused by Epstein-Barr virus characterized by fever, pharyngitis, exudative tonsillitis, swollen lymphoglands, splenomegaly and hepatomegaly.The inflamed pharynx and necrotic tonsils of infectious mononucleosis are subject to bacterial superinfection initially or during the course of the illness; the reduced PO2 tension and low oxidation-reduction potential that prevail in a vascular and necrotic tissues favour the growth of anaerobes. In this article we reported the clinical case of a ten years old children, who presented fever and tonsillopharyngitis; he was treated with cefotaxime and piperacillin, he did not improve in health. He was admitted to hospital (Department of Otorhinolaryngology. The patient was treated with aminoglycoside (tobramycin, piperacillin and cortisone; the clinical situation deteriorated. Pus sample was collected from the tonsils and cultured. Isolated strain from culture anaerobic was identified biochemically (Rapid-ID32ANA.The microorganism isolated was: Prevotella denticola (oral anaerobic gram-negative rods; β-lactamase production was tested by using the chromogenic cephalosporin disk test.The susceptibility to antibiotics was performed according to NCCLS recommendations. Prevotella denticola (β-lactamase production was resistant to penicillin, cefoxitin, cefotetan, piperacillin, clindamycin and metronidazole it was susceptible to piperacillin-tazobactam, amoxicillin-clavulanate, ticarcillin-clavulanate, imipenem and chloramphenicol. Children was treated with piperacillin-tazobactam, with rapid symptomatic relief.

  14. A case of relapsing polychondritis mimicking Ludwig’s angina

    Directory of Open Access Journals (Sweden)

    Adnan Agha

    2009-09-01

    Full Text Available Relapsing polychondritis (RP is a severe progressive inflammatory condition involving cartilaginous structures and caused by an autoimmune process, for which there is no confirmatory serological biomarker and which still is diagnosed on a mainly clinical basis. RP has been associated with many diseases like Sweet’s syndrome, Behcet’s disease, rheumatoid arthritis, and other autoimmune disorders. We attempt to describe here a unique case of a 38-year-old female with a high-grade fever, sore throat, difficulty in swallowing, hoarseness of the voice, and found to have signs of tongue swelling and inflammation of the oral cavity that mimicked Ludwig’s angina, necessitating antibiotic use. On careful re-evaluation the patient was diagnosed to have relapsing polychondritis based on auricular and respiratory tract chondritis and response to steroids. The purpose of this report is to emphasize the fact that careful clinical assessment is needed to diagnose RP, which may be misdiagnosed as Ludwig’s angina.

  15. [Significance of the fusospirillum complex (Plaut-Vincent angina)].

    Science.gov (United States)

    Van Cauwenberge, P

    1976-01-01

    The results are discussed of a retrospective study of 126 patients by whom an excess of the fusospirochaetal complex was found by direct microscopic examination of tonsillar material. These bacteria are not only found in unilateral ulcero-necrotic tonsillitis, but also in different other tonsillar and general diseases. Vincent's angina appears almost exclusively in young persons, aged from 16 to 25 years; in the adolescence (16-20 years) it forms about 40% of all cases of acute tonsillitis. The fusospirochaetal complex is also often found in chronic tonsillitis and even in morfologically normal tonsils, especially in patients with general diseases like rheumatic arthritis. In one third of the patients with infectious mononucleosis, the complex is present in the tonsillar lesions. The occurrence of Vincent's angina is double as high in women than in men. From our assessments we can conclude that the fusospirochaetal complex has a very low pathogenity, and that it only can grow in patients with a reduced local or general resistance, even without causing local lesions.

  16. Salvianolate injection in the treatment of unstable angina pectoris

    Science.gov (United States)

    Zhang, Dan; Wu, Jiarui; Liu, Shi; Zhang, Xiaomeng; Zhang, Bing

    2016-01-01

    Abstract Background: To systematically evaluate the clinical efficacy and safety of Salvianolate injection in the treatment of unstable angina pectoris (UAP). Methods: Using literature databases, we conducted a thorough and systematic retrieval of randomized controlled trials (RCTs) that using Salvianolate injection for treating UAP. The Cochrane Risk of Bias Assessment Tool was used to evaluate the methodological quality of the RCTs, and then the data were extracted and meta-analyzed by RevMan5.2 software. Results: A total of 22 RCTs with 2050 participants were included. The meta-analysis indicated that the combined use of Salvianolate injection and western medicine (WM) in the treatment of UAP can achieve a superior effect in angina pectoris total effective rate (risk ratio [RR] = 1.22, 95% confidence interval [CI] (1.17, 1.27), Z = 10.15, P Adverse drug reactions (ADRs) or adverse drug events (ADEs) were reported in 6 RCTs involving 15 cases; however, there were no serious ADRs/ADEs. Conclusion: Based on the systematic review, the combined use of Salvianolate injection and WM in the treatment of UAP can achieve a better effect; however, there was no definitive conclusion about its safety. More the large-sample and multicenter RCTs are needed to support its clinical usage. PMID:28002341

  17. Transcutaneous electrical nerve stimulation (TENS) in angina pectoris.

    Science.gov (United States)

    Mannheimer, C; Carlsson, C A; Vedin, A; Wilhelmsson, C

    1986-09-01

    The aim of this study was to determine the efficacy of transcutaneous electrical nerve stimulation (TENS) in the treatment of chronic stable severe angina pectoris. In a short-term study the effect of TENS was studied in 10 male patients with angina pectoris (functional class III and IV). All patients had previously been stabilized on long-term maximal oral treatment. The effects of the treatment were measured by means of repeated bicycle ergometer tests. All patients had an increased working capacity (16-85%), decreased ST segment depression and reduced recovery time during TENS. No adverse effects were observed. A long-term study of TENS on similarly selected patients showed beneficial effects in terms of pain reduction, reduced frequency of anginal attacks, increased physical activity and increased working capacity during bicycle ergometer tests. An invasive study was carried out with respect to systemic and coronary hemodynamics and myocardial metabolism during pacing provoked myocardial ischemia in 13 patients. The results showed that TENS led to an increased tolerance to pacing, improved lactate metabolism, less pronounced ST segment depression. A drop in systolic blood pressure during TENS treatment at identical pacing rates indicated a decreased afterload. An increased coronary flow to ischemic areas in the myocardium was supported by the fact that the rate pressure product during anginal pain increased during TENS.

  18. Effect of Glucose - Insulin - Potassium (Gik Solution on Short Term Prognosis of Unstable Angina

    Directory of Open Access Journals (Sweden)

    A Azimi

    2007-12-01

    Full Text Available Introduction: Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction (MI and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium (GIK solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal of this study was evaluation of the effectiveness of GIK solution on prognosis of hospitalized unstable angina patients. Methods: This randomized clinical trial included patients with class II and III unstable angina (two groups of 94 patients, each with a mean age of 62.47±13.20 years and Female /Male ratio of 1.35 admitted in the CCU’s of Yazd from September 2003 to May 2004 . Results: There was no significant difference between the study and control groups regarding mean age, sex ratio and unstable angina class (P=0.15, P=0.77 and P=0.76. The study group had significant reduction in recurrent chest pain and duration of hospitalization (P=0.001 and P=0.02. The most common adverse effect of GIK solution was pain at infusion site. Conclusion: Use of GIK solution causes early stabilization of unstable angina patients without any significant or life threatening adverse effect.

  19. Meta-analysis of acupuncture therapy for the treatment of stable angina pectoris.

    Science.gov (United States)

    Zhang, Ze; Chen, Min; Zhang, Li; Zhang, Zhe; Wu, Wensheng; Liu, Jun; Yan, Jun; Yang, Guanlin

    2015-01-01

    Angina pectoris is a common symptom imperiling patients' life quality. The aim of this study is to evaluate the efficacy and safety of acupuncture for stable angina pectoris. Clinical randomized-controlled trials (RCTs) comparing the efficacy of acupuncture to conventional drugs in patients with stable angina pectoris were searched using the following database of PubMed, Medline, Wanfang and CNKI. Overall odds ratio (ORs) and weighted mean difference (MD) with their 95% confidence intervals (CI) were calculated by using fixed- or random-effect models depending on the heterogeneity of the included trials. Total 8 RCTs, including 640 angina pectoris cases with 372 patients received acupuncture therapy and 268 patients received conventional drugs, were included. Overall, our result showed that acupuncture significantly increased the clinical curative effects in the relief of angina symptoms (OR=2.89, 95% CI=1.87-4.47, Pacupuncture therapy was superior to conventional drugs. Although there was no significant difference in overall effective rate relating reduction of nitroglycerin between two groups (OR=2.13, 95% CI=0.90-5.07, P=0.09), a significant reduction on nitroglycerin consumption in acupuncture group was found (MD=-0.44, 95% CI=-0.64, -0.24, Pacupuncture therapy than for traditional medicines (MD=2.44, 95% CI=1.64-3.24, Pacupuncture therapy were found. Acupuncture may be an effective therapy for stable angina pectoris. More clinical trials are needed to systematically assess the role of acupuncture in angina pectoris.

  20. Efficacy of anipamil, a phenylalkylamine calcium antagonist, in treatment of angina pectoris

    DEFF Research Database (Denmark)

    Sørum, C; Larsen, C T; Rasmussen, Verner

    1994-01-01

    with > or = 0.1-mV horizontal or downsloping ST-segment depression limited by angina, and (c) at least 10 attacks of angina pectoris in a single-blind 3-week run-in period. Nineteen patients were randomized to enter the study. In 3-week periods, they received either anipamil 80 mg once daily (o.d.), anipamil...... 160 mg o.d., or placebo. At the end of each period, an exercise test was performed. The number of angina pectoris attacks was significantly reduced during treatment with anipamil 80 mg (p ... reduced during treatment with anipamil 80 mg (p Heart rate (HR) at 0...

  1. Management of Stable Angina with Ivabradine as Safe Alternative to Patients with Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    Giuliano Ohde Dalledone

    2016-01-01

    Full Text Available Management of cardiac symptoms in myasthenia gravis (MG patients can be challenging. The aim of this report is to describe the safe use of ivabradine for stable angina in MG patients. A 48 y.o. woman, with MG diagnosis, presented stable angina. Therapies choices were reduced considering concomitant disease as well as previous and unsuccessful cardiologic managements. Ivabradine showed unexpected results. The patient presented an improvement of neurological and cardiac symptoms, bringing ivabradine as one more therapeutic option to similar patients. In this report we recommend ivabradine as an effective and safe drug for treatment of stable angina in MG patients.

  2. [Myocardial infarct and unstable angina pectoris: diagnostics and therapy].

    Science.gov (United States)

    Weber, M; Hamm, C

    2007-04-01

    Acute coronary syndromes include ST-elevation and non-ST elevation myocardial infarction, and unstable angina pectoris. These are characterised by the acute onset of chest pain. For the diagnostic work up in the acute phase, ECG and the assessment of cardiac markers play a central role. For patients with ST-elevation, primary interventional therapy is the first choice. For patients with an acute coronary syndrome without ST-elevation, a risk adapted therapeutic strategy should be chosen. High risk patients (elevated troponins, clinical, rhythmological and hemodynamic instability, ST-depression and diabetes mellitus) should be treated by an early invasive approach with angiography performed within 48-72 h. Low risk patients should be treated conservatively. For all patients who are treated interventionally, the administration of an aggressive antiaggregatory therapy including aspirin, clopidogrel, glycoprotein IIb/IIIa inhibitors and heparin is indicated in the acute phase. In the chronic phase, the treatment of cardiovascular risk factors is of paramount importance.

  3. Pulmonary artery dilatation: an overlooked mechanism for angina pectoris.

    Science.gov (United States)

    Ginghina, Carmen; Popescu, Bogdan A; Enache, Roxana; Ungureanu, Catalina; Deleanu, Dan; Platon, Pavel

    2008-07-01

    Dilatation of the pulmonary artery may lead to the compression of adjacent structures. Of those, the extrinsic compression of the left main coronary artery is the most worrisome. We present the case of a 48-year-old woman who was diagnosed with pulmonary artery dilatation due to severe, thromboembolic pulmonary hypertension. She also had angina and coronary angiography revealed a 70% ostial stenosis of the left main coronary artery. The presence of this isolated lesion in a young woman without risk factors for atherosclerosis suggests extrinsic compression of the left main coronary artery by the dilated pulmonary artery as the likely mechanism. The patient underwent direct stenting of the left main coronary stenosis with a good result.

  4. Effects of acupuncture in moderate, stable angina pectoris

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Pedersen, F; Pietersen, A

    1990-01-01

    In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian...... system. The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption. There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture...... there was a significant increase in exercise tolerance (median 9%) and in delay of onset to pain (median 10%). No significant changes were observed in patients receiving sham acupuncture. Within both groups there was a median reduction of 50% in anginal attack rate and nitroglycerin consumption...

  5. An Unusual Case of Suspected Microvascular Angina in a Newborn

    Directory of Open Access Journals (Sweden)

    Stefania Cataldo

    2012-01-01

    Full Text Available Myocardial ischemia in pediatric population is uncommon and usually due to congenital heart disease or extracardiac conditions leading to poor coronary perfusion. A 6-day-old newborn presented with respiratory distress and signs of heart failure. ECG, echocardiography, and laboratory results were consistent with myocardial ischemia. Coronary angiography was performed to exclude anomalous origin of coronary arteries, showing normal coronary artery origin and course. Thrombophilia and extra-cardiac causes were ruled out. Clinical conditions improved with mechanical ventilation and diuretics, enzyme levels lowered, repolarisation and systolic function abnormalities regressed, but ischemic electrocardiographic and echocardiographic signs still presented during intense crying. Becaues of suspicion of microvascular angina, therapy with ASA and beta-blocker was started. At 5 month followup, the baby was in good clinical condition and no more episodes were recorded. We believe it is an interesting case, as no similar cases have been recorded till now.

  6. Atypical presentations among Medicare beneficiaries with unstable angina pectoris.

    Science.gov (United States)

    Canto, John G; Fincher, Contessa; Kiefe, Catarina I; Allison, Jeroan J; Li, Qing; Funkhouser, Ellen; Centor, Robert M; Selker, Harry P; Weissman, Norman W

    2002-08-01

    Chest pain is a hallmark symptom in patients with unstable angina pectoris (UAP). However, little is known regarding the prevalence of an atypical presentation among these patients and its relation to subsequent care. We examined the medical records of 4,167 randomly sampled Medicare patients hospitalized with unstable angina at 22 Alabama hospitals between 1993 and 1999. We defined typical presentation as (1) chest pain located substernally in the left or right chest, or (2) chest pain characterized as squeezing, tightness, aching, crushing, arm discomfort, dullness, fullness, heaviness, pressure, or pain aggravated by exercise or relieved with rest or nitroglycerin. Atypical presentation was defined as confirmed UAP without typical presentation. Among patients with confirmed UAP, 51.7% had atypical presentations. The most frequent symptoms associated with atypical presentation were dyspnea (69.4%), nausea (37.7%), diaphoresis (25.2%), syncope (10.6%), or pain in the arms (11.5%), epigastrium (8.1%), shoulder (7.4%), or neck (5.9%). Independent predictors of atypical presentation for patients with UAP were older age (odds ratio 1.09, 95% confidence interval 1.01 to 1.17/decade), history of dementia (odds ratio 1.49, 95% confidence interval 1.10 to 2.03), and absence of prior myocardial infarction, hypercholesterolemia, or family history of heart disease. Patients with atypical presentation received aspirin, heparin, and beta-blocker therapy less aggressively, but there was no difference in mortality. Thus, over half of Medicare patients with confirmed UAP had "atypical" presentations. National educational initiatives may need to redefine the classic presentation of UAP to include atypical presentations to ensure appropriate quality of care.

  7. Serum cardiac troponin T in unstable angina pectoris patients.

    Science.gov (United States)

    Leowattana, W; Mahanonda, N; Bhuripanyo, K; Pokum, S; Kiartivich, S

    2000-11-01

    Cardiac troponin T (cTnT) is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. In this study, we used a second-generation enzyme immunoassay for cTnT to determine whether its presence in the serum of patients with unstable angina was a prognostic indicator. Thirty patients with unstable angina pectoris (UAP) and 30 patients with Q-wave acute myocardial infarction (AMI) were screened for serum CK-MB activity and cTnT at 6, 12, 24 and 48 hours after the onset of chest pain, All of the mean concentrations of CK-MB activity determined in UAP patients were less than the upper limit of normal (25 U/L). Meanwhile, the mean concentration of cTnT at 6, 12, 24 and 48 hours after onset of chest pain were higher than the cutoff values (0.1 microg/L), We found that one third of UAP patients had serum cTnT at the time of admission more than 0.1 microg/L and that these groups of patients were associated with a high risk for cardiac events. Our results suggested that patients with elevated serum cTnT could be considered as high-risk patients for developing myocardial infarction, Patients with normal cTnT levels and a low or intermediate clinical risk could be stabilized and further stratified noninvasively.

  8. Impact of pre-infarction angina on angiographic and echocardiographic outcomes in patients with acute ante

    Directory of Open Access Journals (Sweden)

    Ahmed El Missiri

    2016-09-01

    Conclusions: For patients suffering from a first attack of acute anterior wall STEMI, pre-infarction angina is associated with a better Killip class at presentation, better TIMI flow grade after PPCI, less incidence of TMP 0 flow grade.

  9. [Clinical trial by perexiline maleate in treatment of angina pectoris (author's transl)].

    Science.gov (United States)

    Corsini, G; Correale, E; Oriani, G; Persico, S; Tritto, C

    1975-01-01

    A controlled double blind clinical trial has been conducted in 16 patients with "angina pectoris" in order to investigate the effect of Perexiline maleate as compared with prenilamine. Perexiline at the dose of 400 mg/die and prenilamine at the dose of 120 mg/die have been administered over a period of 4 weeks each. Between these periods placebo has been administered for two weeks. The number of attacks of angina and the number of tablets of nitroglycerine used per week by the patient during each period has been used for the evaluation. Furthermore ECG at rest and after exercise has been performed every two weeks. Our results statistically evaluated show a definite antianginal effect of Perexiline. According to our experience Perexiline should be considered the drug of choise in the treatment of angina complicated by bradicardia, left ventricular failure, bronchospasm, and in angina unresponsive to other drugs.

  10. Gender differences in the management and clinical outcome of stable angina

    DEFF Research Database (Denmark)

    Daly, Caroline; Clemens, Felicity; Sendon, Jose L. Lopez;

    2006-01-01

    Background- We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results- The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable...... angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42% were female. Women were......, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions- Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less...

  11. Benefit of abciximab in patients with refractory unstable angina in relation to serum troponin T levels.

    NARCIS (Netherlands)

    C.W. Hamm (Christian); C. Heeschen (Christopher); B. Goldmann (Britta); A. Vahanian (Alec); J. Adgey (Jennifer); C.M. Miguel (Carlos); W.R. Rutsch (Wolfgang); J. Berger (Jürgen); J.G. Kootstra (Jille); M.L. Simoons (Maarten)

    1999-01-01

    textabstractBACKGROUND: In patients with refractory unstable angina, the platelet glycoprotein IIb/IIIa-receptor antibody abciximab reduces the incidence of cardiac events before and during coronary angioplasty. We investigated whether serum troponin T levels identify patients most

  12. Structural and Functional Coronary Artery Abnormalities in Patients With Vasospastic Angina Pectoris

    DEFF Research Database (Denmark)

    Ong, Peter; Aziz, Ahmed; Hansen, Henrik Steen

    2015-01-01

    Coronary spasm is involved in many clinical scenarios, such as stable angina, acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical cohere...

  13. Refractory angina pectoris in end-stage coronary artery disease : Evolving therapeutic concepts

    NARCIS (Netherlands)

    Schoebel, FC; Frazier, OH; Jessurun, GAJ; DeJongste, MJL; Kadipasaoglu, KA; Jax, TW; Heintzen, MP; Cooley, DA; Strauer, BE; Leschke, M

    1997-01-01

    Refractory angina pectoris in coronary artery disease is defined as the persistence of severe anginal symptoms despite maximal conventional antianginal combination therapy. Further, the option to use an invasive revascularization procedure such as percutaneous coronary balloon angioplasty or aortoco

  14. The prognostic significance of angina pectoris experienced during the first month following acute myocardial infarction

    DEFF Research Database (Denmark)

    Jespersen, C M

    1997-01-01

    BACKGROUND: Angina pectoris accompanied by transient ST-segment changes during the in-hospital phase of acute myocardial infarction (AMI) is a well established marker of subsequent cardiac death and reinfarction. HYPOTHESIS: This study was undertaken to record the prognostic significance of angina...... on study treatment 1 month after discharge. Of these patients, 311 (39%) reported chest pain during the first month following discharge. RESULTS: Patients with angina pectoris had a significantly increased risk of reinfarction [hazard 1.71; 95%-confidence limit (CL): 1.09, 2.69] and increased mortality...... risk which, however, only reached borderline statistical significance (hazard 1.52; 95%-CL: 0.96, 2.40). When patients were subdivided according to both angina pectoris and heart failure, those with one or both of these risk markers had significantly increased mortality (p 0.03) and reinfarction (p 0...

  15. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-02-01

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted.

  16. Management policies and prognosis in unstable angina pectoris : use of coronary angiography in different practice settings

    OpenAIRE

    Miltenburg-van Zijl, Addy

    1992-01-01

    textabstractUnstable angina encompasses a wide range of clinical presentations of myocardial ischemia, usually caused by sudden deteriorations of coronary lesions. Sometimes, extracardiac conditions disturbing the oxygen balance, such as severe anaemia, fever or thyrotoxicosis, may cause myocardial ischemia. In this thesis unstable angina is referred to as myocardial ischemia due to obstructive atherosclerotic coronary artery disease. In the literature and in clinical practice a variety of de...

  17. Plasma endothelin in coronary venous blood from patients with either stable or unstable angina.

    OpenAIRE

    Stewart, J T; Nisbet, J A; Davies, M J

    1991-01-01

    STUDY OBJECTIVE--To test the hypothesis that the active coronary endothelial lesions in unstable angina raise the endothelin concentration in coronary venous blood. DESIGN--Systemic and coronary venous blood samples were obtained from unselected patients with the clinical syndromes of either stable or unstable angina at the time of cardiac catheterisation and coronary arteriography. Control venous blood samples were obtained from healthy laboratory workers and from patients with chronic renal...

  18. Angina-like chest pain: a joint medical and psychiatric investigation.

    OpenAIRE

    Colgan, S M; Schofield, P.M.; Whorwell, P. J.; Bennett, D.H.; Brooks, N H; Jones, P. E.

    1988-01-01

    Sixty three patients with chest pain typical of angina and who had normal coronary angiograms were investigated for left ventricular, oesophageal and psychiatric abnormalities. An additional 21 patients, age and sex matched, who had angina and significant coronary artery disease were also studied. Eighty six per cent of the 63 patients without evidence of coronary artery disease could be demonstrated to have a physical abnormality (left ventricular dysfunction in 35%, oesophageal disorder 51%...

  19. [Crescendo angina - an indication for surgery: A short literature survey and a discussion of three cases].

    Science.gov (United States)

    Meyer, J M; Kleynhans, P H; Hugo, J M; Verwoerd, C A; Steyn, J G

    1980-08-01

    A definition of crescendo angina is given, followed by a short discussion of the literature on this disease. A case of a patient treated surgically for crescendo angina is reported, and the angiograms of 2 other patients are reviewed to further illustrate the problem. The favourable postoperative course of the patients who underwent an operation for this life-threatening disease is a strong indication for this mode of treatment.

  20. Variant angina and coronary artery spasm: the clinical spectrum, pathophysiology, and management.

    Science.gov (United States)

    Kusama, Yoshiki; Kodani, Eitaro; Nakagomi, Akihiro; Otsuka, Toshiaki; Atarashi, Hirotsugu; Kishida, Hiroshi; Mizuno, Kyoichi

    2011-01-01

    Variant angina is a form of angina pectoris that shows transient ST-segment elevation on electrocardiogram during an attack of chest pain. Ischemic episodes of variant angina show circadian variation and often occur at rest from midnight to early morning. Ischemic episodes also occur during mild exercise in the early morning. However, they are not usually induced by strenuous exercise in the afternoon. Other important clinical features of variant angina include the high frequency of asymptomatic ischemic episodes and the syncope that sometimes occur during the ischemic episodes. Syncope is due to severe arrhythmias, including ventricular tachycardia, ventricular fibrillation, and high-degree atrioventricular block. Coronary artery spasm is the mechanism of ischemic episodes in variant angina. The incidence of coronary artery spasm shows a racial difference and is higher in Japanese than in Caucasians. Coronary arteriograms are normal or near-normal in most Japanese patients with variant angina. Deficient basal release of nitric oxide (NO) due to endothelial dysfunction, and enhanced vascular smooth muscle contractility with the involvement of the Rho/Rho-kinase pathway are reported to play important roles in the pathogenesis of coronary artery spasm. Other precipitating factors of coronary artery spasm include imbalance in autonomic nervous activity, increased oxidative stress, chronic low-grade inflammation, magnesium deficiency, and genetic susceptibility. The genetic risk factors associated with coronary artery spasm include gene polymorphisms of endothelial NO synthase (NOS), paraoxonase, and other genes. Calcium channel blockers are extremely effective in preventing coronary spasm. The long-acting nitrate, nicorandil, and Rho-kinase inhibitor are also useful for inhibiting coronary artery spasm. Because variant angina can lead to acute myocardial infarction, fatal arrhythmias, and sudden death, early treatment is important. The prognosis of patients with

  1. The prognostic significance of post-infarction angina pectoris and the effect of verapamil on the incidence of angina pectoris and prognosis. The Danish Study Group on Verapamil in Myocardial Infarction

    DEFF Research Database (Denmark)

    Jespersen, C M; Hansen, J F; Mortensen, L S

    1994-01-01

    The prognostic significance of angina pectoris and the effect of intervention with verapamil on the incidence of angina pectoris were studied in patients recovering from myocardial infarction and included in the Danish Verapamil Infarction Trial II. During the second week after admission patients...... were doubly-blindly randomized to treatment with verapamil 360 mg.day-1 or placebo. Treatment was continued for up to 18 months. At discharge angina pectoris was reported in 11% of 869 patients randomized to verapamil and in 12% of 888 randomized to placebo (ns). One month after discharge a significant...... increase in the prevalance of angina pectoris was reported in both the verapamil (33%) (P angina pectoris (P = 0.03) and the 18 months overall incidence of angina pectoris (P = 0.002) were both significantly lower...

  2. [Diltiazem versus intravenous nitroglycerin in the treatment of unstable angina pectoris. A randomized study].

    Science.gov (United States)

    Castro, P; Corbalán, R; Vergara, I; Kunstmann, S

    1995-07-01

    Prognosis of unstable angina pectoris is related to admission EKG changes and prompt symptom control. The aim of this study was to compare the clinical effects of intravenous diltiazem (DTZ) or nitroglycerin (NTG) in patients with unstable angina pectoris. We studied 43 patients admitted to the hospital with a history of rest angina within the last 48 hours, associated with EKG evidence of ischemia. All subjects received intravenous heparin and oral aspirin, 23 were randomly assigned to receive intravenous DTZ and 20 to receive intravenous NTG. Both groups had similar baseline features and the endpoints of treatment were recurrence of angina, myocardial infarction, death during hospitalization and secondary side effects. Treatment with DTZ, when compared to NTG, resulted in a significant reduction of recurrent angina (8.7 and 59% respectively; p bradicardia with DTZ (28% of patients). In each group, one patient had a myocardial infarction and one patient died. It is concluded that intravenous DTZ reduces myocardial ischemia to a greater extent than NTG and can be safely used in patients with unstable angina pectoris.

  3. TREATMENT OPTIMIZATION IN PATIENTS WITH STABLE ANGINA PECTORIS: FOCUS ON VERAPAMIL SR

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2011-01-01

    Full Text Available Possibilities of angina pectoris pharmacotherapy are analyzed. Achievement of target heart rate (HR 55-60 beats per minute in these patients is possible due to three classes of antianginal medications that slow down HR: beta blockers (BB, If-channel inhibitors, nondihydropyridine calcium channel blockers (CCB. Nondihydropyridine CCB verapamil in slow release (SR formulation is focused. The main results of randomized clinical trials (APSIS, VHAS, CRIS, EVERESTH, VAMPHYRE, INVEST, VESPA, DAVIT-1, DAVIT-2, which have proven efficacy and safety, are presented. Verapamil SR is indicated for the treatment of angina pectoris in patients without history of myocardial infarction (MI; angina patients experienced MI without systolic heart failure and with contraindications to BB; angina with arterial hypertension; left ventricular diastolic dysfunction; peripheral arteries obliterating atherosclerosis; silent myocardial ischemia; vasospastic angina; angina associated with supraventricular cardiac arrhythmias (especially in permanent atrial fibrillation except Wolff-Parkinson-White and Lown-Ganong-Levine syndromes; after coronary angioplasty and the placement of bare metal stents.

  4. Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina.

    Science.gov (United States)

    Zarifis, John; Kallistratos, Manolis; Katsivas, Apostolos

    2016-12-01

    Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion. Patient QoL was assessed using the EQ-5D questionnaire. From baseline to study completion; ivabradine administration on top of metoprolol decreased heart rate (HR) from 80.8 ± 9.6 to 64.2 ± 6.2 bpm (P Ivabradine combined with metoprolol significantly decreased angina symptoms and use of nitroglycerin in patients with stable angina and CAD, leading to improved QoL. The benefits observed with this combination explain the high rate of adherence to treatment.

  5. Combination therapy with metoprolol and nifedipine versus monotherapy in patients with stable angina pectoris. Results of the International Multicenter Angina Exercise (IMAGE) Study

    DEFF Research Database (Denmark)

    Savonitto, S; Ardissiono, D; Egstrup, K

    1996-01-01

    10, the groups randomized to combination therapy had a further increase in time to 1-mm ST segment depression (p ...OBJECTIVES: This study was designed to investigate whether combination therapy with metoprolol and nifedipine provides a greater anti-ischemic effect than does monotherapy in individual patients with stable angina pectoris. BACKGROUND: Combination therapy with a beta-adrenergic blocking agent...... (which reduces myocardial oxygen consumption) and a dihydropyridine calcium antagonist (which increases coronary blood flow) is a logical approach to the treatment of stable angina pectoris. However, it is not clear whether, in individual patients, this combined therapy is more effective than monotherapy...

  6. Effect of anxiety and depression on endothelial function and inflammation degree of coronary heart disease patients with angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Lin Ni; Xiang-Yang Xia; Ka Han; Yong-Xin Wu

    2016-01-01

    Objective:To study the effect of anxiety and depression on endothelial function and inflammation degree of coronary heart disease patients with angina pectoris.Methods: 80 cases of patients diagnosed with angina pectoris of coronary heart disease in our hospital from May 2012 to August 2014 were enrolled for study; anxiety and depression were judged by anxiety subscale (HADS-a) and depression subscale (HADS-d). Endothelial progenitor cell and endothelial microparticle contents in peripheral blood as well as serum ET-1, CGRP, IL-6, IL-6R, IL-18, ADAMTS-1 and NO contents were detected.Results:EPC, NO and CGRP contents of angina pectoris patients with anxiety were lower than those of angina pectoris patients without anxiety, and EMP, ET-1, IL-6, IL-6R, IL-18 and ADAMTS-1 contents were higher than those of angina pectoris patients without anxiety; EPC, NO and CGRP contents of angina pectoris patients with depression were lower than those of angina pectoris patients without depression, and EMP, ET-1, IL-6, IL-6R, IL-18 and ADAMTS-1 contents were higher than those of angina pectoris patients without depression.Conclusions:Angina pectoris of coronary heart disease patients complicated with anxiety and depression have endothelial dysfunction and inflammatory reaction activation; endothelial dysfunction and inflammatory reaction activation are possible pathways that anxiety and depression cause the progression of coronary heart disease.

  7. The impact of guideline compliant medical therapy on clinical outcome in patients with stable angina: findings from the Euro Heart Survey of stable angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    AIMS: The European Society of Cardiology published guidelines for the management of stable angina in 1997, with the objective of promoting an evidence-based approach to the condition. This study focuses on the impact of guideline compliant medical treatment on clinical outcome in patients with stabl

  8. Renal artery stenosis presenting as crescendo angina pectoris.

    Science.gov (United States)

    Tami, L F; McElderry, M W; al-Adli, N M; Rubin, M; Condos, W R

    1995-07-01

    The coexistence of different clinical syndromes due to atherosclerosis in different organs is not rare and emphasizes the diffuse nature of this vascular process. Although renovascular disease may cause hypertension and/or renal insufficiency, it may also occur in the absence of the usual clinical markers that suggest renovascular hypertension. We report a patient with stable coronary anatomy who presented with crescendo angina pectoris. Diagnosis of renovascular hypertension was made by screening renal angiography at the time of the cardiac catheterization. Renal artery stenting resulted in stabilization of the coronary syndrome and obviated the need for further coronary intervention. To our knowledge, this is the first case of renovascular hypertension precipitating an unstable coronary syndrome in a patient with documented stable coronary anatomy. Review of the literature supports that patients undergoing cardiac catheterization are a high risk population for renovascular disease, particularly in the presence of other predictive factors such as documented coronary artery disease, older age, female gender, congestive heart failure, peripheral vascular disease, renal insufficiency, and smoking. Firm recommendations for routine screening renal angiography in patients undergoing peripheral or coronary angiography will need further studies.

  9. The Study of hemodynamics and coronary arteriography of Patients with Different Types of Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    谢小鲁; 王燕妮; 祝家庆; 袁祖贻

    2003-01-01

    Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pecto ris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 eases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with nary capillary wedge pressure of positive patients rose,at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes.However, both PCWP and CI of the negative patients arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease,9% single vessel disease and left main narrowing 22.7% in AEA. There are separately 76%, 24%,were separately compared with AD, AEA/AD: P < 0. 05(P = 0.031); MA/AD: P < 0.01 (P = 0. 000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.

  10. Comparison of Results of Coronary Angioplasty in Patients with Unstable vs. Stable Angina

    Institute of Scientific and Technical Information of China (English)

    梅卫义; 杜志民; 罗初凡; 胡承恒; 李怡; 马虹

    2002-01-01

    Objectives To comparethe short and mid - term outcomes in cases of percuta-neous transluminal coronary angioplasty (PTCA) inpatients with unstable v stable angina. MethodsPatients selected for PTCA/stenting were divided into two groups, one with stable angina pectoris (SAgroup, n--92) and one with unstable angina pectoris(UA group, n = 112). The outcomes of coronary angiographies (CAG), initial (30-d) success of theprocedure, and follow- up status in the two groupswere compared. Results Baseline characteristicswere similar, although the patients with unstablesymptoms more females ( P< 0.05), and had a higheraverage CCS class ( P< 0.05) and a higher incidenceof postinfarction angina ( P< 0. 01 ). The frequency of"complex" stenosis in patients with unstable anginawas higher than that of patients with stable angina,33% v 20% (P<0.01). A total of 309 vessels accepted the procedure; including 210 stents were successfully delivered to 156 patients. 143 and 67 stentswere implanted in the UA and SA group, respectively(P< 0.01 ). No major complication occurred in thetwo groups, except 12 patients experienced reoccurring chest pain initially, 9 in UA group v 3 in SAgroup ( P< 0.05). The averaged six - month follow -up status was compared too. Only 3 cases developedmyocardial infarction, including 2 patients with unstable angina. 12 and 16 reoccurring chest pains werefound in the two groups, respectively (13% in SAgroup vs 14% in UA group). There were no significant differences between groups in rates of clinicalrestenosis, follow- up angina class, or overall clinicalsuccess. Conclusions Patients with unstable anginareceiving PTCA/stenting have similar complication,restenosis, and initial and midterm success rate ascompared to patients with stable symptoms with strictcases select and careful preparation.

  11. Comparison of results of intracoronary stenting in patients with unstable vs. stable angina.

    Science.gov (United States)

    Malosky, S A; Hirshfeld, J W; Herrmann, H C

    1994-02-01

    Percutaneous transluminal coronary angioplasty (PTCA) has higher complication and restenosis rates when performed in the setting of unstable angina. Balloon-expandable intracoronary stenting is a new technique with the potential to improve the results of PTCA. In order to determine whether stenting is associated with a poorer outcome in patients with unstable angina, we retrospectively examined our experience with the Palmaz-Schatz balloon-expandable intracoronary stent in 105 patients. Patients were divided into 2 groups on the basis of symptoms at the time of stent insertion: group I (n = 57) had stable angina pectoris, and group II (n = 48) had unstable angina defined as pain at rest despite antianginal therapy (Braunwald class II, III). Initial (30-d) and final (6-mo) success rates were defined as stent insertion without myocardial infarction, need for bypass surgery, death, and significant angina. Baseline characteristics were similar, although the patients with unstable symptoms were older, more likely to be female, and had a higher incidence of postinfarction angina. A total of 136 stents were successfully delivered to 97 target sites in 92% of patients. Major complications occurred in 4 patients (4%) and were due to subacute thrombosis in 3 of them. There were no differences in complication rates between patients receiving stents electively with stable vs. unstable symptoms (2% vs. 6%, p = NS). Six-mo. follow-up status was ascertained in 96% of patients and revealed overall clinical success in 83% with angiographic restenosis (> or = 50% stenosis) in 28% of patients. There were no significant differences between groups in rates of restenosis, follow-up angina class, or overall clinical success.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Critical evaluation of ivabradine for the management of chronic stable angina

    Directory of Open Access Journals (Sweden)

    Khan W

    2011-09-01

    Full Text Available Waqas Khan, Jeffrey S BorerDivision of Cardiovascular Medicine and the Department of Medicine, State University of New York Downstate Medical Center and College of Medicine, Brooklyn and New York, NY, USAAbstract: Angina pectoris is the most common symptom of coronary artery disease (CAD. Angina results from an imbalance between myocardial oxygen supply and demand. Heart rate (HR reduction can beneficially alter both elements of this imbalance by increasing diastolic filling time and reducing myocardial oxygen demand. Therefore, HR reduction is an accepted approach to angina prevention. ß-blockers, calcium-channel blockers, and long-acting nitrates are currently the cornerstones in prevention and management of stable angina. However, use of these treatments may be limited by adverse effects or development of tolerance. Thus, additional approaches to angina prevention may be useful for many patients with CAD. The discovery of the f-channel and the resulting current, If, that modulates the rate of spontaneous diastolic depolarization of sinoatrial nodal (SAN myocytes led to the study of these channels as targets for lowering HR. This resulted in the development of a novel agent, ivabradine, a selective and specific If inhibitor. Ivabradine slows the slope of diastolic depolarization of the action potential in the SAN cells, decreasing HR at rest and during exercise, but has no other cardiovascular effects. In different subpopulations with chronic stable angina, ivabradine markedly improves exercise capacity and significantly decreases the number of ambient angina attacks. In a post-hoc analysis of the BEAUTIFUL trial (morBidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left-ventricULar dysfunction, ivabradine also reduced mortality, myocardial infarctions, and heart failure hospitalizations among patients with angina. To date, the drug has been well tolerated; transient visual disturbances and

  13. SIMULACIÓN BIDIMENSIONAL DE UN SISTEMA DE COMBUSTIÓN INESTABLE TWO-DIMENSIONAL SIMULATION OF AN UNSTABLE COMBUSTION SYSTEM

    Directory of Open Access Journals (Sweden)

    Javier Achury Varila

    2010-04-01

    Full Text Available La inestabilidad en la combustión es una condición indeseada en algunos sistemas de combustión como en turbinas de gas por ejemplo. Se refiere a la presencia autogenerada de oscilaciones en la presión que pueden afectar a la cámara de combustión y de paso llegar a generar ruido. Una reciente tendencia generalizada en los procesos de combustión apunta al uso de mezclas pobres para la reducción de contaminantes, no obstante que este tipo de mezclas son más susceptibles a la inestabilidad en la combustión. Las complicadas relaciones que gobiernan el fenómeno se pueden resumir como el acoplamiento entre la llama y la acústica del sistema. En el presente trabajo se presenta un planteamiento numérico que permite aproximarse al fenómeno a través de la solución de un modelo de combustión básico implementado computacionalmente. En este modelo se simula una autoexcitación del sistema a través de oscilaciones en la entrada de flujos de reactantes. Finalmente, se comparan los resultados de la simulación numérica con otras simulaciones y datos experimentales.The Combustion instability is an undesirable condition reached in some combustion systems, as during the operation of gas turbines. It refers to self-excited oscillations of pressure that may affect the combustion chamber and generate noise. A recent generalized tendency in combustion processes aims to the use of lean combustion (low fuel/air ratios for pollutants reduction, nevertheless this sort of mixtures are more susceptible to combustion instabilities. The complex relationship that generates the phenomenon can be summarized as the coupling between flame and acoustics. In this paper it is outlined a numerical approach to this phenomenon by solving a basic computational combustion model (by Direct Numerical Simulation. In this model a self-excited system is simulated through imposed oscillations in reactants flows. Finally, results for this numerical simulation are compared

  14. Value of iodine-123 metaiodobenzylguanidine scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Taki, Junichi; Nakajima, Kenichi; Matsunari, Ichiro; Takayama, Teruhiko; Tonami, Norihisa [Kanazawa Univ. School of Medicine (Japan). Dept. of Nuclear Medicine; Yasuhara, Shuichiro; Takamatsu, Tsuyoshi; Tatami, Ryozo; Ishise, Syozo [Maizuru Kyosai Hospital (Japan). Dept. of Internal Medicine

    1998-03-01

    To assess the presence and location of presynaptic myocardial sympathetic abnormality in patients with vasospastic angina, iodine-123 labelled metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET) was performed. Fifty patients suspected of having vasospastic angina pectoris were enrolled in the study. All patients underwent a provocative test with intracoronary ergonovine infusion during coronary angiography, in which 99%-100% obstructive spasm was defined as a positive result. Twenty-five patients were diagnosed as having vasospastic angina based on a positive provocative test. MIGB SPET was performed at 20 min and 3 h after administration of 111 MBq of MIBG. On early images, only 5 of 25 patients with vasospastic angina showed a mild reduction in MIBG uptake, whereas 3-h delayed images demonstrated MIBG abnormality in 20 patients (80%). The location of the MIBG abnormality was completely or partially consistent with the spastic coronary territory in 18 patients. On the other hand, only 4 of 25 patients (16%) with a negative provocative test demonstrated reduced MIBG uptake. Accordingly, positive and negative predictive values of MIBG SPET for the provocative test were 83% (20/24) and 81% (21/26) respectively. In conclusion, MIBG scintigraphy with SPET can permit the non-invasive detection and evaluation of suspected vasospastic angina. (orig.)

  15. The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Peng, Song; Zhao, Min; Wan, Jing; Fang, Qi; Fang, Dong; Li, Kaiyong

    2014-12-20

    This meta-analysis aimed to evaluate the efficacy of trimetazidine in combination with other anti-anginal drugs versus other anti-anginal drugs in the treatment of stable angina pectoris (SAP). Randomized controlled trials (RCTs) published in English and Chinese were retrieved from computerized databases: Embase, PubMed, and CNKI. Primary outcomes consist of clinical parameters (numbers of weekly angina attacks and nitroglycerin use) and ergometric parameters (time to 1mm ST-segment depression, and total work (in Mets) and exercise duration (in seconds) at peak exercise) in stable angina pectoris treated by trimetazidine or not. The quality of studies was evaluated using Jadad score. Data analysis of 13 studies was performed using Stata 12.0 software. Results showed that treatment of trimetazidine and other anti-anginal drugs was associated with a smaller weekly mean number of angina attacks (WMD=-0.95, 95%CI: -1.30 to -0.61, Z=5.39, Pangina pectoris. Sensitivity analysis was performed. Sub-group analysis showed that treatment duration was not a significant moderator and patients treated within 8 weeks and above 12 weeks had no difference in the outcomes addressed in this meta-analysis. No publish bias was detected. This meta-analysis confirms the efficacy of trimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration.

  16. Narrowing of the Coronary Sinus: A Device-Based Therapy for Persistent Angina Pectoris.

    Science.gov (United States)

    Konigstein, Maayan; Verheye, Stefan; Jolicœur, E Marc; Banai, Shmuel

    2016-01-01

    Alongside the remarkable advances in medical and invasive therapies for the treatment of ischemic heart disease, an increasing number of patients with advanced coronary artery disease unsuitable for revascularization continue to suffer from angina pectoris despite optimal medical therapy. Patients with chronic angina have poor quality of life and increased levels of anxiety and depression. A considerable number of innovative therapeutic modalities for the treatment of chronic angina have been investigated over the years; however, none of these therapeutic options has become a standard of care, and none are widely utilized. Current treatment options for refractory angina focus on medical therapy and secondary risk factor modification. Interventions to create increased pressure in the coronary sinus may alleviate myocardial ischemia by forcing redistribution of coronary blood flow from the less ischemic subepicardium to the more ischemic subendocardium, thus relieving symptoms of ischemia. Percutaneous, transvenous implantation of a balloon expandable, hourglass-shaped, stainless steel mesh in the coronary sinus to create a fixed focal narrowing and to increase backwards pressure, may serve as a new device-based therapy destined for the treatment of refractory angina pectoris.

  17. The initial management of stable angina in Europe, from the Euro Heart Survey: a description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: In order to assess adherence to guidelines and international variability in management, the Euro Heart Survey of Newly Presenting Angina prospectively studied medical therapy, percutaneous coronary intervention (PCI), and surgery in patients with new-onset stable angina in Europe. METHODS AND

  18. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

    DEFF Research Database (Denmark)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe

    2015-01-01

    ,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST...

  19. [Clinical presentation and coronary angiographic results in unstable angina pectoris].

    Science.gov (United States)

    Weber, T; Kirchgatterer, A; Auer, J; Wimmer, L; Lang, G; Mayr, H; Maurer, E; Punzengruber, C; Eber, B

    1999-01-01

    The syndrome "unstable angina" (UA) covers a broad spectrum of patients. In this study we tried to determine the relationship between the severity of UA and angiographic findings. We evaluated 1000 consecutive patients undergoing coronary angiography. Those with the clinical diagnosis "UA" were included in the study. In a retrospective analysis of their records we categorized them, using the Braunwald-classification for determination of the severity of the disease. 352 patients were include, 209 men and 143 women, the mean age was 65 years. 47% met Braunwald-Class I, 26% Class II and 27% Class III. Coronary single-vessel disease was present in 29%, two-vessel disease in 20%, three-vessel disease in 25%, normal coronaries in 13% and coronary atherosclerosis without critical narrowing in 13%. Left ventricular function was preserved in 72%, mild systolic dysfunction was found in 10%, moderate in 13% and severe in 5%. There was no overall correlation between clinical presentation (Braunwald-Classes) and angiographic findings. Women showed a similar distribution of Braunwald-Classes, but significantly more coronary arteries without critical obstruction. In patients with reduced systolic function the percentage of multi-vessel disease was significantly higher, the percentage without relevant coronary artery narrowing was significantly lower. 1) The lack of overall correlation between clinical presentation and angiographic findings supports the importance of coronary angiography in the evaluation of patients with UA. 2) The assessment of women with chest pain is more difficult than of men with regard to coronary heart disease. 3) UA in patients with impaired left ventricular function is a predictor of severe coronary artery disease.

  20. A new scoring system to stratify risk in unstable angina

    Directory of Open Access Journals (Sweden)

    Salzberg Simón

    2003-08-01

    Full Text Available Abstract Background We performed this study to develop a new scoring system to stratify different levels of risk in patients admitted to hospital with a diagnosis of unstable angina (UA, which is a complex syndrome that encompasses different outcomes. Many prognostic variables have been described but few efforts have been made to group them in order to enhance their individual predictive power. Methods In a first phase, 473 patients were prospectively analyzed to determine which factors were significantly associated with the in-hospital occurrence of refractory ischemia, acute myocardial infarction (AMI or death. A risk score ranging from 0 to 10 points was developed using a multivariate analysis. In a second phase, such score was validated in a new sample of 242 patients and it was finally applied to the entire population (n = 715. Results ST-segment deviation on the electrocardiogram, age ≥ 70 years, previous bypass surgery and troponin T ≥ 0.1 ng/mL were found as independent prognostic variables. A clear distinction was shown among categories of low, intermediate and high risk, defined according to the risk score. The incidence of the triple end-point was 6 %, 19.2 % and 44.7 % respectively, and the figures for AMI or death were 2 %, 11.4 % and 27.6 % respectively (p Conclusions This new scoring system is simple and easy to achieve. It allows a very good stratification of risk in patients having a clinical diagnosis of UA. They may be divided in three categories, which could be of help in the decision-making process.

  1. Myocardial oxygen supply/demand ratio in aortic stenosis: hemodynamic and echocardiographic evaluation of patients with and without angina pectoris.

    Science.gov (United States)

    Nadell, R; DePace, N L; Ren, J F; Hakki, A H; Iskandrian, A S; Morganroth, J

    1983-08-01

    Angina pectoris is a common symptom in patients with aortic stenosis without coronary artery disease. To investigate the correlates of angina pectoris, echocardiographic and hemodynamic data from 44 patients with aortic stenosis and no coronary artery disease (mean age 56 +/- 10 years) were analyzed. Twenty-three patients had no angina pectoris and 21 patients had angina pectoris. The ratio of the diastolic pressure-time index (area between the aortic and left ventricular pressure curves during diastole) to the systolic pressure-time index (area under the left ventricular pressure curve during systole), an index of the oxygen supply/demand ratio, was not different in patients with or without angina pectoris. There were no differences between patients with and without angina pectoris in echocardiographically determined wall thickness, chamber size, systolic and diastolic wall stress and left ventricular mass; in electrocardiographically defined voltage; and in hemodynamically defined aortic valve area, transaortic gradient and stroke work index. Thus, echocardiographic and hemodynamic measurements at rest are not significantly different in the presence or absence of angina pectoris in patients with aortic stenosis. Dynamic data appear to be essential for evaluation of the mechanisms of angina pectoris in patients with aortic stenosis.

  2. Ludwig's angina and ketoacidosis as a first manifestation of diabetes mellitus.

    Science.gov (United States)

    Infante-Cossío, Pedro; Fernández-Hinojosa, Esteban; Mangas-Cruz, Miguel-Angel; González-Pérez, Luis-Miguel

    2010-07-01

    Ludwig's angina is a serious and rapidly progressive infectious process that spreads through the floor of the mouth and neck. In this paper we present an infrequent case of a patient who suffered an odontogenic infection with poor response to the previous treatment, which evolved towards a Ludwig's angina combined with ketoacidosis in the context of a diabetes mellitus not known before. According to the literature reviewed, this case report represents the first contribution of a Ludwig's angina and ketoacidosis as an initial manifestation of a diabetes mellitus. The airway management, the antibiotic prescription and the surgical drainage allowed the healing of the patient without medical complications. Factors of co-morbidity like the diabetes mellitus together with focus tooth of infection may eventually turn into serious medical complications as the diabetic ketoacidosis and develop potentially lethal cervical infections.

  3. Ventetid og omkostninger ved diagnostik og behandling af stabil angina pectoris

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sanchez, Ricardo

    Introduction: The objective of this pilot study was to examine possible consequences of a logistically non-optimal regimen, for the diagnosis and treatment of stable angina pectoris, on waiting time and costs to inform whether a larger study is warranted. Material and methods: Retrospective cohort...... study among 104 consecutive patients referred on suspected stable angina pectoris. Data on the diagnostic regimen was systematically collected from patient files and data on other resource use was collected using a questionnaire for self- reporting. Non-parametric bootstrapping was applied. Results...... of stable angina pectoris, which ceteris paribus would be associated with cost savings in the health care sector. However, these potentials should be examined in a larger- scale study....

  4. Aspiration Thrombectomy and Drug-Eluting Stent Implantation Decrease the Occurrence of Angina Pectoris One Year After Acute Myocardial Infarction.

    Science.gov (United States)

    Lee, Wei-Chieh; Fang, Chih-Yuan; Chen, Huang-Chung; Hsueh, Shu-Kai; Chen, Chien-Jen; Yang, Cheng-Hsu; Yip, Hon-Kan; Hang, Chi-Ling; Wu, Chiung-Jen; Fang, Hsiu-Yu

    2016-04-01

    Angina pectoris is a treatable symptom that is associated with mortality and decreased quality of life. Angina eradication is a primary care goal of care after an acute myocardial infarction (AMI). Our aim was to evaluate factors influencing angina pectoris 1 year after an AMI.From January 2005 to December 2013, 1547 patient received primary percutaneous intervention in our hospital for an acute ST-segment elevation myocardial infarction (MI). Of these patients, 1336 patients did not experience post-MI angina during a 1-year follow-up, and 211 patients did. Univariate and multivariate logistic regression analyses were performed to identify the factors influencing angina pectoris 1 year after an AMI. Propensity score matched analyses were performed for subgroups analyses.The average age of the patients was 61.08 ± 12.77 years, with a range of 25 to 97 years, and 82.9% of the patients were male. During 1-year follow-up, 13.6% of the patients experienced post-MI angina. There was a longer chest pain-to-reperfusion time in the post-MI angina group (P = 0.01), as well as a higher fasting sugar level, glycohemoglobin (HbA1C), serum creatinine, troponin-I and creatine kinase MB (CK-MB). The post-MI angina group also had a higher prevalence of multiple-vessel disease. Manual thrombectomy, and distal protective device and intracoronary glycoprotein IIb/IIIa inhibitor injection were used frequently in the no post-MI angina group. Antiplatelet agents and post-MI medication usage were similar between the 2 groups. Multivariate logistic regression analyses demonstrated that prior MI was a positive independent predictor of occurrence of post-MI angina. Manual thrombectomy use and drug-eluting stent implantation were negative independent predictors of post-MI angina. Higher troponin-I and longer chest pain-to-reperfusion time exhibited a trend toward predicting post-MI angina.Prior MIs were strong, independent predictors of post-MI angina. Manual thrombectomy and drug

  5. Stellenwert des sympathischen Nervensystems und positiver Feedback-Mechanismen in der Pathophysiologie der instabilen Angina pectoris

    Directory of Open Access Journals (Sweden)

    Schauenstein K

    1999-01-01

    Full Text Available Die klinischen Begriffe "stabile" und "instabile" Angina beschreiben primär die Vorhersehbarkeit von pektanginösen Beschwerden. Dennoch weisen diese beiden Formen auch objektivierbare pathohistologische und pathophysiologische Unterschiede auf, die in der vorliegenden Einführung diskutiert werden. Besonders betont wird der Stellenwert des sympathischen Nervensystems sowie das Auftreten positiver Feedbackmechanismen im anginösen Anfallsgeschehen, die eine kritische Vertiefung des myokardialen Sauerstoffmangels bewirken können. Andererseits wird auf die Gefahr der häufigen asymptomatischen Koronarinsuffizienz ("stumme Angina" hingewiesen. Aus den skizzierten pathophysiologischen Überlegungen werden die Kriterien für eine effektive Therapie diskutiert.

  6. Transient myocardial ischaemia during ambulatory monitoring out of hospital in patients with chronic stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    Transient myocardial ischaemia during daily life, detected by ambulatory electrocardiographic monitoring, was investigated in 42 patients with chronic stable angina and documented coronary artery disease. Ambulatory monitoring was initiated for 36 hours after all prophylactic antianginal medication...... had been withdrawn for 5 days. There were 196 episodes of ST-segment depression, 145 (74%) of which were not accompanied by angina. As well, a tendency to more prolonged and greater ST-segment change with symptomatic ischaemic episodes was noted. A diurnal variation in transient ischaemia both...

  7. Inadequate control of heart rate in patients with stable angina: results from the European heart survey.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2010-01-01

    AIMS: To examine resting heart rate (HR) in a population presenting with stable angina in relation to prior and subsequent pharmacological treatment, comorbid conditions and clinical outcome. METHODS AND RESULTS: The European Heart Survey was a prospective, observational, cohort study of 3779 patien

  8. SAFETY AND EFFICACY OF BETA-BLOCKERS IN THE TREATMENT OF STABLE ANGINA-PECTORIS

    NARCIS (Netherlands)

    DEMUINCK, ED; LIE, KI

    1990-01-01

    In stable exercise-induced angina pectoris, beta-blockers exert their beneficial effects mainly through a reduction in heart rate, blood pressure, and contractility. Additional beneficial effects are an improvement in myocardial oxygen supply through a redistribution of coronary flow, a lengthening

  9. HEPARIN THERAPY IN PATIENT WITH NON-Q WAVE MYOCARDIAL INFARCTION AND UNSTABLE ANGINA

    Directory of Open Access Journals (Sweden)

    M.H EMAMI

    2000-03-01

    Full Text Available Introduction. This study was conducted to find that, is there any advantage from (5000 IU/6h in patient with non-Q wave MI and unastable angina. Methods. In a randomized clinical trial two group of patients with non-Q wave MI and unstable angina were compared about their prognosis and management outcomes. In interventional group (n= 145, heparin (5000 IU/6h was administered and in another group (n= 133 no treatment with heparin was used. Duration of chest pain, recurrent angina, intrahospital mortality were indices for patients outcome study. Findings. Anticoagulant complication was not report in any patient in interventional group. There is no significant difference between two groups about prognosis factors. Conclusion. Heparin administration (5000 IU/6h may have not any role in improving management outcome in patient with non-Q wave MI and unastable angina at least in acute phase. So, it is recommended that heparin have been administered to these patients in continuous regimen (1000-1500 U/hour continuously effusion.

  10. Spinal cord stimulation for refractory angina in a patient implanted with a cardioverter defibrillator.

    Science.gov (United States)

    Ferrero, Paolo; Grimaldi, Roberto; Massa, Riccardo; Chiribiri, Amedeo; De Luca, Anna; Castellano, Maddalena; Cardano, Paola; Trevi, Gian Paolo

    2007-01-01

    Spinal cord stimulation is currently used to treat refractory angina. Some concerns may arise about the possible interaction concerning the spinal cord stimulator in patients already implanted with a pacemaker or a cardioverter defibrillator. We are going to describe the successful implantation of a spinal cord stimulator in a patient previously implanted with a cardioverter defibrillator.

  11. Cardiologists' Use of clinical information for management decisions for patients with unstable angina: a policy analysis

    NARCIS (Netherlands)

    P.M.M. Bossuyt (Patrick); R.W. Nette (Robert); M.L. Simoons (Maarten); T.R. Taylor (Thomas); A.J.M. van Miltenburg-van Zijl (Addy)

    1997-01-01

    textabstractPrevious studies of management of unstable angina have revealed substantial differences in management between different hospitals, especially with respect to the use of coronary angiography. Physicians in a hospital with angiography facilities were more inclined to perform angiography th

  12. Invasive Evaluation of Patients with Angina in the Absence of Obstructive Coronary Artery Disease

    Science.gov (United States)

    Lee, Bong-Ki; Lim, Hong-Seok; Fearon, William F.; Yong, Andy; Yamada, Ryotaro; Tanaka, Shigemitsu; Lee, David P.; Yeung, Alan C.; Tremmel, Jennifer A.

    2017-01-01

    Background More than 20% of patients presenting to the cardiac catheterization laboratory with angina have no angiographic evidence of coronary artery disease (CAD). Despite a “normal” angiogram, these patients often have persistent symptoms, recurrent hospitalizations, a poor functional status, and adverse cardiovascular outcomes, without a clear diagnosis. Methods and Results In 139 patients with angina in the absence of obstructive CAD (no diameter stenosis >50%), endothelial function was assessed, the index of microcirculatory resistance (IMR), coronary flow reserve (CFR), and fractional flow reserve (FFR) were measured, and intravascular ultrasound (IVUS) was performed. There were no complications. The average age was 54.0±11.4 years and 107 (77%) were women. All patients had at least some evidence of atherosclerosis based on IVUS examination of the LAD. Endothelial dysfunction (a decrease in luminal diameter of >20% after intracoronary acetylcholine) was present in 61 patients (44%). Microvascular impairment (an IMR ≥25) was present in 29 patients (21%). Seven patients (5%) had an FFR ≤0.80. A myocardial bridge was present in 70 patients (58%). Overall, only 32 patients (23%) had no coronary explanation for their angina, with normal endothelial function, normal coronary physiologic assessment, and no myocardial bridging. Conclusions The majority of patients with angina in the absence of obstructive CAD have occult coronary abnormalities. A comprehensive invasive assessment of these patients at the time of coronary angiography can be performed safely and provides important diagnostic information which may affect treatment and outcomes. PMID:25712205

  13. Spinal cord stimulation in refractory angina pectoris - Clinical results and mechanisms

    NARCIS (Netherlands)

    Oosterga, M; tenVaarwerk, IAM; DeJongste, MJL; Staal, MJ

    1997-01-01

    Patients with therapeutically refractory angina pectoris do not respond to adequate anti-anginal medication and are not suitable anymore for revascularisation procedures. This group of patients has a poor quality of Life, since their exercise capacity is severely afflicted. A new additional therapy

  14. The significance of {sup 123}I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio [Fukushima Medical Coll. (Japan); Katohno, Eiichi; Ohwada, Kenji

    1998-06-01

    Some patients of ischemic heart disease have low uptake in {sup 123}I-labeled beta methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT in spite of normal uptake in thallium-201 (Tl) SPECT. To investigate their clinical significance, we performed both Tl and BMIPP myocardial SPECT in 26 cases with stable angina (n=16) and unstable angina (n=10), and compared with clinical backgrounds electrocardiogram (ECG) and left ventriculography (LVG). In 11 patients of them, the uptake of BMIPP was moderately reduced. We divided 26 cases into two groups according to uptake of BMIPP (normal/reduced). The two groups had no differences in length of angina attack and duration of disease, but they had a significant difference in the abnormality of either ECG or LVG. Three to six months after PTCA, we examined LVG in 18 cases, 12 of 16 cases with the abnormality of LVG showed the improvement of wall motion. We concluded the reduced uptake of BMIPP with normal uptake of Tl was related to more severe ischemia in cases with unstable angina. (author)

  15. Emerging treatment options for refractory angina pectoris: ranolazine, shock wave treatment, and cell-based therapies.

    Science.gov (United States)

    Gennari, Marco; Gambini, Elisa; Bassetti, Beatrice; Capogrossi, Maurizio; Pompilio, Giulio

    2014-01-01

    A challenge of modern cardiovascular medicine is to find new, effective treatments for patients with refractory angina pectoris, a clinical condition characterized by severe angina despite optimal medical therapy. These patients are not candidates for surgical or percutaneous revascularization. Herein we review the most up-to-date information regarding the modern approach to the patient with refractory angina pectoris, from conventional medical management to new medications and shock wave therapy, focusing on the use of endothelial precursor cells (EPCs) in the treatment of this condition. Clinical limitations of the efficiency of conventional approaches justify the search for new therapeutic options. Regenerative medicine is considered the next step in the evolution of organ replacement therapy. It is driven largely by the same health needs as transplantation and replacement therapies, but it aims further than traditional approaches, such as cell-based therapy. Increasing knowledge of the role of circulating cells derived from bone marrow (EPCs) on cardiovascular homeostasis in physiologic and pathologic conditions has prompted the clinical use of these cells to relieve ischemia. The current state of therapeutic angiogenesis still leaves many questions unanswered. It is of paramount importance that the treatment is delivered safely. Direct intramyocardial and intracoronary administration has demonstrated acceptable safety profiles in early trials, and may represent a major advance over surgical thoracotomy. The combined efforts of bench and clinical researchers will ultimately answer the question of whether cell therapy is a suitable strategy for treatment of patients with refractory angina.

  16. Tissue Doppler echocardiography improves the diagnosis of coronary artery stenosis in stable angina pectoris

    DEFF Research Database (Denmark)

    Hoffmann, Soren; Jensen, Jan Skov; Iversen, Allan Zeeberg

    2012-01-01

    Aim To determine if colour tissue Doppler imaging (TDI) performed at rest in patients with suspected stable angina pectoris (SAP) is able to predict the presence of significant coronary artery disease (CAD). METHODS AND RESULTS: This study comprises 296 consecutive patients with clinically...

  17. [INTERVENTIONAL AND SURGICAL TREATMENT OF THE ANGINA PECTORIS RECURRENCE AFTER CORONARY SHUNTING OPERATION].

    Science.gov (United States)

    Fanta, S M

    2015-12-01

    There were examined 134 patients, in whom in the clinic in 2005-2014 yrs a coronary shunting operation was performed. In patients with the angina pectoris recurrence a reoperation is indicated. The data of repeated coronaroventriculography and shuntography were analyzed. Efficacy of the surgical and interventional methods application in the patients was proved.

  18. Mechanisms of angina pectoris in syndrome X assessed by myocardial perfusion dynamics and heart rate variability

    NARCIS (Netherlands)

    Meeder, JG; Blanksma, PK; Crijns, HJGM; Anthonio, RL; Pruim, J; Brouwer, J; DeJong, RM; VanderWall, EE; Vaalburg, W; Lie, KI

    1995-01-01

    The fundamental abnormality in syndrome X (angina pectoris, ischaemia-like stress ECG despite angiographically normal coronary arteries) might be patchily distributed increased tone in pre-arteriolar coronary vessels with compensatory release of adenosine. The aim of this study was to confirm this h

  19. Immediate and long-term clinical outcome after spinal cord stimulation for refractory stable angina pectoris.

    Science.gov (United States)

    Di Pede, Francesco; Lanza, Gaetano Antonio; Zuin, Guerrino; Alfieri, Ottavio; Rapati, Massimo; Romanò, Massimo; Circo, Antonio; Cardano, Paola; Bellocci, Fulvio; Santini, Massimo; Maseri, Attilio

    2003-04-15

    The treatment of patients with angina pectoris refractory to medical therapy and unsuitable for revascularization procedures has yet not been well standardized. Previous retrospective studies and small prospective studies have suggested beneficial effects of spinal cord stimulation (SCS) in these patients. We created a Prospective Italian Registry of SCS to evaluate the short- and long-term clinical outcome of patients who underwent SCS device implantation because of severe refractory angina pectoris. Overall, 104 patients were enrolled in the registry (70 men, aged 68 +/- 17 years), most of whom (83%) had severe coronary artery disease. Average follow-up was 13.2 +/- 8 months. Overall, 17 patients (16%) died, 8 (8%) due to cardiac death. Among clinical variables, only age was found to be significantly associated both with total mortality (p = 0.04) and cardiac mortality (p = 0.02) on Cox regression analysis. A significant improvement of anginal symptoms (> or =50% reduction of weekly anginal episodes, compared with baseline) occurred in 73% of patients, and Canadian Cardiovascular Society angina class improved by > or =1 class in 80% and by > or =2 classes in 42% of patients, with a relevant reduction in the rate of hospital admission and days spent in the hospital because of angina (p <0.0001 for both). No life-threatening or clinically serious complications were observed. The most frequent side effect consisted of superficial infections, either at the site of puncture of electrode insertion or of the abdominal pocket, which occurred in 6 patients. In conclusion, our prospective data point out that SCS can be performed safely and is associated with a sustained improvement of anginal symptoms in a relevant number of patients with refractory stable angina pectoris.

  20. Erhöhter oxidativer Streß bei Patienten mit instabiler Angina pectoris

    Directory of Open Access Journals (Sweden)

    Bodlaj G

    1998-01-01

    Full Text Available Die instabile Angina pectoris führt oft zum akuten Myokardinfarkt. Da die Lipid-Peroxidation im Verdacht steht, chronische und akute Ereignisse der Atherosklerose und der koronaren Herzkrankheit zu fördern, untersuchten wir die Lipid-Peroxidations-Parameter und alpha-Toco-pherol-Spiegel bei 100 KHK-Patienten und verglichen sie mit denen einer entprechenden Kontrollgruppe. 50 konsekutive Patienten mit stabiler Angina pectoris (SAP und 50 konsekutive Patienten mit instabiler Angina pectoris (IAP wurden untersucht und mit 100 klinisch gesunden Personen verglichen. Zusätzlich zur herkömmlichen Lipid- und Lipoprotein-Analyse wurden die Lipid-Peroxidations-Produkte als Hydroperoxide und Thiobarbituric acid reactive substances (TBARS gemessen. Die konjugierten Diene wurden nur bei den Patienten bestimmt. Da alpha-Tocopherol eines der wichtigsten Antioxidantien ist, wurde es ebenfalls quantifiziert. Wie erwartet hatten die Patienten wesentlich höhere Cholesterin-, Triglyzerid-, LDL-C- und Lp(a-Spiegel und niedrigere HDL-C-Spiegel als die Kontrollgruppe. Als die Patienten in Gruppen mit stabiler und instabiler Angina pectoris geteilt wurden, waren Peroxide und TBARS in der letzteren Gruppe wesentlich höher als bei den anderen Patienten und der Kontrollgruppe. Auch konjugierte Diene waren eindeutig höher bei den Patienten mit instabiler Angina pectoris. Der alpha-Tocopherol-Gesamtspiegel war in allen 3 Gruppen vergleichbar, aber der alpha-Tocopherol-Gehalt pro LDL-Partikel war bei den Patienten mit IAP am niedrigsten, gefolgt von denen mit SAP und der Kontrollgruppe. Wir schließen daraus, daß die Lipid-Peroxidations-Parameter bei Patienten mit IAP erhöht sind und SAP-Patienten von IAP-Patienten unterscheiden.

  1. Histopathological examination of specimens removed during directional coronary atherectomy in patients presenting with crescendo angina show mural thrombus.

    Science.gov (United States)

    Bellamy, C M; Grech, E D; Ashworth, M T; Ramsdale, D R

    1993-02-01

    Thrombus formation over a fissured coronary atheromatous plaque has been shown by post mortem histological examination to be the pathophysiological mechanism responsible for myocardial ischaemia in those patients who died following a crescendo pattern of angina. Histological examination of plaques responsible for a crescendo pattern of angina in patients who do not die has not been available until recently. We describe two patients who presented with a crescendo pattern of angina. A new technique of coronary revascularization, directional coronary atherectomy, produced symptomatic relief and resolution of myocardial ischaemia. Histological examination of material from the stenosis responsible for their myocardial ischaemia, obtained using this technique, confirmed thrombus formation overlying a fissured atheromatous plaque.

  2. [Changes of fatty acids spectrum of plasma triglycerides and their pharmacological correction by statins in patients with unstable angina].

    Science.gov (United States)

    Lyzohub, V H; Artemchuk, O O; Dolynna, O V; Altunina, N V; Sharaieva, M L; Koniuk, T N

    2013-01-01

    The fatty acid composition of plasma triglycerides by gas chromatography, the dynamics of the segment ST, cardiac arrhythmia by daily monitoring of electrocardiogram in patients with unstable angina (progressive) and the effects of treatment with statins were studied. Revealed marked qualitative abnormalities of plasma triglycerides in patients with progressive angina manifest increase in the amount of saturated and reduction--of unsaturated fatty acids. High therapeutic effect of simvastatin and atorvastatin may be due to the identified strong correlation between the dynamics of the fatty acid components of plasma triglycerides and indicators of ischemia, ectopic activity in patients with progressive angina.

  3. Transient myocardial ischemia during daily life in rest and exertional angina pectoris and comparison of effectiveness of metoprolol versus nifedipine

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1991-01-01

    The clinical characteristics of 65 patients with mixed angina were classified by means of (1) a questionnaire investigating the proportion of symptoms occurring at rest and on effort, (2) an exercise stress test, (3) 24-hour ambulatory Holter monitoring, and (4) coronary arteriography. According...... life (p less than 0.05) irrespective of the patients' clinical characteristics. Nifedipine was ineffective, particularly in patients with angina predominantly on effort and with a moderate to severe reduction in exercise tolerance. It is concluded that in patients with mixed angina, ischemic episodes...

  4. Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells.

    Science.gov (United States)

    Mutin, M; Canavy, I; Blann, A; Bory, M; Sampol, J; Dignat-George, F

    1999-05-01

    Circulating endothelial cells (CECs) have been detected in association with endothelial injury and therefore represent proof of serious damage to the vascular tree. Our aim was to investigate, using the technique of immunomagnetic separation, whether the pathological events in unstable angina (UA) or acute myocardial infarction (AMI) could cause desquamation of endothelial cells in circulating blood compared with effort angina (EA) and noncoronary chest pain. A high CEC count was found in AMI (median, 7.5 cells/mL; interquartile range, 4.1 to 43.5, P chest pain as compared with controls (0; 0 to 0 cells/mL) and stable angina (0; 0 to 0 cells/mL). CEC levels in serial samples peaked at 15.5 (2.7 to 39) cells/mL 18 to 24 hours after AMI (P angina, confirming that these diseases have different etiopathogenic mechanisms.

  5. Case management does not decrease mortality of patients with myocardial infarction or unstable angina: Evidence from a systematic review

    Directory of Open Access Journals (Sweden)

    Li-Juan Yi

    2016-06-01

    Conclusion: Case management is not beneficial to all-cause mortality after myocardial infarction or unstable angina compared to routine care. Additional, prospective RCTs of high quality and large scale are warranted to verify these results.

  6. Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    王荣英

    2003-01-01

    Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction@王荣英$河北医科大学第二医院!石家庄050000 0311-70469016011

  7. Spinal cord stimulation for long-term treatment of severe angina pectoris: what does the evidence say?

    Science.gov (United States)

    Börjesson, Mats; Andréll, Paulin; Mannheimer, Clas

    2011-11-01

    Patients who continue to suffer from severe and disabling angina pectoris, despite optimum treatment in terms of conventional pharmacological therapy and/or revascularization procedures, have been termed as having refractory angina pectoris. The future group of patients with refractory angina pectoris will be different from today's patients and represent a 'moving target' as risk factors, efficacy of treatment and indications continue to change. Spinal cord stimulation (SCS) is today considered as first-line treatment of refractory angina pectoris, by the European Society of Cardiology, with an anti-ischemic effect. There is strong evidence for SCS giving symptomatic benefits (decrease in anginal attacks), improved quality of life and improvement of functional status. In addition, SCS seems to be cost effective with a 'break-even' after approximately 15-16 months.

  8. A risk score for predicting coronary artery disease in women with angina pectoris and abnormal stress test finding.

    Science.gov (United States)

    Lo, Monica Y; Bonthala, Nirupama; Holper, Elizabeth M; Banks, Kamakki; Murphy, Sabina A; McGuire, Darren K; de Lemos, James A; Khera, Amit

    2013-03-15

    Women with angina pectoris and abnormal stress test findings commonly have no epicardial coronary artery disease (CAD) at catheterization. The aim of the present study was to develop a risk score to predict obstructive CAD in such patients. Data were analyzed from 337 consecutive women with angina pectoris and abnormal stress test findings who underwent cardiac catheterization at our center from 2003 to 2007. Forward selection multivariate logistic regression analysis was used to identify the independent predictors of CAD, defined by ≥50% diameter stenosis in ≥1 epicardial coronary artery. The independent predictors included age ≥55 years (odds ratio 2.3, 95% confidence interval 1.3 to 4.0), body mass index angina pectoris and abnormal stress test findings. This tool, if validated, could help to guide testing strategies in women with angina pectoris.

  9. TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

    Science.gov (United States)

    Mendoza-Ticona, Alberto

    2014-01-01

    Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

  10. Use of myocardial perfusion imaging to predict the effectiveness of coronary revascularisation in patients with stable angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Allan [Odense University Hospital, Department of Clinical Physiology and Nuclear Medicine, Odense (Denmark); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming; Moeldrup, Mette [Odense University Hospital, Department of Clinical Physiology and Nuclear Medicine, Odense (Denmark); Christensen, Henrik Wulff [Nordic Institute of Chiropractic and Clinical Biomechanics, Odense (Denmark); Vach, Werner [University of Southern Denmark, Department of Statistics, Odense (Denmark); Haghfelt, Torben [Odense University Hospital, Department of Cardiology, Odense (Denmark)

    2005-12-01

    Coronary revascularisation is the treatment of choice in patients with stable angina who have significant stenoses. From a pathophysiological point of view, however, mitigation of angina is to be expected only in the presence of reversible ischaemia. Therefore it was the aim of this study to examine the effect of revascularisation on stable angina in relation to the myocardial perfusion imaging (MPI) pattern prior to intervention. Three hundred and eighty-four patients (58.0{+-}8.8 years) referred for angiography underwent MPI. Prior to MPI and at 2-year follow-up, patients were classified as having typical angina, atypical angina, non-cardiac chest pain or no pain, and the severity of chest pain was graded according to the Canadian Cardiovascular Society (CCS) criteria. The patients themselves estimated their pain on a visual analogue scale. Management was based on symptoms and angiographic findings, since the results of MPI were not communicated. Among the 240 patients who were not revascularised, 79% had typical or atypical angina at study entrance versus 40% at follow-up. In comparison, 93% of the 144 revascularised patients had typical or atypical angina before intervention versus only 36% at follow-up. This additional advantage of invasive therapy was present only in patients with reversible defects; revascularisation had no additional effect in patients with normal perfusion or irreversible defects. Similarly, additional, significant reductions in CCS class and visual analogue score were observed exclusively in patients with reversible defects. In patients referred for coronary angiography owing to known or suspected stable angina, revascularisation was significantly more effective than medical treatment exclusively in patients with reversible ischaemia. (orig.)

  11. Prognostic significance of myocardial imaging with iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid in patients with angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Hatano, Tsuguhisa; Chikamori, Taishiro; Kamada, Tatsuya; Morishima, Takayuki; Hida, Satoshi; Yanagisawa, Hidefumi; Iino, Hitoshi; Yamashina, Akira [Tokyo Medical Coll. (Japan)

    2001-09-01

    To assess the clinical significance of iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT), the predictive value of BMIPP imaging in patients with angina pectoris was evaluated. One hundred seventy-four patients who underwent BMIPP imaging in our institution were aged 61.8{+-}11 years. One hundred thirty-five patients had stable angina and 39 had unstable angina at the time of examination. Patients with previous myocardial infarction or myocardial disorders were excluded. Early and delayed images were acquired in BMIPP SPECT, and the images were analyzed visually. Cardiac events were classified into hard and soft events: the former consisted of cardiac death and nonfatal myocardial infarction, and the latter included coronary revascularization and heart failure. The findings of BMIPP imaging were normal in 82 patients and abnormal in 92. During follow-up of 15.5{+-}9.5 months, hard events were observed in 4 patients and soft events in 53. In patients with normal BMIPP imaging, soft events were observed in nine patients, but no hard event was encountered. Furthermore, in patients with both normal BMIPP and stress thallium imagings, no cardiac event was observed during 2 years. In contrast, 4 hard events and 44 soft events occurred in patients with abnormal BMIPP imaging. Patients with abnormal BMIPP imaging had a higher incidence of soft events than those with normal BMIPP imaging, regardless of the type of angina (16/62 vs 3/73, p<0.0005 for stable angina; 28/30 vs 6/9, p<0.0001 for unstable angina). The finding of BMIPP imaging correlates well with the mid-term prognosis of patients with angina pectoris. Since BMIPP SPECT is performed without stress to the patient, this imaging modality is important in evaluating patients with stable or unstable angina. (author)

  12. Visceral chest pain in unstable angina pectoris and effects of transcutaneous electrical nerve stimulation. (TENS). A review.

    Science.gov (United States)

    Börjesson, M

    1999-04-01

    A substantial proportion of patients with chest pain referred to hospital, show signs of coronary artery disease. Anginal pain could be conceptualized as a warning signal for coronary artery disease and impending death. But, for many reasons this theory is partly disputed. Firstly, not all ischemic episodes are accompanied by anginal pain (silent ischemia). Secondly, chest pain indistinguishable from true angina pectoris may be the result of other abnormalities of thoracic viscera. Nevertheless acute severe cardiac ischemia often gives rise to anginal chest pain. Unstable angina pectoris is carrying a higher risk for future events in spite of intensive medical treatment. A special problem are patients awaiting coronary intervention because of severe ischemia and maximum medical treatment, who experience ischemic pain. New treatment regimens are needed for these patients. This review discusses the symptom of visceral pain from the heart, angina pectoris, its relation to ischemia and unstable angina pectoris. It also addresses the role of afferent nerve stimulation (transcutaneous electrical nerve stimulation, TENS) in the treatment of severe angina pectoris as well as recent findings of TENS applicability in unstable angina.

  13. Asymptomatic myocardial ischemia as a predictor of cardiac events after coronary artery bypass grafting for stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    Thirty-six patients with chronic stable angina were studied before and after coronary artery bypass grafting (CABG) to assess the prevalence and prognostic implications of asymptomatic myocardial ischemia obtained by ambulatory monitoring. Ambulatory monitoring performed during medical therapy be...... for angina pectoris in some patients, whereas angina did not occur during the follow-up period in others. This study does not reveal whether or not these patients are at higher risk for cardiac events during long-term follow-up.......Thirty-six patients with chronic stable angina were studied before and after coronary artery bypass grafting (CABG) to assess the prevalence and prognostic implications of asymptomatic myocardial ischemia obtained by ambulatory monitoring. Ambulatory monitoring performed during medical therapy...... to 39 episodes after CABG (41%, p less than 0.05). During a follow-up of 9 months, 8 cardiac events occurred: 6 in group 1 comprising sudden death (1), revascularization (2), and angina (3) and 2 in group 2, including revascularization (1) and angina (1) (p = 0.005). Kaplan-Meier analysis demonstrated...

  14. Randomized double-blind comparison of metoprolol, nifedipine, and their combination in chronic stable angina

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    In a randomized double-blind study, treatment with either metoprolol, nifedipine, or their combination was compared for effects on ischemic variables and heart rate obtained during ambulatory monitoring in 42 patients with chronic stable angina. All patients had severe chronic stable angina...... of at least 6 months' duration despite medical treatment, and exhibited coronary artery stenosis of 75% in one or more coronary arteries. Metoprolol reduced the frequency of total (p less than 0.01) and asymptomatic ischemic episodes (p less than 0.05), the duration of ischemia (p less than 0.......05), and the ischemic burden (p less than 0.05), which contrasted to the lack of any similar significant effect during nifedipine monotherapy. During combination therapy, there was a tendency to further improvement, which did not reach statistical significance compared with metoprolol monotherapy. Heart rate...

  15. Treatment of Unstable Angina Pectoris with Modified Nuan Gan Jian - A Report of 33 Cases

    Institute of Scientific and Technical Information of China (English)

    贺敬波; 黄绵清; 张勤; 廖万柏; 王立军; 张玉英

    2004-01-01

    Objective: To observe the effectiveness of Modified Nuan Gan Jian Jiao Nang (MNGJ 加减暖肝煎胶囊Modified Liver-Warming Capsule) in treating unstable angina pectoris. Method: Sixty-six eligible cases were assigned randomly into a treatment group and a control group and treated for 3 weeks. Results:MNGJ produced an effect in reducing episodes, improving the abnormal findings in electro-cardiogram (ECG) (P<0.05) significantly, and decreasing myocardial oxygen consumption (P<0.05). In addition, it could decrease the plasma TXB2 level and increase 6-keto-prostaglandin F1α (6-Keto-PGF1α) level (P<0.01). Conclusion: MNGJ was quite effective in treating unstable angina pectoris, suggesting that the treatment of the disease could start from the liver.

  16. A Destabilized Case of Stable Effort Angina Pectoris Induced by Low-dose Adenosine Triphosphate

    Science.gov (United States)

    Sueta, Daisuke; Kojima, Sunao; Izumiya, Yasuhiro; Yamamuro, Megumi; Kaikita, Koichi; Hokimoto, Seiji; Ogawa, Hisao

    2016-01-01

    A 79-year-old man was diagnosed with sudden deafness. He had previously experienced a suspected episode of angina pectoris. At a local hospital, after 500 mg of hydrocortisone and 80 mg adenosine triphosphate (ATP) were administered, he became aware of chest discomfort. An electrocardiogram revealed serious ST-segment depressions. He was diagnosed with a non-ST elevated myocardial infarction (NSTEMI). Emergency coronary angiography revealed triple vessel disease, and the lesion was successfully stented. The mechanisms whereby the stable effort angina pectoris destabilized in this case were thought to include a reduction of the local blood flow because of an ATP product and probable thrombus formation in response to the administered steroids. PMID:27853071

  17. ONE CASE REPORT OF ANGINA TONSILLARIS INDUCED MEDIASTINAL ABSCESS AND THORACIC EMPYEMA

    Institute of Scientific and Technical Information of China (English)

    LI Qing-yun; WANG Xi; WAN Huan-ying; DENG Wei-wu

    2009-01-01

    A 27-year-old female patient with mediastinal abscess and thoracic empyema developed from angina tonsillaris was studied clinically on the manifestations, computed tomography (CT) scan, and the treatment process. The patient was admitted to hospital with a history of fever, sore throat, and chest and neck pain. CT showed air and air-fluid levels within mediastinal dense fatty planes that extended from the thoracic inlet to the sub-carinal region and left pleural empyema. She was cured by mediastinal drainage and extensive debridement of the necrotic tissue under operation and broad spectrum antibiotics treatment. Angina tonsillaris induced acute mediastitis and mediastinal abscess is a relatively rare inflammatory pathology but actually a fatal situation for its high mortality rate. CT scanning is extremely useful for early diagnosis and surgical treatment planning. The main treatment is aggressive and adequate surgical drainage of the abscess and intravenous effective antibiotic treatment.

  18. Percutaneous Device to Narrow the Coronary Sinus: Shifting Paradigm in the Treatment of Refractory Angina?

    Directory of Open Access Journals (Sweden)

    Daniela Benedetto

    2016-10-01

    Full Text Available Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and / or revascularization (percutaneous or surgical. In addition the presence of myocardial ischemia as a cause of the symptoms must have been documented. The coronary sinus Reducer (CSR is a recently introduced percutaneous device to treat patients with severe anginal symptoms refractory to optimal medical therapy and not amenable to conventional revascularization. The purpose of this review is to describe the current evidence from available studies measuring the clinical effect of the CSR implantation on the health and well-being of patients with refractory angina.

  19. The Neuromatrix Theory of Pain and Angina during Exercise Stress Testing: Results from the PIMI Study

    Science.gov (United States)

    2011-05-27

    al., 1988; Glusman et al., 1996). In these individuals, the opioid reactivity would produce stronger analgesia of pain from most inputs, including...pain thresholds in silent ischemics might generalize to other areas as well. Pain tests in areas such as the toe, finger or dental pain thresholds...induced opioid Angina and the Neuromatrix 20 analgesia . Indeed, perhaps people who genetically have greater β-endorphin reactivity to stress

  20. Percutaneous transluminal coronary angioplasty in refractory unstable angina pectoris: are new devices useful?

    Science.gov (United States)

    Bertaglia, E; Ramondo, A; Cacciavillani, L; Isabella, G; Reimers, B; Marzari, A; Maddalena, F; Chioin, R

    1996-11-15

    This study was undertaken to assess if the introduction of new angioplasty devices (autoperfusion balloon catheters, stent and atherectomy) could ameliorate early and late results of prompt percutaneous transluminal coronary angioplasty (PTCA) in patients with refractory unstable angina. From January 1993 to June 1995, 59 of 278 patients (14 female, 45 male; mean age: 61 +/- 10 years; range: 38-78) admitted to our Coronary Care Unit with the diagnosis of unstable angina had more than one episode of chest pain at rest with dynamic electrocardiographic ST-T changes and without signs of cardiac necrosis while on medical therapy including oxygen, aspirin, heparin, nitroglycerin and either a beta-blocker or a calcium-antagonist. Coronary angiography was performed within 48 h from the last ischemic attack and a culprilesion technically suitable for PTCA was identified. PTCA was performed in 73 lesions. Elective stent implantation was considered for 16 type B or C lesions in 14 patients. The procedure was initially successful in 52/59 patients (88%), uncomplicated unsuccessful in 4/59 (7%) and complicated in 3/59 (5%). Elective stent insertions were all successful (16/16, 100%). All successfully treated patients were followed up for a mean of 12 +/- 7 months (range: 6-27): 2/52 patients (3.8%) suffered from non-transmural myocardial infarction, 14/52 (26.9%) had a recurrence of angina and 2/52 (3.8%), asymptomatic, had a positive stress test. We conclude that prompt PTCA in refractory unstable angina using 1990s 'state of the art' equipment compares favorably to previous study and that stent delivery might become the elective treatment of complex lesions in this subset of patients.

  1. Diagnosis of coronary vasospasm in patients with clinical presentation of unstable angina pectoris using ergonovine echocardiography.

    Science.gov (United States)

    Song, J K; Park, S W; Kang, D H; Lee, C W; Choi, K J; Hong, M K; Kim, J J; Kim, Y H; Park, S J

    1998-12-15

    Although coronary vasospasm can contribute to the development of unstable angina, the definite diagnostic method has not been established. The purpose of this study was to determine if ergonovine echocardiography (detection of regional wall motion abnormality during bedside ergonovine challenge) after angiographic confirmation of insignificant fixed disease would be useful and safe in detecting coronary vasospasm in patients with unstable angina. After control of chest pain with medications in patients admitted to the coronary care unit under the tentative diagnosis of unstable angina, diagnostic coronary angiography was performed. All patients with normal or insignificant fixed disease underwent ergonovine echocardiography after discontinuation of medications for 4+/-1 days. Among 208 consecutive patients enrolled for this study, 75% (156 of 208) showed significant fixed disease in the angiography. Ergonovine echocardiography was performed in 52 patients with insignificant disease, and coronary vasospasm was documented in 33 (63%, 33 of 52). No serious procedure-related arrhythmia or myocardial infarction occurred. Esophageal motility disorder and hypertrophic cardiomyopathy were diagnosed in 6 and 3 patients, respectively. Chest pain of undetermined etiology was the final diagnosis at discharge in 10 patients (5%, 10 of 208); among them chest pain redeveloped in 2 patients, and repeated ergonovine echocardiography revealed positive results. Our data suggest that among patients with the clinical presentation of unstable angina, coronary vasospasm is the main cause of myocardial ischemia in a considerable number of patients with a normal or near-normal angiogram, and ergonovine echocardiography after confirmation of absence of significant fixed disease is useful and safe for noninvasive diagnosis of coronary vasospasm in this setting.

  2. Optimal treatment of chronic angina in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kaur H

    2014-07-01

    Full Text Available Harjinder Kaur,1 Kully Sandhu,2 Awais Jabbar,3 Azfar G Zaman3,4 1City Hospitals Sunderland, Sunderland, UK; 2University Hospital of North Staffordshire, Stoke-on-Trent, UK; 3Freeman Hospital, Newcastle-upon-Tyne, UK; 4Institute of Cellular Medicine, Newcastle University, Newcastle, UK Abstract: Type 2 diabetes mellitus (T2DM trebles the risk of developing coronary artery disease (CAD; once CAD has developed, the risk of acute coronary syndromes (ACS and clinical risk associated with a coronary event, both double in diabetic patients. Patients with T2DM have more extensive CAD and present at a younger age; therefore, identification and management of chronic angina in these patients presents an opportunity to limit both cardiovascular symptoms and adverse outcomes. This article reviews the role of screening and treatment for chronic angina in patients with T2DM. There is a strong evidence base for modifying lifestyle as a way of reducing adverse cardiovascular outcomes in the diabetic population and this article reviews evidence of lifestyle modification as an important and necessary adjunct to pharmacologic intervention. Management of chronic stable angina is addressed by looking at treatments that reduce ischemic symptoms and those that reduce adverse cardiovascular outcomes. Trials specific to the diabetic population are limited, with information largely obtained from the diabetic subgroup analysis of large intervention trials. The growing diabetic population with increased propensity to cardiovascular disease mandates trials specifically in this patient population. Revascularization in patients with diabetes is associated with more complications than in the non-diabetic population. Recent trials specific to this population suggest surgical revascularization to be associated with better long-term outcomes and therefore, this article reviews the evidence for the optimal mode of revascularization in this population. Keywords: type 2 diabetes

  3. Chronic pseudo-angina left precordial chest pain caused by a thoracic meningioma

    OpenAIRE

    Azabou, Eric; Kumako, Vincent; Moussawi, Mahmoud; Berger, Colette; André-Obadia, Nathalie; Kocher, Laurence; Gonnaud, Pierre-Marie

    2013-01-01

    International audience; Left precordial chest pain (LPCP) evokes above all angina. Eliminating a cardiac origin is then always the first priority. When cardiac causes are eliminated, non-cardiac causes are sought in order to avoid leaving patients with undiagnosed or undifferentiated chest pain. There is a myriad of non-cardiac causes ranging from heartburn, panic attacks, pleurisy, pulmonary embolism, pneumothorax, Tietze syndrome, bruises and fractures of the ribs, to spine meningioma, neur...

  4. Acetylcholine test in patients with angina pectoris and normal coronary angiography

    Science.gov (United States)

    Barbieri, Enrico; Destro, Gianni; Oliva, Massimo; Zardini, Piero

    1994-02-01

    Angina pectoris with normal coronary artery on the coronary angiography is an intriguing issue. Intracoronary infusion of acetylcholine has recently been used to test the integrity of endothelial cells. We studied 16 patients with this syndrome. A relationship has been found between the acetylcholine test and the exercise stress test in normotensive patients. The presence of hypertension makes the evaluation of the test more unpredictable, probably because of the damage on the endothelial cells related to systemic hypertension.

  5. The efficacy and safety of dilevalol in patients with chronic stable angina pectoris.

    Science.gov (United States)

    Glasser, S P; Bittar, N; Kinhal, V; Bennett, W T; Koehn, D K

    1989-11-01

    This is the first reported large clinical trial of the antianginal and acute ischemic effectiveness and safety of dilevalol (the R, R-isomer of labetalol) in patients with chronic stable angina pectoris. This was a multicenter double blind fixed-dose parallel group placebo controlled trial. Patients with chronic stable angina and positive and reproducible exercise tests (+/- 20%) were included. If randomized, patients entered one of four fixed dose groups (twice a day placebo, 100 mgm, 200 mgm and 400 mgm bid for 2 weeks). Exercise testing was performed at 2 hours (peak) and 12 hours (trough) postdosing. This was followed by a 2-week once-a-day dosing regimen in which patients received the same total daily dose as the prior 2 weeks, with the full dose in the morning and a matched placebo in the evening. Exercise testing was performed at 2 hours (peak) and 24 hours (trough) postdosing. Anginal frequency and NTG consumption were significantly reduced, and equally so, by qd and bid regimens. The time of exercise to the onset of angina increased and the proportion of patients terminating exercise because of moderate angina decreased in a dose response fashion for both peak and trough tests and for both qd and bid regimens. There was also a dose related decrease in exercise induced ST segment depression and an increase in time to 1 mm ST depression. In 15 patients, 24-hour ambulatory monitoring also revealed a decrease in episodes of silent ischemia. No significant side effects related to the study drug occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Angiotensin-converting enzyme in acute myocardial infarction and angina pectoris.

    Science.gov (United States)

    Rømer, F K; Kornerup, H J

    1981-06-01

    Serum activity of angiotensin-converting enzyme was measured by serial analysis in 19 patients with acute myocardial infarction and in eight patients with angina pectoris. As a rule no changes in enzyme activity occurred during 6 days observations. However, two patients with infarction exhibited a pronounced fall of enzyme activity which could not be related to clinical events. The analysis seems to have no place in the diagnosis and management of patients with myocardial infarction.

  7. Comparison of coronary artery specific leukocyte-platelet conjugate formation in unstable versus stable angina pectoris.

    Science.gov (United States)

    Patel, Parag B; Pfau, Steven E; Cleman, Michael W; Brennan, Joseph J; Howes, Christopher; Remetz, Michael; Cabin, Henry S; Setaro, John F; Rinder, Henry M

    2004-02-15

    This study evaluates transcoronary changes in neutrophil and platelet activation and conjugate formation in patients with angina pectoris secondary to coronary artery disease. We examined parameters of neutrophil and platelet activation as well as the neutrophil-platelet conjugate formation in patients who underwent diagnostic coronary angiography. Thirty-nine patients with chest pain referred for cardiac catheterization were studied (23 patients with unstable angina pectoris [UAP] and 16 with stable angina pectoris [SAP]). Before coronary angiography, blood samples were obtained simultaneously from the aortic root and coronary sinus to assess leukocyte (CD11b) and platelet (CD62P) activation and leukocyte-platelet conjugates. There was a 94% increase in CD62-expressing platelets from the aorta to the coronary sinus in patients with UAP compared with a 49% increase in patients with SAP. The percentage of neutrophil-platelet conjugates increased by 22% in patients with UAP compared with a 16% decrease in those with SAP (p <0.01). In contrast, monocyte-platelet binding across the coronary bed increased to a similar degree in both groups. This study demonstrates an increase in neutrophil-platelet conjugates across the coronary circulation in UAP, compatible with a higher activation state in both cell types.

  8. [The quality of life of the patient with unstable angina treated by spinal cord electrical stimulation].

    Science.gov (United States)

    González-Darder, J M; Vázquez, J L; Canela, P; González Martínez, V

    1990-12-01

    Quality of life was evaluated in patients with unstable angina before and after surgical therapy with spinal cord electrical stimulation (SCES). Overall 12 patients were evaluated, with quantification of the mean weekly number of anginal attacks, the degree of effort provoking them and the Nottingham Health Profile (NHP). The criteria of inclusion in the study were: angina grade IV, resistant to drug therapy and without indication of surgery. The mean follow-up period was 9.8 +/- 8.2 months. A significant reduction in the weekly number of anginal attacks (preoperative 30.9 +/- 14.5; postoperative 9.6 +/- 8.2; p less than 0.01); improvement in functional class (p less than 0.001), and significant improvement (p greater than 0.05) in the pain, energy, sleep, social isolation and emotional reactions areas of NHP were observed. It was concluded that SCES is a useful procedure in patients with unstable angina untreatable by other medical or surgical methods, as it reduces the number of anginal attacks and increases quality of life of the patients without additional risk.

  9. Efficacy evaluation of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression

    Institute of Scientific and Technical Information of China (English)

    Chun-Hua Liao

    2015-01-01

    Objective:To study the efficacy of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression. Methods:120 cases of unstable angina patients with depression were randomly divided into two groups. The anti-depression group received fluoxetine combined with conventional drug therapy; the conventional group received conventional drug therapy. Then contents of monoamine neurotransmitters and their metabolites, antioxidants and inflammatory mediators of both groups were compared. Results:Serum monoamine neurotransmitters NE, 5-HT and HA levels of the anti-depression group were higher than those of the conventional group and metabolites 5-HIAA and HVA contents were lower than those of the conventional group; serum SOD, CAT, GSH and HSP-70 contents of the anti-depression group were higher than those of the conventional group, and hs-CRP, MMP9, MCP1 and HMGB1 contents were lower than those of the conventional group. Conclusion:Fluoxetine combined with conventional drug therapy can increase the contents of monoamine neurotransmitters and antioxidants, and reduce oxidative stress response and inflammatory response; it is an ideal method for treating unstable angina complicated with depression.

  10. Terminalia arjuna in Chronic Stable Angina: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Navjot Kaur

    2014-01-01

    Full Text Available Background. Terminalia arjuna is a popular Indian medicinal plant with its bark been used for over centuries as cardiotonic. The bark has been found to contain several bioactive compounds including saponins and flavonoids. A number of experimental and clinical studies have been conducted to explore therapeutic potential of Terminalia arjuna in cardiovascular ailments specially in patients of coronary heart disease. A number of narrative reviews have been done but no systematic review has been conducted to date. Objective. To systematically review and conduct a meta-analysis on the available literature evaluating the efficacy of Terminalia arjuna in patients of chronic stable angina. Study selection. We included randomised, pseudo-randomized and before-after comparative studies which compared Terminalia arjuna/commercial preparation of Terminalia arjuna with current standard/ conventional treatment regimens in patients with chronic stable angina. Findings. Studies were found to be of poor methodological design. We found no significant difference in the Terminalia arjuna group as compared to control arm in the outcomes for which we were able to pool data and undertake meta-analysis. Conclusions. Currently, the evidence is insufficient to draw any definite conclusions in favour of or against Terminalia arjuna in patients of chronic stable angina. Further, well-controlled multicentric clinical trials need to be conducted in large number of patients to explore the therapeutic potential of Terminalia arjuna if any.

  11. Heart rate dynamics in patients with stable angina pectoris and utility of fractal and complexity measures

    Science.gov (United States)

    Makikallio, T. H.; Ristimae, T.; Airaksinen, K. E.; Peng, C. K.; Goldberger, A. L.; Huikuri, H. V.

    1998-01-01

    Dynamic analysis techniques may uncover abnormalities in heart rate (HR) behavior that are not easily detectable with conventional statistical measures. However, the applicability of these new methods for detecting possible abnormalities in HR behavior in various cardiovascular disorders is not well established. Conventional measures of HR variability were compared with short-term ( 11 beats, alpha2) fractal correlation properties and with approximate entropy of RR interval data in 38 patients with stable angina pectoris without previous myocardial infarction or cardiac medication at the time of the study and 38 age-matched healthy controls. The short- and long-term fractal scaling exponents (alpha1, alpha2) were significantly higher in the coronary patients than in the healthy controls (1.34 +/- 0.15 vs 1.11 +/- 0.12 [p angina pectoris have altered fractal properties and reduced complexity in their RR interval dynamics relative to age-matched healthy subjects. Dynamic analysis may complement traditional analyses in detecting altered HR behavior in patients with stable angina pectoris.

  12. Breviscapine Injection Improves the Therapeutic Effect of Western Medicine on Angina Pectoris Patients.

    Science.gov (United States)

    Wang, Chuan; Li, Yafeng; Gao, Shoucui; Cheng, Daxin; Zhao, Sihai; Liu, Enqi

    2015-01-01

    To evaluate the beneficial and adverse effects of breviscapine injection in combination with Western medicine on the treatment of patients with angina pectoris. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, the China National Knowledge Infrastructure, the Wanfang Database, the Chongqing VIP Information Database and the China Biomedical Database were searched to identify randomized clinical trials (RCTs) that evaluated the effects of Western medicine compared to breviscapine injection plus Western medicine on angina pectoris patients. The included studies were analyzed using RevMan 5.1.0 software. The literature search yielded 460 studies, wherein 16 studies matched the selection criteria. The results showed that combined therapy using Breviscapine plus Western medicine was superior to Western medicine alone for improving angina pectoris symptoms (OR=3.77, 95% Cl: 2.76~5.15) and also resulted in increased electrocardiogram (ECG) improvement (OR=2.77, 95% Cl: 2.16~3.53). The current evidence suggests that Breviscapine plus Western medicine achieved a superior therapeutic effect compared to Western medicine alone.

  13. COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

    Directory of Open Access Journals (Sweden)

    A. A. Anderzhanova

    2016-01-01

    Full Text Available Aim. To compare antihypertensive, antianginal and antiischemic efficacy of β1-selective adrenoblockers (betaxolol and metoprolol tartrate in patients with arterial hypertension (HT of 1-2 degree associated with stable angina class II.Material and methods. 100 patients (aged 23-66 y.o. with HT associated with stable angina or without angina were involved in the study. Patients were randomized into 2 groups (G1 and G2. G1 patients were treated with betaxolol, and G2 patients – with metoprolol tartrate. Ambulatory BP and electrocardiogram monitoring, exercise stress-test, echocardiography, evaluating of respiratory function, blood analysis was performed initially and in 30 and 90 days of treatment.Results. Target BP level was reached in 44 (88% patients treated with betaxolol (average daily dose 10±4 mg. 34 patients of G1 took 10 mg daily. Target BP level was reached in 41 (82% patients treated with metoprolol tartrate (average daily dose 150±27 mg. 30 patients of G2 took 150 mg daily. Exercise tolerance increased and a number of ischemic ST segment depressions reduced significantly in both groups. There were no significant differences in antihypertensive, antianginal, and antiischemic efficacy between groups.Conclusion. Betaxolol advantage is an ability to maintain target BP level more than 24 hours. A possibility to take betaxolol once a day raises patient’s compliance with therapy.

  14. ENDOTHELIAL DYSFUNCTION IN STABLE ANGINA AND MYOCARDIAL INFARCTION COMBINED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    M. A. Popova

    2015-01-01

    Full Text Available The research objective is to determine the state of endothelium-dependent and endothelium-independent vasodilatation in patients with coronary heart disease (CHD associated with chronic obstructive pulmonary disease (COPD.Material and methods. In the cross-sectional study included 122 patients with CHD associated with COPD: 68 people of them are patients with stable angina without acute coronary events in history and 54 patients with acute ST segment elevation myocardial infarction (STEMI. Comparison group comprised 53 patients with stable angina and 51 patients after STEMI without concomitant COPD. Patients were included if they met the following inclusion criteria: male, age <60 years, verified forms of CHD (stable angina, STEMI, documented with COPD without exacerbation and forced expiratory volume in 1 second > 30% in the groups with CHD and COPD. Arterial endothelial function was tested with high-resolution ultrasonography: brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation, and after administration of sublingual nitroglycerin (an endothelium-independent dilator.Results. We found that endothelial dysfunction in patients with acute and chronic forms of CHD in combination with COPD are more pronounced than in isolated CHD.Conclusion. Expressed depression functional vascular reserve in patients with CHD associated with COPD, should be taken into account when conducting individualized therapy of these patients.

  15. El donjuanismo como conocimiento

    Directory of Open Access Journals (Sweden)

    Ernesto Cortés Ahumada

    1965-07-01

    Full Text Available ¡Don Juan! ¡Como un estudiante! ¡Como un infante! ¡Como un pirata! Se trata, por tanto, de pensar sobre el donjuanismo. Pero no bien acabo de escribir esta palabra, o mejor todavía, de balbucir una meditación acerca de esta perspectiva dinámica y en extremo viviente, porque aún sin saber nada de él algo de nosotros se dispara en emotivas tensiones y sensuales distensiones, cuando caigo en la cuenta de que el tema es sumamente complejo.

  16. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  17. The treatment of angina pectoris with nitroglycerin plasters. A multicenter study involving 6,986 patients.

    Science.gov (United States)

    Agabiti Rosei, E; Muiesan, M L; Pollavini, G; Bichisao, E; Muiesan, G

    1987-10-01

    A multicenter study was carried out in order to evaluate the efficacy and tolerability of 2 doses of a nitroglycerin transdermal system (TTS-NG 5 mg/24 h and TTS-NG 10 mg/24 h) on a large population of patients affected by angina pectoris. Nine hundred and seventy three cardiologists enrolled a total of 6,986 patients, 4,290 males and 2,696 females, mean age 61.7 years (range 26-95), 3,283 with effort-angina, 2,062 with mixed angina and 1,641 with angina at rest. Patients whose angina was not satisfactorily controlled by their previous therapy, were given TTS-NG 5 for 1 week in the morning, while continuing their antianginal treatment, with the exception of nitrates which were gradually withdrawn. At the end of this period, patients who responded to the treatment continued taking the same dose for a further 6 weeks, while poor responders were given a double dose of the study medication over the same period. Six thousand two hundred and sixty patients (90%) completed the study. TTS-NG 5 proved to be effective in 2,091 patients (33%) with a reduction in weekly anginal attacks after only 1 week of treatment (from 5.8 +/- 2.9 to 2.4 +/- 2.3). This reduction improved in the following 2 weeks (from 2.4 +/- 2.3 to 1.2 +/- 1.6) and subsequently remained virtually unchanged. Four thousand one hundred and sixty-nine patients (67%), whose angina was not sufficiently controlled by TTS-NG 5 (from 5.0 +/- 2.4 to 4.3 +/- 2.8), received double the dose at the end of the first week. TTS-NG 10 brought about a reduction in weekly anginal symptoms during the 2nd and the 3rd week (from 4.3 +/- 2.8 to 2.0 +/- 2.2), with a further decrease during the following 2 weeks (from 2.0 +/- 2.2 to 1.1 +/- 1.7). The reduction in anginal attacks was of the same extent both during the day and the night, thus suggesting that the drug is effective throughout 24 hours. A similar pattern was observed in the reduction of the number of anginal attacks weighted by their severity, the severity of attacks

  18. El derecho como hecho o como norma

    Directory of Open Access Journals (Sweden)

    Roberto José Vernengo

    2015-10-01

    Full Text Available Para el historiador, antiguamente, y para el sociólogo, en nuestros días, el derecho es un fenómeno empírico. El derecho de una sociedad es un dato de su realidad: historiador o sociólogo tienen que buscar el derecho en alguna experiencia empírica accesible. Sin embargo, no es fácil toparse con el derecho de una sociedad, como, por caso, con el derecho argentino actual, pues no sabemos muy bien a qué datos de la realidad apuntar. Aquéllos que discernimos aparecen teñidos por alguna concepción previa que tengamos sobre qué haya de entenderse por derecho. (...

  19. Effect of Enhanced External Counterpulsation (EECP on Exercise Time Duration and Functional Capacity in Patients with Refractory Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Ali Bozorgi

    2015-10-01

    Full Text Available Background: Enhanced external counterpulsation (EECP is a noninvasive technique used for patients with refractory angina pectoris. There are controversial data on the effectiveness of EECP in improving patients with refractory stable angina. The aim of the present study was to evaluate the effectiveness and safety of EECP for the treatment of patients with refractory angina pectoris.Methods: Twenty consecutive patients with refractory angina pectoris were treated with EECP, and their symptoms, echocardiographic measures, treadmill exercise test parameters, and Canadian Cardiovascular Society Class were evaluated before and immediately after EECP. The patients were followed up for 6months post treatment.Results: There were significant differences regarding total exercise time before and after treatment (p value < 0.001. The patients showed a significant reduction in angina classes III and IV immediately after EECP (p value < 0.001; for most of the patients, these beneficial effects were sustained for 6 months (p value = 0.010. There was no significant improvement in the echocardiographic parameters.Conclusion: EECP decreased symptoms and increased total exercise time in our study population. These beneficial effectswere sustained for 6 months.

  20. Xuesaitong Soft Capsule (Chinese Patent Medicine for the Treatment of Unstable Angina Pectoris: A Meta-Analysis and Systematic Review

    Directory of Open Access Journals (Sweden)

    Xiaochen Yang

    2013-01-01

    Full Text Available Objective. To provide a systematic review to evaluate the effectiveness and safety of Xuesaitong soft capsule (XST in treating unstable angina (UA. Methods. An extensive search of 6 medical databases was performed up to August 2013. Randomized controlled trials (RCTs involving XST alone or combined with conventional drugs versus conventional drugs were included. A meta-analysis of reduction of angina symptoms and electrocardiogram (ECG improvement was performed to evaluate the effects of XST on UA. Results. After researching, a total of 6 RCTs with 716 participants were included. Our review showed that XST combined with conventional drugs had significant effect on relieving angina symptoms (RR: 1.14 [1.07,1.22]; P=0.0001 and improving ECG (RR: 1.26 [1.12,1.42]; P=0.0001 compared with conventional drugs alone. Conclusions. XST appears to have beneficial effects on improvement of ECG, reduction of angina symptoms, and decreasing the frequency and duration of angina attack in participants with UA. However, the findings should be interpreted with caution due to the poor methodological quality of the included trials.

  1. [Prognostic value of high-sensitivity C-reactive protein in assessing intrahospital outcome of unstable angina].

    Science.gov (United States)

    Ben Halima, Afef; Kammoun, Ikram; Sdiri, Wissem; Bachraoui, Kaouther; Chine, Samira; Zoaoui, Walid; Châabène, Olfa; Gargouri, Sami; Keskes, Hend; Lefi, Abdellatif; Ben Ammar, Slim; Boujnah, M Rachid; Kachboura, Salem

    2003-01-01

    Inflammation has been shown to play an important role in the pathogenesis of unstable angina. CRP has been demonstrated to be a reliable marker of prognosis is unstable angina. The aim of this study was to investigate the prognostic value of CRP in assessing short outcome of unstable angina. Our study is a prospective double blinded one. We measured CRP in 33 consecutive patients admitted for unstable angina at the 24th and 48th hour. The mean age is 60 years (30 to 84 years). There were 22 men and 11 women. 8 patients were included in class I of Braunwald classification, 5 were in class II and 20 in class III. 14 patients presented cardiac events. The CRP mean value was significantly higher among these patients (12 mg/l vs 5 mg/l, p or = 3 mg/l have a higher risk of developing complications (66% vs 13%, p = 0.002). Elevation of CRP predicted poor outcome of intrahospital evolution with a sensitivity of 86%, a specificity 68%, a positive and negative predictive values of 66% and 86%. The CRP in our preliminary study is an independent risk factor of early outcome of unstable angina. In association with clinical scores and other cardiac markers will lead to a better identification of high risk patients.

  2. Tratamento de angina mesentérica em pacientes com arterite de Takayasu Treatment of mesenteric angina in patients with Takayasu's arteritis

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    Luana Thayse Barros de Lima

    2011-04-01

    Full Text Available Aarterite de Takayasu (AT é uma doença inflamatória crônica do tecido conectivo, idiopática, que acomete preferencialmente a aorta e seus ramos. A terapêutica utilizada baseia-se sobretudo no uso de corticosteroides e imunossupressores. É relatado o caso de uma paciente, 33 anos, com mal-estar, febre, mialgia, cefaleia intensa, pulsátil, holocraniana, resistente a analgésicos, hipertensão arterial sistêmica de difícil controle, claudicação no membro inferior direito e dor abdominal de forte intensidade, a qual piorava após a alimentação. A angiotomografia revelou aneurisma da aorta ascendente, estenose da artéria ilíaca comum direita, estenose das artérias renais e estenose da artéria mesentérica superior, fato que embasou o diagnóstico de angina mesentérica e a conduta intervencionista através da angioplastia transluminal percutânea múltipla com a colocação de stents.Takayasu's arteritis (TA is an idiopathic chronic inflammatory disease of the connective tissue that affects mainly the aorta and its branches. Treatment is mainly based on corticosteroids and immunosuppressants. We report the case of a 33-year-old female complaining of malaise, fever, myalgia, severe pulsing holocranial headache resistant to analgesics, systemic arterial hypertension hard to control, right lower limb claudication, and severe abdominal pain that worsened after the meals. Angiotomography revealed aneurysm of the ascending aorta, and stenosis of the following vessels: right common iliac artery, renal arteries, and superior mesenteric artery. Those findings supported the diagnosis of mesenteric angina and the interventional approach by use of percutaneous transluminal angioplasty with stent placement.

  3. Facilitação e dominância dos sintomas sôbre a dor da angina de peito e causalgia

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    Nelson Pires

    1962-09-01

    Full Text Available O autor traz à consideração clínica a "facilitação" que Sherrington apreciou nos experimentos de neurofisiologia, e que explica aspectos clínicos importantíssimos em psicologia e em neurologia visceral. Pretende o autor explicar seus casos de dor (um de causalgia no membro superior e três de angina de peito em portadores de esclerose coronária. Ora a anestesia terapêutica no gânglio estrelado, ora na cadeia ganglionar torácica simpática, ora a radioterapia, ora a psicoterapia removeram a dor "facilitada" a tal ponto que se tornara "dominante", isto é, mesmo estímulos inadequados a provocavam. Os doentes eram inválidos e recuperaram-se. A neurofisiologia moderna autoriza a interpretação dessa terapêutica: suprimiu-se - com a anestesia, com a radioterapia e com a psicoterapia - o circuito neural auto-alimentado reverberante, hiperfuncionante em todo ou em parte de seu trajeto, quer aferente ao córtex quer aferente às coronárias. O autor discute o valor clínico dos acessos anginosos apontando fatos que documentam que o acesso "ilegítimo" (psicógeno deve ter como causa a estimulação das aferências vegetativas ao córtex em qualquer ponto (ganglionar, medular ou cortical. Os acessos "legítimos", produzindo lesões transitórias ou definitivas e até morte,, devem ser explicados pela atividade das eferências vagais que executam os efetôres espásticos das coronárias. A dor é apresentada como fenômeno de "gravação neural", aprendido, memorizado e automatizado, ativado em feed-back ora nas aferências vegetativas ao córtex, ora nas eferências, mais perigosas e mortais. Debate-se a superestimada psicogenia da angina de peito.

  4. [The treatment of chronic stable angina with isradipine. A cooperative Latin American study].

    Science.gov (United States)

    Román, O; Alcocer, L; Espinoza, J; Arcos, R; Gómez, G; Mayorga, E; Buzzi, A; Tavella, N; Romero, C; Kuster, F

    1991-04-01

    In order to study the efficacy and tolerance of isradipine, a new Ca++ antagonist for the treatment of stable chronic angina, a multicentric cooperative study was carried out in eight Latin American countries (Argentine, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay and Venezuela), which included 169 patients (60% men and 40% women), average age 62.6 +/- 9.7. Patients with more than 4 biweekly anginal crisis were accepted, with one or more of the following inclusion criteria: coronariographic evidence of obstruction greater than 60% in one or more vessels, IAM history, positive scintigraphy and positive effort test. The trial was single-blind, with placebo during the admission phase (2 weeks) and active treatment for 12 weeks. isradipine was administered in increasing doses of 2.5, 5, and 7 mg thrice a day, according to the presence or absence of anginal crisis. It was observed that the average frequency of weekly pains decreased from 8.2 +/- 7 under placebo to 6.3 +/- 7.5 under isradipine at low doses, and to 2.0 +/- 2.0 (p less than 0.001) under maximum doses. TNT intake decreased parallel also in a significant way. At the end of the trial, 37% of patients had become asymptomatic, and angina had reduced to less than two crisis a week in 33%. A clear relation doses-effect was observed. There was no alteration in laboratory exams neither in ECG. Seven patients had complications derived from the evolutional course of disease (2 IAM, 5 unstable angina and one sudden death). Adverse events were relatively frequent and the majority derived from vasodilator effect (tibial oedema 37%, flushing 17%, headache 23%).(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Alteration in metabolic signature and lipid metabolism in patients with angina pectoris and myocardial infarction.

    Science.gov (United States)

    Park, Ju Yeon; Lee, Sang-Hak; Shin, Min-Jeong; Hwang, Geum-Sook

    2015-01-01

    Lipid metabolites are indispensable regulators of physiological and pathological processes, including atherosclerosis and coronary artery disease (CAD). However, the complex changes in lipid metabolites and metabolism that occur in patients with these conditions are incompletely understood. We performed lipid profiling to identify alterations in lipid metabolism in patients with angina and myocardial infarction (MI). Global lipid profiling was applied to serum samples from patients with CAD (angina and MI) and age-, sex-, and body mass index-matched healthy subjects using ultra-performance liquid chromatography/quadruple time-of-flight mass spectrometry and multivariate statistical analysis. A multivariate analysis showed a clear separation between the patients with CAD and normal controls. Lysophosphatidylcholine (lysoPC) and lysophosphatidylethanolamine (lysoPE) species containing unsaturated fatty acids and free fatty acids were associated with an increased risk of CAD, whereas species of lysoPC and lyso-alkyl PC containing saturated fatty acids were associated with a decreased risk. Additionally, PC species containing palmitic acid, diacylglycerol, sphingomyelin, and ceramide were associated with an increased risk of MI, whereas PE-plasmalogen and phosphatidylinositol species were associated with a decreased risk. In MI patients, we found strong positive correlation between lipid metabolites related to the sphingolipid pathway, sphingomyelin, and ceramide and acute inflammatory markers (high-sensitivity C-reactive protein). The results of this study demonstrate altered signatures in lipid metabolism in patients with angina or MI. Lipidomic profiling could provide the information to identity the specific lipid metabolites under the presence of disturbed metabolic pathways in patients with CAD.

  6. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

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    A. V. Rudakova

    2015-12-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  7. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2012-01-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  8. Study protocol: a randomised controlled trial investigating the effect of exercise training on peripheral blood gene expression in patients with stable angina

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    Crossman David C

    2010-10-01

    Full Text Available Abstract Background Exercise training has been shown to reduce angina and promote collateral vessel development in patients with coronary artery disease. However, the mechanism whereby exercise exerts these beneficial effects is unclear. There has been increasing interest in the use of whole genome peripheral blood gene expression in a wide range of conditions to attempt to identify both novel mechanisms of disease and transcriptional biomarkers. This protocol describes a study in which we will assess the effect of a structured exercise programme on peripheral blood gene expression in patients with stable angina, and correlate this with changes in angina level, anxiety, depression, and exercise capacity. Methods/Design Sixty patients with stable angina will be recruited and randomised 1:1 to exercise training or conventional care. Patients randomised to exercise training will attend an exercise physiology laboratory up to three times weekly for supervised aerobic interval training sessions of one hour in total duration. Patients will undergo assessments of angina, anxiety, depression, and peripheral blood gene expression at baseline, after six and twelve weeks of training, and twelve weeks after formal exercise training ceases. Discussion This study will provide comprehensive data on the effect of exercise training on peripheral blood gene expression in patients with angina. By correlating this with improvement in angina status we will identify candidate peripheral blood transcriptional markers predictive of improvements in angina level in response to exercise training. Trial Registration Clinicaltrials.gov identifier: NCT01147952

  9. La identidad como problema social y sociológico

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    Martínez Sahuquillo, Irene

    2006-12-01

    Full Text Available This paper approaches the problem of identity in the modern world with the theoretical support of important sociologists such as Berger, Bauman, or Beck. In the first place, the general issue is tackled of how with the transition to modernity identity changes its nature and acquires specific traits which are examined, together with the discontents and reactions this change gives birth to. In the second place, two fundamental stages of modernity are distinguished which have a different effect on identity. Thus, I attempt to show that in the first stage of modernity identity rested on solid pillars, such as work, family, nation and religion, which tend to grow weaker in the second stage, so that identity becomes more fragile and unstable. To scape this fate, I conclude, many individuals adhere to a group identity, sometimes of a monolithic character, a rising phenomenon that will require further inquiries.Este artículo aborda la problemática de la identidad en el mundo moderno apoyándose en las ideas de teóricos importantes de la sociología como Berger, Bauman o Beck. En primer lugar, se trata la cuestión general de cómo con el paso a la modernidad la identidad cambia de naturaleza y adquiere rasgos propios, que se analizan, junto a los descontentos y reacciones que genera este cambio. En segundo lugar, se distinguen dos etapas fundamentales en la modernidad que afectan de forma diferenciada a la identidad. Así, intento mostrar cómo en la primera modernidad la identidad descansaba en unos pilares sólidos- trabajo, familia, nación y religión- que tienden a debilitarse en la segunda modernidad, por lo que la identidad se vuelve más frágil e inestable. Para escapar a este destino, concluyo, muchos individuos se adhieren a una identidad grupal, a veces de carácter monolítico, un fenómeno en alza que merecerá estudiarse detenidamente.

  10. Arteriosclerotic coronary arterial aneurysms in a 49-year-old man with crescendo angina: family history, natural course and prevalence.

    Science.gov (United States)

    Schneider, K W; Jesse, R; Deeg, P

    1977-01-01

    In a 49-year-old man with crescendo angina, elevated serum cholesterol level and an old posterior myocardial infarction, selective coronary arteriography showed multiple arteriosclerotic aneurysms of the right coronary artery associated with extensive and severe arteriosclerotic disease of the left coronary artery. The patient's mother and brother have both died of a myocardial infarction. Another brother suffers from angina and has documented arteriosclerotic coronary artery disease. Two sisters suffer from angina as well. The possibility of embolization of distal vessels from a friable clot of the aneurysms as a cause of the patient's infarction is discussed. To the best of our knowledge, this is the tenth patient with nonfistulous arteriosclerotic coronary artery aneurysm diagnosed and documented angiographically ante mortem. Including the present case and reviewing the literature, the prevalence of this condition among nonfistulous coronary aneurysms diagnosed ante mortem is 35 per cent and henceforth cannot be regarded as an incidental autopsy finding in cardiac asymptomatic patients.

  11. Diagnostic Value of Spiral on Kidney Angina%螺旋CT对肾绞痛的诊断价值

    Institute of Scientific and Technical Information of China (English)

    杨泽年; 张婷

    2003-01-01

    Objective Study the three methods' diacrisis value:X ray sheet of kidney angina cause of urinary calculus,vein renal pelvis contrast and spiral CT. Method Look back on and study 50 clinical kidney angina patients who have taken X ray sheet,or vein renal pelvis contrast, or spiral CT treatment. Compare those three methods and find the calculus positive rate and the areas of calculus frequently happening. Result X ray sheet finds that the calculus positive rate is 58%. Vein renal pelvis contrast finds that the calculus positive rate is 74%. Spiral CT finds that the calculus positive rate is 96% .All the calculus leans to appearing at the hypo - segment of ureter. And the Same - side kidney gets dropsy of different degree.Conclusion Urinary calculus, especially ureter hypo - segment calculus is the main cause of kidney angina. And spiral CT scanning is the best way to find calculus.

  12. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Hvelplund, Anders; Abildstrøm, Steen Z

    2012-01-01

    AimsPatients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD...... with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 1998-2009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events.......ConclusionPatients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease....

  13. Detection of culprit lesion in patients with unstable angina pectoris by using ATP thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Tokuo; Mori, Yutaka [Jikei Univ., Tokyo (Japan). School of Medicine; Yamashina, Akira; Kubo, Toru; Usui, Yasuhiro

    1999-10-01

    The purpose of this study is to determine the diagnostic accuracy for detection of culprit lesions in patients with unstable angina. Both ATP {sup 201}Tl SPECT and coronary angiography were performed in 51 patients with unstable angina pectoris within a week since the last attack. SPECT images were divided into 17 segments and the regional uptakes were scored semiquantitatively (0=normal to 3=no activity) and compared with the coronary angiographic findings. ATP {sup 201}Tl SPECT revealed decreased uptakes in 54 of 56 culprit lesions. The sensitivity, specificity and accuracy for detection of culprit lesions were 96.4%, 89.5% and 92.4%, respectively. Although adverse effects during ATP administration were complicated in 28 (54.9%) patients, all the complications were mild and resolved within two minutes. ATP {sup 201}Tl SPECT is sensitive and reliable method for detecting culprit lesions and can be performed safely even at acute phase in patients with unstable angina pectoris. (author)

  14. Angina-like chest pain and syncope as the clinical presentation of left ventricular endomyocardial fibrosis: a case report.

    Science.gov (United States)

    Bestetti, Reinaldo B; Corbucci, Helio A R; Fornitano, Luis D; Godoy, Moacyr F; Cury, Patricia M; Villafanha, Daniel; Santana, Domingos A; Soares, Marcelo J F; Braile, Domingo M

    2005-01-01

    A 47-year-old woman complained of angina-like chest pain, near-syncope, and syncopal episodes of 17 years' duration. Physical examination was unremarkable. A 12-lead resting ECG showed symmetrically inverted T waves in the inferior and anterolateral leads. A graded treadmill exercise stress test precipitated angina-like chest pain accompanied by a near-syncopal episode associated with a systemic arterial pressure of 60/40 mm Hg. Echocardiography disclosed left ventricular apical obliteration. Left ventriculogram showed a typical "ace of heart'' shadow as well as filling defects and apical obliteration. Endomyocardial biopsy of the left ventricle diagnosed left ventricular endomyocardial fibrosis. Thus, angina-like chest pain and near-syncopal episodes should be added to the list of clinical manifestations of pure left ventricular endomyocardial fibrosis.

  15. Comparing systems for costing hospital treatments. The case of stable angina pectoris.

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

  16. Unusual case of a large midoesophageal diverticulum mimicking unstable angina pectoris.

    Science.gov (United States)

    Hoffmann, J C; Pistorius, G; Müller, P; Zeitz, M

    2002-04-01

    We describe a 77-year-old lady who presented with progressive retrosternal pain radiating to the left arm and the back. After exclusion of cardiac causes a large midoesophageal diverticulum was found on oesophago-gastro-duodenoscopy. Importantly, the retrosternal pain completely disappeared after endoscopic removal of impacted food from the diverticulum. After the surgical resection the patient became fully asymptomatic. This is the first example of angina-like chest pain which definitively resulted from a midoesophageal diverticulum. Therefore, midoesophageal diverticula should be considered as a rare differential diagnosis of exercise-induced retrosternal pain.

  17. Late sodium current: A mechanism for angina, heart failure, and arrhythmia.

    Science.gov (United States)

    Makielski, Jonathan C

    2016-02-01

    The peak sodium current underlies excitability and conduction in heart muscle, but a late sodium current flowing after the peak contributes to maintaining and prolonging the action potential plateau, and also to intracellular sodium loading, which in turn increases intracellular calcium with consequent effects on arrhythmia and diastolic function. Late sodium current is pathologically increased in both genetic and acquired heart disease, making it an attractive target for therapy to treat arrhythmia, heart failure, and angina. This review provides an overview of the underlying bases for the clinical implications of late sodium current block.

  18. Insulin-resistant glucose metabolism in patients with microvascular angina--syndrome X

    DEFF Research Database (Denmark)

    Vestergaard, H; Skøtt, P; Steffensen, R;

    1995-01-01

    Studies in patients with microvascular angina (MA) or the cardiologic syndrome X have shown a hyperinsulinemic response to an oral glucose challenge, suggesting insulin resistance and a role for increased serum insulin in coronary microvascular dysfunction. The aim of the present study...... was to examine whether patients with MA are insulin-resistant. Nine patients with MA and seven control subjects were studied. All were sedentary and glucose-tolerant. Coronary arteriography was normal in all participants, and exercise-induced coronary ischemia was demonstrated in all MA patients. A euglycemic...

  19. Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

    DEFF Research Database (Denmark)

    Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

    2010-01-01

    successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...... tolerable level of stimulation was carried out to exclude inference with the ICD. The following treatment with SCS has in all cases been successful, with significant pain relief and improved quality of life. There were no incidences of inappropriate defibrillator shocks. Spinal cord stimulation...

  20. Association between thyroid dysfunction and incidence of atrial fibrillation in patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    徐予

    2014-01-01

    Objective To explore the correlation between incidence of atrial fibrillation(AF)and thyroid dysfunction.Methods Patients with stable angina pectoris with thyroid function test results hospitalized at Fuwai Hospital from2011 Jan to 2011 Dec were included in this analysis(n=2 541).General clinical data and related biochemical parameters were analyzed.We divided patients into 5subgroups according to TSH levels:<0.55 mI U/L(n=105),0.55-2.49 mI U/L(n=1 599),2.50-4.77

  1. Percutaneous coronary intervention for poor coronary microcirculation reperfusion of patients with stable angina pectoris.

    Science.gov (United States)

    Li, J S; Zhao, X J; Ma, B X; Wang, Z

    2016-01-01

    Percutaneous coronary intervention (PCI) has been extensively applied to repair the forward flow of diseased coronary artery and can achieve significant curative results. However, some patients with acute myocardial infarction (AMI) develop non-perfusion or poor perfusion of cardiac muscle tissue after PCI, which increases the incidence of cardiovascular events and the death rate. PCI can dredge narrowed or infarct-related artery (IRA) and thus induce full reperfusion of ischemic myocardium. It is found in practice that some cases of AMI still have no perfusion or poor perfusion in myocardial tissue even though coronary angiography suggests opened coronary artery after PCI, which increases the incidence of vascular events and mortality. Therefore, to explore the detailed mechanism of PCI in treating coronary microcirculation of patients with stable angina pectoris, we selected 140 patients with stable angina pectoris for PCI, observing the index of microcirculatory resistance (IMR) of descending branch and changes of myocardial injury markers and left ventricular systolic function, and made a subgroup analysis based on the correlation between clinical indexes, IMR and other variables of diabetic and non-diabetic patients, PCI-related and non-PCI-related myocardial infarction patients. The results suggest that IMR of anterior descending branch after PCI was higher compared to that before PCI, and the difference was significant (P less than 0.05); creatine kinase-MB (CK-MB), myohemoglobin and high sensitive troponin T were all increased after PCI, and the difference was also significant (P less than 0.05); brain natriuretic peptide (BNP) level became higher after PCI, with significant difference (P less than 0.05); left ventricular ejection fraction (LVEF) declined after PCI, and the difference before and after PCI was statistically significant (P less than 0.05). Moreover, subgroup analysis results of the three groups all demonstrated statistically significant

  2. Brugada syndrome: a case report of an unusual association with vasospastic angina and coronary myocardial bridging.

    Science.gov (United States)

    Imazio, Massimo; Ghisio, Aldo; Coda, Luisella; Tidu, Massimo; Belli, Riccardo; Trinchero, Rita; Brusca, Antonio

    2002-04-01

    This report describes a case of an unusual association between vasospastic angina, coronary myocardial bridging, and Brugada syndrome. The patient complained of chest pain followed by rhythmic palpitation and syncope. Brugada syndrome ECG markers were documented with transient ST-segment elevation in lateral leads. A coronary angiogram showed a myocardial bridging in the left anterior descending artery and coronary vasospasm was reproduced after intracoronary ergonovine injection in the circumflex coronary artery. Ventricular fibrillation was induced by programmed electrical stimulation. The described association can be important because interaction between ischemia and Brugada syndrome electrophysiological substrate could modulate individual susceptibility to life-threatening ventricular tachyarrhythmias.

  3. A CASE OF LUDWiG ANGiNA ENDING WITH MORTALITY

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    Abdullah Onur Goksel

    2013-06-01

    Full Text Available Ludwig angina is a serious infection which is defines as edema, quickly progressing gangrenous sellulitis of soft tissues in neck and flor of the mouth. Airway obstruction is the most common cause of death. We present a case who applied to our outpatient clinic with a swelling under jaw and neck and was dignosed a a Ludwig Anjina. Broad spectrum antibiotherapy was given and followed without tracheotomy. He died because of cardiac arrest. [J Contemp Med 2013; 3(2.000: 112-115

  4. Cetoacidosis Diabética como causa de ingreso en UTIPP

    Directory of Open Access Journals (Sweden)

    Frank Ernesto Medina Alí

    2005-01-01

    Full Text Available Se realizó un estudio descriptivo con el objetivo de describir el comportamiento de los ingresos por cetoacidosis diabética en adolescentes en la unidad de terapia intensiva polivalente pediátrica (utipp de Camagüey, desde enero de 1999 hasta diciembre del 2003, teniendo en cuenta que el adolescente diabético presenta problemas y características en su comportamiento que lo hacen marcadamente diferentes del niño y el adulto diabético y generalmente la diabetes del adolescente se considera ¿inestable¿ dado sus frecuentes episodios de hipoglucemia y cetoacidosis . El universo quedó integrado por 54 pacientes que ingresaron por esta causa, los cuales se obtuvieron del libro de ingresos y egresos y de la revisión de historias clínicas y los datos se procesaron en microstat. Se obtuvo como resultados que el grupo de edades más afectados fue el de 10-14 años con 62.96%, las féminas con 57.40% predominando como el año más afectado, el 1999 con 17 pacientes para un 31.48% con una disminución significativa en los años siguientes sólo ingresando el 12.97% en el 2003, el debut de la diabetes y las transgresiones dietéticas fueron las causas que más se presentan. Se concluye que la cetoacidosis es frecuente en la adolescencia, que la CAD severa constituye la forma más frecuente de debut, y que todo médico debe estar capacitado para reconocer precozmente dicho cuadro con el fin de evitar las complicaciones fatales para la vida de estos pacientes.

  5. Efficacy of Ligustrazine Injection as Adjunctive Therapy for Angina Pectoris: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Shao, Huikai; Zhao, Lingguo; Chen, Fuchao; Zeng, Shengbo; Liu, Shengquan; Li, Jiajia

    2015-11-29

    BACKGROUND In the past decades, a large number of randomized controlled trials (RCTs) on the efficacy of ligustrazine injection combined with conventional antianginal drugs for angina pectoris have been reported. However, these RCTs have not been evaluated in accordance with PRISMA systematic review standards. The aim of this study was to evaluate the efficacy of ligustrazine injection as adjunctive therapy for angina pectoris. MATERIAL AND METHODS The databases PubMed, Medline, Cochrane Library, Embase, Sino-Med, Wanfang Databases, Chinese Scientific Journal Database, Google Scholar, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and the Chinese Science Citation Database were searched for published RCTs. Meta-analysis was performed on the primary outcome measures, including the improvements of electrocardiography (ECG) and the reductions in angina symptoms. Sensitivity and subgroup analysis based on the M score (the refined Jadad scores) were also used to evaluate the effect of quality, sample size, and publication year of the included RCTs on the overall effect of ligustrazine injection. RESULTS Eleven RCTs involving 870 patients with angina pectoris were selected in this study. Compared with conventional antianginal drugs alone, ligustrazine injection combined with antianginal drugs significantly increased the efficacy in symptom improvement (odds ratio [OR], 3.59; 95% confidence interval [CI]: 2.39 to 5.40) and in ECG improvement (OR, 3.42; 95% CI: 2.33 to 5.01). Sensitivity and subgroup analysis also confirmed that ligustrazine injection had better effect in the treatment of angina pectoris as adjunctive therapy. CONCLUSIONS The 11 eligible RCTs indicated that ligustrazine injection as adjunctive therapy was more effective than antianginal drugs alone. However, due to the low quality of included RCTs, more rigorously designed RCTs were still needed to verify the effects of ligustrazine injection as adjunctive therapy for

  6. Anomalous Origin of a Stenosed Left Circumflex Coronary Artery in a Patient Presenting with Unstable Angina: A Case Report

    Directory of Open Access Journals (Sweden)

    Vakili Hossein

    2016-12-01

    Full Text Available 73 year-old man presented to our emergency department with complaint of retrosternal chest pain since 2 day and admitted with diagnosis of unstable angina. He underwent diagnostic coronary angiography in which left circumflex artery (LCX was not visualized during injection of the left coronary artery; indeed, it was originated, with common origin with RCA, from right coronary sinus of Valsalva. This case report is one of the uncommon cases with aberrant coronary arteries who presented with unstable angina. Moreover, coronary angiography with following coronary angioplasty was performed for him in a challenging course and angle for coronary intervention.

  7. Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease

    DEFF Research Database (Denmark)

    Mygind, Naja Dam; Michelsen, Marie Mide; Pena, Adam;

    2016-01-01

    BACKGROUND: The majority of women with angina-like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary.......01), hypertension (P=0.02), current smoking (Pheart rate (P.... CONCLUSION: Impaired CFVR was detected in a substantial proportion, which suggests that coronary microvascular dysfunction plays a role in the development of angina pectoris. CFVR was associated with few cardiovascular risk factors, suggesting that CFVR is an independent parameter in the risk evaluation...

  8. [Percutaneous myocardial laserrevascularization (PMR), a new therapy for patients with refractory angina pectoris].

    Science.gov (United States)

    Lauer, B; Stahl, F; Bratanow, S; Schuler, G

    2000-10-01

    In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous coronary angioplasty or coronary artery bypass surgery, transmyocardial laser revascularization (TMR) often leads to improvement of clinical symptoms and increased exercise capacity. One drawback of TMR is the need for surgical thoracotomy in order to gain access to the epicardial surface of the heart. Therefore, a catheter-based system has been developed, which allows creation of laser channels into the myocardium from the left ventricular cavity.Between January 1997 and November 1999, this "percutaneous myocardial laser-revascularization" (PMR) was performed in 85 patients at the Herzzentrum Leipzig. In 43 patients, only one region of the heart (anterior, lateral, inferior or septal) was treated with PMR; in 42 patients two or three regions were treated in one session. 12.3±4.3 (range 4-22) channels/region were created into the myocardium.Six months after PMR, the majority of patients reported significant improvement of clinical symptoms (CCS class at baseline: 3.3±0.4; after 6 months: 1.6±0.9) (p PMR treated regions.PMR seems to be a safe and feasible new therapeutic option for patients with refractory angina pectoris due to end-stage coronary artery disease. The first results indicate improvement of clinical symptoms and increased exercise capacity; evidence of increased perfusion in the laser-treated regions is still lacking.

  9. [Percutaneous myocardial laser revascularization (PMR), a new therapeutic procedure for patients with refractory angina pectoris].

    Science.gov (United States)

    Lauer, B; Stahl, F; Bratanow, S; Schuler, G

    2000-01-01

    In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous coronary angioplasty or coronary artery bypass surgery, transmyocardial laser revascularization (TMR) often leads to improvement of clinical symptoms and increased exercise capacity. One drawback of TMR is the need for surgical thoracotomy in order to gain access to the epicardial surface of the heart. Therefore, a catheter-based system has been developed, which allows creation of laser channels into the myocardium from the left ventricular cavity. Between January 1997 and November 1999, this "percutaneous myocardial laser-revascularization" (PMR) was performed in 85 patients at the Herzzentrum Leipzig. In 43 patients, only one region of the heart (anterior, lateral, inferior or septal) was treated with PMR; in 42 patients two or three regions were treated in one session. 12.3 +/- 4.3 (range 4-22) channels/region were created into the myocardium. Six months after PMR, the majority of patients reported significant improvement of clinical symptoms (CCS class at baseline: 3.3 +/- 0.4; after 6 months: 1.6 +/- 0.9) (p PMR treated regions. PMR seems to be a safe and feasible new therapeutic option for patients with refractory angina pectoris due to end-stage coronary artery disease. The first results indicate improvement of clinical symptoms and increased exercise capacity; evidence of increased perfusion in the laser-treated regions is still lacking.

  10. Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise {sup 201}Tl myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hori, Masatsugu; Nishimura, Tsunehiko [Osaka Univ., Suita (Japan). Medical School

    1996-12-01

    Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise {sup 201}Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients` impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on {sup 201}Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated `improved` or better. In the improvement rating on the exercise {sup 201}Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as `improved` or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as `no problem`, while in 4 patients it was evaluated as `useful` or more. (author)

  11. An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

    Directory of Open Access Journals (Sweden)

    Xiaoxia Zhang

    2015-01-01

    Full Text Available Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI for unstable angina (UA. Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

  12. RE-EVALUATION OF THE MECHANISM AND TREATMENT OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 陈在嘉; 徐义枢; 高润霖; 寇文蓉; 姚康宝; 于全俊; 陶寿琪

    1996-01-01

    30 patients with angina decubittus(AD) were studied during hospitalization. These patients were found to have severe coronary artery obstructive lesions and an increase of myocardial oxygen consumption (MOC) before the onset to AD, indicating that AD belongs to the category of effort angina. 18 patients were investigated by continuous hemodynamic mordtoring. Three patients had significant increase in pulmonary artery diastolic pressure (PADP) before the onset. In the other 15 patients, PADP increased slightly in J2 and remained unchanged in 3 cases before the onset. Left ventriculography showed ejection fraction (EF))45% in 25 of the 27 patients. These results indicate that left ventricular (LV) systolic dysfunction is not a major factor in the pathogenesis of AD. The patients with LVEDP>12 mmHg constituted 60% of 25 patients with EF)45%, suggesting that these patients had obvious LV diastolic dysfunction, which may he the major factor in the pathogenesis of AD. According to the results of our treatment, Beta blockers may be used as the major form of treatment in the patients with AD.

  13. El libro como performance

    OpenAIRE

    2015-01-01

    La comunidad poética Estación Pringles entabla un diálogo intrigante con el formato libro. Por una parte, su acercamiento teatral a la poesía parecería excluir la posibilidad de ver este medio como un modelo para el proyecto. Sin embargo, en su diálogo con la línea poética iniciada por Stéphane Mallarmé, esta iniciativa artística propone un concepto del libro como performance. Esta orientación es evidente, además, en la producción impresa de Estación Pringles. The poetry community Estación...

  14. O corpo como pulso

    Directory of Open Access Journals (Sweden)

    Flavia Liberman

    Full Text Available O corpo é foco de muitos estudos e intervenções. Alguns paradigmas o concebem apenas em seu aspecto sensório-motor, enquanto outros transitam prioritariamente por uma dimensão psicológica. Procurando contribuir para a formulação de outras perspectivas no campo, apresentam-se aspectos da concepção de corpo de Stanley Keleman em ressonância com os estudos de Regina Favre. A partir de cenas clínicas em grupos de seminários, podemos pensar o corpo como pulso, multimídia, multifacetado, que se (des constrói permanentemente nos encontros. Articulando experiências clínicas da autora como terapeuta ocupacional e docente da graduação e em grupos de estudos, essas concepções servem como guia para uma clínica pensada, construída e balizada pelo corpo mediante utilização de abordagens corporais para a promoção de encontros plasmados por afetos e acontecimentos, na tentativa de criar corpos que possam sustentar as intensidades vividas e permitam a observação de si, a aproximação com o outro e a produção de singularidades.

  15. O corpo como pulso

    Directory of Open Access Journals (Sweden)

    Flavia Liberman

    2010-06-01

    Full Text Available O corpo é foco de muitos estudos e intervenções. Alguns paradigmas o concebem apenas em seu aspecto sensório-motor, enquanto outros transitam prioritariamente por uma dimensão psicológica. Procurando contribuir para a formulação de outras perspectivas no campo, apresentam-se aspectos da concepção de corpo de Stanley Keleman em ressonância com os estudos de Regina Favre. A partir de cenas clínicas em grupos de seminários, podemos pensar o corpo como pulso, multimídia, multifacetado, que se (des constrói permanentemente nos encontros. Articulando experiências clínicas da autora como terapeuta ocupacional e docente da graduação e em grupos de estudos, essas concepções servem como guia para uma clínica pensada, construída e balizada pelo corpo mediante utilização de abordagens corporais para a promoção de encontros plasmados por afetos e acontecimentos, na tentativa de criar corpos que possam sustentar as intensidades vividas e permitam a observação de si, a aproximação com o outro e a produção de singularidades.

  16. Addition of felodipine to metoprolol vs replacement of metoprolol by felodipine in patients with angina pectoris despite adequate beta-blockade - Results of the felodipine ER and metoprolol CR in angina (FEMINA) study

    NARCIS (Netherlands)

    Dunselman, P; Liem, AH; Verdel, G; Kragten, H; Bosma, A; Bernink, P

    1997-01-01

    Aims The study aimed to compare the addition of felodipine to metoprolol, and of the replacement of metoprolol by felodipine, with continuation of metoprolol, in patients with angina pectoris despite optimal beta-blockade. Methods and results The study was double-blind, parallel, randomized and cont

  17. Regional myocardial perfusion in patients with atherosclerotic coronary artery disease, at rest and during angina pectoris induced by tachycardia

    Energy Technology Data Exchange (ETDEWEB)

    Maseri, A.; L' Abbate, A.; Pesola, A.; Michelassi, C.; Marzilli, M.; De Nes, M.

    1977-03-01

    We studied regional myocardial perfusion by scintigraphic computer-assisted analysis of initial distribution, washout rates, and residual activity of /sup 133/Xe injected into the left coronary artery of four patients with normal arteriograms and 14 patients with coronary stenosis. At rest, residual activity in poststenotic regions was always greater than in control regions, but initial washout rates were not slower. During angina, following xenon injections, the amount of indicator distributed to the poststenotic regions was markedly reduced; the increase of the initial washout rates was smaller than in control regions relative to rest, and residual activity was higher. Initial washout rates did not differ as much as from those of normal myocardium because in severe ischemia too little indicator is deposited initially in these regions to produce a change of any magnitude. Indeed, when angina was induced immediately after the xenon injection, poststenotic washout rates became much slower during angina than at rest, a finding that implicates functional factors in impairing poststenotic myocardial perfusion during angina.

  18. Effects of successful percutaneous transluminal coronary angioplasty on global and regional left ventricular function in unstable angina pectoris

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); P.G. Hugenholtz (Paul)

    1987-01-01

    textabstractSixty-eight patients (58 men, 10 women, mean age 56.3 years, range 31 to 72) with unstable angina pectoris, either initially stabilized with or refractory to optimal pharmacologic treatment, were studied to determine whether regional dysfunction due to stunning of the myocardium caused b

  19. Electrical neuromodulation improves myocardial perfusion and ameliorates refractory angina pectoris in patients with syndrome X : fad or future?

    NARCIS (Netherlands)

    Jessurun, G; Hautvast, RWM; Tio, RA; DeJongste, M

    2003-01-01

    At present, there is no reliable antianginal drug therapy for patients with cardiac syndrome X. Therefore, the effect of electrical neuromodulation on refractory angina pectoris and myocardial perfusion in cardiac syndrome X was assessed. Eight patients (aged 55 +/- 7 years) with heterogeneous myoca

  20. Modulation of intrinsic cardiac neurons by spinal cord stimulation : implications for its therapeutic use in angina pectoris

    NARCIS (Netherlands)

    Foreman, RD; Linderoth, B; Ardell, JL; Barron, KW; Chandler, MJ; Hull, SS; TerHorst, GJ; DeJongste, MJL; Armour, JA

    2000-01-01

    Objective: Electrical stimulation of the dorsal aspect of the upper thoracic spinal cord is used increasingly to treat patients with severe angina pectoris refractory to conventional therapeutic strategies. Clinical studies show that spinal cord stimulation (SCS) is a safe adjunct therapy for cardia

  1. Creatine kinase and creatine kinase subunit-B in coronary sinus blood in pacing-induced angina pectoris

    DEFF Research Database (Denmark)

    Bagger, J P; Ingerslev, J; Heinsvig, E M

    1982-01-01

    In nine out of 10 patients with angiographic documented coronary artery disease, pacing-induced angina pectoris provoked myocardial production of lactate, whereas no significant release of either creatine kinase or creatine kinase subunit-B to coronary sinus and peripheral venous blood could...

  2. Infuences of Previous Angina Pectoris on Coronary Collateral Circulation and Left Ventricular Function in Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    罗初凡; 杜志民; 胡承恒; 梅卫义; 伍贵富; 李怡; 马虹

    2001-01-01

    Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed.Results ① In the 307 patients, there were 192(62.5 % ) with previous angina [PA ( + ) group] and 115 (37.5 % ) without [PA ( - ) group]. ②The peak creatine kinase (CK) and CK- MB were significantly higher in PA (-) group than in PA (+) group ( P < 0.05 for both comparisons) . ③ Collateral circulation to infarct- related artery was more likely to be present in PA (+) group than in PA (-) group ( P < 0.05) . ④ The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA ( + ) group than in PA ( - ) group ( P < 0.01 for both comparisons) .Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular unction.

  3. Outcomes after revascularisation with everolimus- and sirolimus-eluting stents in patients with acute coronary syndromes and stable angina pectoris

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Thayssen, Per; Hansen, Henrik S

    2014-01-01

    Aims: The aim of this substudy of the SORT OUT IV trial was to compare clinical outcomes among patients with acute coronary syndromes (ACS) and stable angina pectoris (SAP) treated with everolimus-eluting stents (EES) or sirolimus-eluting stents (SES). Methods and results: We performed a post hoc...

  4. Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris

    DEFF Research Database (Denmark)

    Ravkilde, J; Nissen, H; Mickley, H

    1994-01-01

    The incidence of cardiac troponin T (Tn-T) and creatine kinase (CK) isoenzyme MB mass release was studied in 23 patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA). Serial blood samples were drawn for measurement of serum Tn...

  5. Burden of Hospital Admission and Repeat Angiography in Angina Pectoris Patients with and without Coronary Artery Disease

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrom, Steen Z; Hvelplund, Anders

    2014-01-01

    AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD) and repeat coronary angiography (CAG) in stable angina pectoris (SAP) with no obstructive coronary artery disease (CAD) versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11...

  6. The Changes of Vasoactive Substances Originated Endothelium in Patients with Unstable Angina Pectoris Treated by Improved Thrombolytic Therapy

    Institute of Scientific and Technical Information of China (English)

    Wang Congxia; Niu Xiaolin; Li Yongqin; Zhang MingJuan; Ding Kangning

    2004-01-01

    Objectives To analyze the changes of vasoactive substances originated from endothelium in patients with unstable angina pectoris treated by modified thrombolytic therapy and explore the mechanisms of the drug to treat unstable angina pectoris.Methods 120 patients with unstable angina pectoris who were not well responsed to common medication were studied. Their ECG stress tests were abnormal and there were ischemic changes in Holter. Urokinase 300,000 U was added in 100 ml normal saline and injected within 30 min once a day for 3 days. 300 mg aspirin was administrated a day before and during urokinase applications. Before and after urokinase treatments, endothelin-1, plasma tissue plasminogen activator and its inhibitor-1were determined. Results Compared with pretreatments, after treatments, the activities of tissue plasminogen activator increased, endothelin-1 and the inhibitor-1 decreased. The changes were significant. Conclusions Modified thrombolytic therapy can regulate the vasoactive substances originated endothelium in patients with unstable angina pectoris . The major substances include endothelin-1 ,plasma tissue plasminogen activator and inhibitor-1. This mechanism may suggest that urokinase can treat coronary heart disease effectively.

  7. EFFICACY OF SPINAL-CORD STIMULATION AS ADJUVANT THERAPY FOR INTRACTABLE ANGINA-PECTORIS - A PROSPECTIVE, RANDOMIZED CLINICAL-STUDY

    NARCIS (Netherlands)

    DEJONGSTE, MJL; HAUTVAST, RWM; HILLEGE, HL; LIE, KI

    1994-01-01

    Objectives. In a prospective, randomized study with an 8-week follow-up period, we evaluated the efficacy of spinal cord stimulation an exercise capacity and quality of life in patients with intractable angina. Background. Despite important achievements in therapy for ischemic heart disease, there r

  8. Effect of preoperative angina pectoris on cardiac outcomes in patients with previous myocardial infarction undergoing major noncardiac surgery (data from ACS-NSQIP).

    Science.gov (United States)

    Pandey, Ambarish; Sood, Akshay; Sammon, Jesse D; Abdollah, Firas; Gupta, Ena; Golwala, Harsh; Bardia, Amit; Kibel, Adam S; Menon, Mani; Trinh, Quoc-Dien

    2015-04-15

    The impact of preoperative stable angina pectoris on postoperative cardiovascular outcomes in patients with previous myocardial infarction (MI) who underwent major noncardiac surgery is not well studied. We studied patients with previous MI who underwent elective major noncardiac surgeries within the American College of Surgeons-National Surgical Quality Improvement Program (2005 to 2011). Primary outcome was occurrence of an adverse cardiac event (MI and/or cardiac arrest). Multivariable logistic regression models evaluated the impact of stable angina on outcomes. Of 1,568 patients (median age 70 years; 35% women) with previous MI who underwent major noncardiac surgery, 5.5% had postoperative MI and/or cardiac arrest. Patients with history of preoperative angina had significantly greater incidence of primary outcome compared to those without anginal symptoms (8.4% vs 5%, p = 0.035). In secondary outcomes, reintervention rates (22.5% vs 11%, p angina. In multivariable analyses, preoperative angina was a significant predictor for postoperative MI (odds ratio 2.49 [1.20 to 5.58]) and reintervention (odds ratio 2.40 [1.44 to 3.82]). In conclusion, our study indicates that preoperative angina is an independent predictor for adverse outcomes in patients with previous MI who underwent major noncardiac surgery, and cautions against overreliance on predictive tools, for example, the Revised Cardiac Risk Index, in these patients, which does not treat stable angina and previous MI as independent risk factors during risk prognostication.

  9. Importance of thrombosis and thrombolysis in silent ischaemia: comparison of patients with acute myocardial infarction and unstable angina.

    Science.gov (United States)

    Gurfinkel, E.; Altman, R.; Scazziota, A.; Rouvier, J.; Mautner, B.

    1994-01-01

    OBJECTIVE--To investigate whether plaque rupture and thrombosis have a role in silent ischaemia as well as in unstable angina. DESIGN--Prospective analysis of the results of haemostatic diagnostic tests at the moment of developing silent ischaemia at rest. SETTING--Coronary care unit. PATIENTS--22 patients with acute myocardial infarction, 12 patients with symptomatic angina (unstable angina), and 10 normal volunteers (control group). INTERVENTIONS--Continuous cardiac monitoring detected 15 asymptomatic episodes (silent ischaemia) in 6 patients with unstable angina. Blood samples were obtained at admission and when an asymptomatic alteration was detected and 10 minutes later. MAIN OUTCOME MEASURES--Comparisons of concentrations of tissue plasminogen activator, urokinase type plasminogen activator, tissue plasminogen activator inhibitor-1, cross-linked fibrin degradation products, von Willebrand factor, and thrombin-antithrombin III complexes in patients and controls at admission; same comparisons in patients with silent ischaemia at the start of an episode and 10 minutes later. RESULTS--Tissue plasminogen activator concentrations were raised at admission in patients with acute myocardial infarction (mean (SD) 14.2 (6) ng/ml) and in patients with unstable angina (10.1 (2.5) ng/ml) in comparison with controls (5.1 (2.7) ng/ml, p < 0.01 and < 0.05 respectively). There was no differences between the two groups of patients, however. Similar results were observed at the start of a silent ischaemic episode (9.8 (1.9) ng/ml) and 10 minutes later (10.5 (2.9) ng/ml) compared with controls (p < 0.05). Tissue plasminogen activator inhibitor-1 concentrations were raised in patients with acute myocardial infarction (45.1 (15) ng/ml) compared with volunteers (20.6 (16) ng/ml, p < 0.01). In patients with silent ischaemia tissue plasminogen activator inhibitor-1 concentrations were slightly but not significantly increased. Concentrations of cross-linked fibrin degradation products

  10. Inherited chromosomally integrated human herpesvirus 6 as a predisposing risk factor for the development of angina pectoris.

    Science.gov (United States)

    Gravel, Annie; Dubuc, Isabelle; Morissette, Guillaume; Sedlak, Ruth H; Jerome, Keith R; Flamand, Louis

    2015-06-30

    Inherited chromosomally integrated human herpesvirus-6 (iciHHV-6) results in the germ-line transmission of the HHV-6 genome. Every somatic cell of iciHHV-6+ individuals contains the HHV-6 genome integrated in the telomere of chromosomes. Whether having iciHHV-6 predisposes humans to diseases remains undefined. DNA from 19,597 participants between 40 and 69 years of age were analyzed by quantitative PCR (qPCR) for the presence of iciHHV-6. Telomere lengths were determined by qPCR. Medical records, hematological, biochemical, and anthropometric measurements and telomere lengths were compared between iciHHV-6+ and iciHHV-6- subjects. The prevalence of iciHHV-6 was 0.58%. Two-way ANOVA with a Holm-Bonferroni correction was used to determine the effects of iciHHV6, sex, and their interaction on continuous outcomes. Two-way logistic regression with a Holm-Bonferroni correction was used to determine the effects of iciHHV6, sex, and their interaction on disease prevalence. Of 50 diseases monitored, a single one, angina pectoris, is significantly elevated (3.3×) in iciHHV-6+ individuals relative to iciHHV-6- subjects (P = 0.017; 95% CI, 1.73-6.35). When adjusted for potential confounding factors (age, body mass index, percent body fat, and systolic blood pressure), the prevalence of angina remained three times greater in iciHHV-6+ subjects (P = 0.015; 95%CI, 1.23-7.15). Analyses of telomere lengths between iciHHV-6- without angina, iciHHV-6- with angina, and iciHHV-6+ with angina indicate that iciHHV-6+ with angina have shorter telomeres than age-matched iciHHV-6- subjects (P = 0.006). Our study represents, to our knowledge, the first large-scale analysis of disease association with iciHHV-6. Our results are consistent with iciHHV-6 representing a risk factor for the development of angina.

  11. COMO? PALETAS MEXICANAS BRASILEIRAS?

    Directory of Open Access Journals (Sweden)

    Daniela Maria Alves Chaud

    2016-03-01

    Full Text Available As informações sobre alimentação estão mais acessíveis e democráticas. As tendências alimentares são inspiradas por diversos fatores, mas sempre estão associados à moda, mídia e como forma de conjectura de um estilo de vida. Há pouco tempo, as grandes cidades brasileiras foram invadidas por uma nova mania: as paletas mexicanas, que, na verdade, não são “tão mexicanas”. Esses sorvetes apresentam qualidades organolépticas marcantes, em virtude, entre outros fatores, ao alto teor de açúcar e, em alguns casos, de gorduras. A concepção gourmetizada e natural dessa iguaria, seu custo e as propriedades nutricionais são peculiares e, aparentemente, um modismo. Esse trabalho teve como objetivo conhecer a composição desses produtos, a partir das informações nutricionais contidas nos sites das empresas produtoras, bem como as suas peculiaridades e concepções. Apesar da conotação natural e gastronômica, alto valor calórico, gorduras (especialmente na versão recheada sabor brigadeiro e elevadas quantidades de açúcares, foram encontrados, em média, por unidade: 207,2 Kcal; 38,4g de carboidratos; 3,9g de proteínas e 5,3g de gorduras. Uma rica ênfase na cultura mexicana, religiosidade e identidade visual marcante foram identificadas nos sites dos produtos pesquisados.

  12. Unstable angina

    Science.gov (United States)

    ... nih.gov/pubmed/25260718 . Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation myocardial infarction. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  13. El docente como investigador

    OpenAIRE

    Corrales Sánchez, Olga; Jiménez Carrillo, María de los Ángeles

    2009-01-01

    En el campo de la docencia se presenta a menudo un gran abismo entre teoría y práctica. Los docente en su mayoría consideran que la teoría y la investigación tienen muy poca la relación con su quehacer diario.El propósito de este trabajo es el de presentar algunas ideas acerca del rol del docente como investigador. Es del conocimiento de las autoras el temor y la preocupación que expresan lo maestros y profesores ante al posibilidad de realizar investigaciones sobre su trabajo en el aula.Segú...

  14. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chen Mao

    2013-01-01

    Full Text Available Chinese herbal medicine (CHM has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR=0.50, 95% confidence interval (CI 0.33–0.78, myocardial infarction (RR=0.32, 95% CI 0.14–0.72, heart failure (RR=0.37, 95% CI 0.15–0.91, and angina (RR=0.46, 95% CI 0.30–0.71 than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR=0.46, 95% CI 0.32–0.66, myocardial infarction (RR=0.37, 95% CI 0.26–0.54, and angina (RR=0.36, 95%CI 0.26–0.51. Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR=0.34, 95% CI 0.17–0.68 and angina (RR=0.46, 95% CI 0.30–0.70 in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine.

  15. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

    Institute of Scientific and Technical Information of China (English)

    Wen-Ying Jin; Xiu-Juan Zhao; Hong Chen

    2016-01-01

    Background:Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD).Women,more frequently than men,are known to develop atypical angina symptoms.The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men.Methods:We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or proven CAD who successively underwent both MSCT and invasive CAG.CAD was defined as any coronary stenosis of≥50% on conventional invasive CAG,which was used as the reference standard.The patients were divided into typical and atypical groups based on their symptoms of angina pectoris.The diagnostic accuracy of MSCT,including its sensitivity,specificity,negative predictive value,and positive predictive value (PPV),was calculated to determine the usefulness of MSCT in assessing stenoses.The diagnostic performance of MSCT was also assessed by constructing receiver operating characteristic (ROC) curves.Results:The PPV (91% vs.97%,x2 =5.705,P < 0.05) and diagnostic accuracy (87% vs.93%,x2 =5.093,P < 0.05) of MSCT in detecting CAD were lower in women than in men.Atypical presentation was an independent influencing factor on the diagnostic accuracy of MSCT in women (odds ratio =4.94,95% confidence intervals:1.16-20.92,Walds =4.69,P < 0.05).Compared with those in the atypical group,women with typical angina pectoris had higher PPV (98% vs.74%,x2 =17.283.P < 0.001),diagnostic accuracy (93% vs.72%,x2 =9.571,P < 0.001),and area under the ROC curve (0.91 vs.0.64,Z =2.690,P < 0.01) in MSCT diagnosis.Conclusions:Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients,gender and atypical symptoms might have some influence on its diagnostic accuracy.

  16. Phase changes caused by hyperventilation stress in spastic angina pectoris analyzed by first-pass radionuclide ventriculography

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Jin; Takeda, Tohoru; Ajisaka, Ryuichi; Masuoka, Takeshi; Watanabe, Sigeyuki; Sato, Motohiro; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Toyama, Hinako; Ishikawa, Nobuyoshi

    1999-02-01

    To understand the effect of hyperventilation (HV) stress in patients with spastic angina, left ventricular (LV) contraction was analyzed by quantitative phase analysis. The study was performed on 36 patients with spastic angina pectoris, including vasospastic angina pectoris (VspAP: 16 patients) and variant angina pectoris (VAP: 20 patients). First-pass radionuclide ventriculography (first-pass RNV) was performed at rest and after HV stress, and standard deviation of the LV phase distribution (SD) was analyzed. The SD was lower in patients with VspAP than in VAP(12.8{+-}1.4 degrees vs. 14.6{+-}2.2 degrees, p<0.005) at rest. After HV stress, the SD (HVSD) tended to increase in VspAP patients (62.5%), whereas the SD decreased in VAP patients (70%). Due to HV stress, the percentage change in SD (%SD) in VspAP patients was 8.9{+-}23.7% whereas that in VAP patients was -9.1{+-}17.3% (p<0.01). Moreover, phase histograms were divided into HVSD increase and HVSD decrease groups. The HVSD increase group had a decrease of HVEF, but the HVSD decrease group tended to have more decreased HVEF than the HVSD increase group. These results indicate that spastic angina pectoris patients show various responses to HV stress. The HVSD increase group might have additional myocardial ischemia due to regional coronary spasm. In contrast, in the HVSD decrease group severe LV dysfunction or diffuse wall motion abnormality might have been generated, and this caused a reduction in the SD value. Phase analysis would therefore add new information regarding electrocardiographically silent myocardial ischemia due to coronary spasm, and HV stress might increase sensitivity for the detection of abnormalities in quantitative phase analysis, especially in VspAP patients. (author)

  17. APLICACIÓN DE LAS METODOLOGÍAS ÁGILES EN EL PROCESO DE PRODUCCIÓN DE PIEZAS DE ARTE DE NUEVOS MEDIOS: BIO-LENCIA COMO CASO DE ESTUDIO

    Directory of Open Access Journals (Sweden)

    María Teresa Gutiérrez Martínez

    2011-08-01

    Full Text Available Inspirado en la idea original del artista plástico Alfredo Salomón y bajo el título de Bio-lencia, se creó un sistema en tiempo real que integra dos áreas del conocimiento: Arte y Computación. En este artículo analizamos, las características de la pieza como un producto de software y los retos que este tipo de productos presentan desde el punto de vista de la ingeniería de software. Presentamos una clasificación para el arte de medios inestables destacando sus características como productos de software y se realiza un ejercicio de producción de una pieza de este tipo utilizando metodologías ágiles de desarrollo. En particular discutimos la utilización de la Programación Extrema, la cual en el caso que aquí se presenta, permitió interactuar correctamente con el artista, quien es también el desarrollador principal. Se menciona también como las características de confiabilidad, robustez y tiempo de respuesta fueron de particular importancia para la correcta evaluación y funcionamiento del software que da vida a Bio-lencia. Finalmente como parte de las conclusiones se discuten los problemas y las lecciones que aprendimos durante el desarrollo de Bio-lencia.

  18. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    OpenAIRE

    Chen Mao; Chung, Vincent C.H.; Jin-Qiu Yuan; Yuan-Yuan Yu; Zu-Yao Yang; Xin-Yin Wu; Jin-Ling Tang

    2013-01-01

    Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33–0.78), myocar...

  19. Antianginal efficacy of the combination of felodipine-metoprolol 10/100 mg compared with each drug alone in patients with stable effort-induced angina pectoris

    DEFF Research Database (Denmark)

    Emanuelsson, H; Egstrup, K; Nikus, K

    1999-01-01

    -induced angina pectoris. The secondary objective was to compare the tolerability of the 3 treatments. METHODS: The main criteria for inclusion were stable effort-induced angina pectoris for at least 2 months before the enrollment and a positive bicycle exercise test result. Patients were allocated to once...... was significantly lower in the groups receiving felodipine-metoprolol and metoprolol than in the group receiving felodipine alone. The combination and metoprolol were better tolerated than felodipine alone. CONCLUSIONS: In stable angina pectoris, the combination felodipine-metoprolol 10/100 mg and felodipine 10 mg...

  20. Fracturas intertrocantéricas inestables tratadas con clavos endomedulares cortos. Intertrocantéricos/Subtrocantéricos. Valoración de la calidad de vida y de la recuperación funcional. [Unstable intertrochanteric fractures treated with ITST short intramedullary nails. Quality of life assessment and functional recovery.

    Directory of Open Access Journals (Sweden)

    Federico José Burgo

    2015-04-01

    Full Text Available Introducción El objetivo del presente estudio consistió en evaluar una serie de pacientes con fracturas intertrocantéricas inestables tratados con clavos cortos Intertrocantéricos/Subtrocantéricos ITST(NR con especial atención en la calidad de vida y la recuperación funcional. Material y métodos Se incluyeron 171 pacientes con fracturas AO 3.1 A2 y A3, con un seguimiento mínimo de 14 meses, y una edad promedio de 79 años. Se evaluó: calidad de vida, utilizando la escala de WOMAC reducida convertida a una escala del 1 al 100, recuperación funcional en función del tiempo en que se logró la bipedestación, necesidad de ortesis al final del seguimiento, y el regreso a las tareas de la vida diaria utilizando la sub-escala de función de la Sociedad Americana de Tumores Musculoesqueléticos. Resultados A los 14 meses el promedio de WOMAC total fue 77. El 73 % de la población caminó dentro de las 36 hs de la cirugía. El 48% retornó a las actividades diarias con una restricción mínima, el resto tuvo restricciones recreacionales y parciales. El 71% del grupo que no utilizaba ortesis conservó tal condición al finalizar el seguimiento. La incidencia de complicaciones intraoperatorias y postoperatoria fue 6,5% y 23%. La fractura distal al clavo y el “cut-out” se produjeron solo en el 1%. Discusión La baja incidencia de “cut-out” y fractura distal al clavo con la posibilidad de inserción temprana a las actividades, conservando una buena calidad de vida y función, convierten al ITST en un alternativa de elección para el tratamiento de las fracturas intertrocantéricas inestables de cadera.

  1. Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

    DEFF Research Database (Denmark)

    D'Souza, Maria; Sarkisian, Laura; Saaby, Lotte

    2015-01-01

    in unselected hospital patients. METHODS: During 2010 we evaluated all patients in whom cardiac troponin I had been measured at a single university hospital. The diagnosis of acute myocardial infarction (ST-elevation myocardial infarction [STEMI] or non-ST-elevation myocardial infarction [NSTEMI......BACKGROUND: Since the arrival of the universal definition of myocardial infarction more sensitive troponin assays have been developed. How these occurrences have influenced the proportions and clinical features of the components of acute coronary syndrome have not been studied prospectively......]) was established in cases of a rise and/or fall of cardiac troponin I together with cardiac ischemic features. Patients with unstable chest discomfort and cardiac troponin I values below the decision limit of myocardial infarction were diagnosed as having unstable angina pectoris. The definition of acute coronary...

  2. A Becker myotonia patient with compound heterozygosity for CLCN1 mutations and Prinzmetal angina pectoris.

    Science.gov (United States)

    Zielonka, Daniel; Jurkat-Rott, Karin; Stachowiak, Paweł; Bryl, Anna; Marcinkowski, Jerzy T; Lehmann-Horn, Frank

    2012-04-01

    Becker myotonia is a recessive muscle disease with prevalence of > 1:50,000. It is caused by markedly reduced function of the chloride channel encoded by CLCN1. We describe a Polish patient with severe myotonia, transient weakness, and muscle cramps who only responds to lidocaine. In addition, the patient has Prinzmetal angina pectoris and multiple lipomatosis. He is compound heterozygeous for a novel p.W303X and a frequent p.R894X CLCN1 mutation. CLCN1 exon number variation was excluded by MLPA. His son with latent myotonia was heterozygeous for p.R894X. We discuss the potential relations of the three rare diseases and the inheritance of p.R894X.

  3. Psychophysical rehabilitation aspects of patient with coronary heart disease and Angina.

    Directory of Open Access Journals (Sweden)

    Mohammed Ali Khaleel.

    2012-03-01

    Full Text Available It is analyzed scientific and methodological literature, considered the views of scientists on the link of stress and cardiovascular diseases. It is determined causes of stress, with recommendations for combating stress and its prevention. A program of rehabilitation for patients with coronary artery disease after hospital discharge is shown. The experiment involved 88 patients of coronary heart disease and angina, II and III functional class at the age of 40-65 years. Participants were divided into two groups the main and control. The control group performed a program of physical rehabilitation, including breathing and physical exercises, in the program we have added to the main group autogenic exercises. At the end the experiment revealed that the health indicators of main group better than the control group in 23%.

  4. Effects on costs of frontline diagnostic evaluation in patients suspected of angina

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Olsen, Jens; Markenvard, John;

    2012-01-01

    associated with downstream diagnostic utilization (DTU), treatment, ambulatory visits, and hospitalizations were registered. There was no difference between cohorts in demographic characteristics or the pre-test probability of significant CAD. The mean (SD) age was 56 (11) years; 52% were men; and 96% were......AIMS: The aim of this study was to investigate in patients with stable angina the effects on costs of frontline diagnostics by exercise-stress testing (ex-test) vs. coronary computed tomography angiography (CTA). METHODS AND RESULTS: In two coronary units at Lillebaelt Hospital, Denmark, 498...... patients were identified in whom either ex-test (n = 247) or CTA (n = 251) were applied as the frontline diagnostic strategy in symptomatic patients with a low-intermediate pre-test probability of coronary artery disease (CAD). During 12 months of follow-up, death, myocardial infarction and costs...

  5. Serum Adenosine deaminase activity and C-reactive protein levels in unstable angina

    Directory of Open Access Journals (Sweden)

    Rani Surekha

    2003-01-01

    Full Text Available In unstable angina (USA patients, immunological responses contributing to inflammation play a vital role in plaque rupture and thrombosis causing stroke. In the present study an attempt is made to estimate the levels of adenosine deaminase activity, an immunoenzyme marker and C-reactive protein, a marker of inflammation in USA patients. 45 patients presenting USA and 50 age and sex matched healthy controls were included in the study. Serum ADA activity was measured spectrophotometrically at 630nm and serum C-reactive protein was detected using Avitex CRP kit, which is a rapid latex agglutination test. The Mean ADA levels were 41.15 ± 11.04 in patients and 20.71±5.63 in controls and 66.6% of patients and none of the controls were positive to CRP. The present study observed the importance of ADA as a serum marker in addition to CRP for assessing the immune response in USA patients.

  6. Terapia gênica com fator de crescimento endotelial vascular 165 para pacientes com angina refratária: mobilização de células progenitoras endoteliais

    Directory of Open Access Journals (Sweden)

    Clarissa G. Rodrigues

    2013-08-01

    Full Text Available FUNDAMENTO: O fator de crescimento endotelial vascular (VEGF - vascular endothelial growth factor induz a mobilização de células progenitoras endoteliais (CPEs com capacidade de proliferação e diferenciação em células endoteliais, contribuindo, dessa forma, para o processo angiogênico. OBJETIVO: Buscamos avaliar o comportamento de CPEs em pacientes com doença cardíaca isquêmica e angina refratária que receberam injeções intramiocardicas de 2000 µg de VEGF165 como terapia única. MÉTODOS: O estudo foi uma subanálise de um ensaio clínico. Pacientes com doença cardíaca isquêmica avançada e angina refratária foram avaliados para inclusão no estudo. Os critérios de inclusão foram: sinais e sintomas de angina e/ou insuficiência cardíaca apesar de tratamento medicamentoso máximo e área de isquemia miocárdica de, no mínimo, 5% conforme avaliado por uma tomografia computadorizada por emissão de fóton único (TCEFU. Os critérios de exclusão foram: idade > 65 anos, fração de ejeção do ventrículo esquerdo < 25% e cancer diagnosticado. Os pacientes cujos níveis de CPE foram avaliados foram incluídos. A intervenção consistiu na administração de 2000 µg de VEGF 165 de plasmídeo injetado no miocárdio isquêmico. A frequência de células CD34+/KDR+ foi analisada por citometria de fluxo antes e 3, 9, e 27 dias após a intervenção. RESULTADOS: Um total de 9 pacientes foram incluídos, 8 homens, média de idade de 59,4 anos, fração de ejeção ventricular esquerda de 59,3%, e classe de angina predominante III. Observou-se um aumento significativo dos níveis de CPEs no terceiro dia após a intervenção. Todavia, 9 e 27 dias após a intervenção, os níveis de CPEs foram similares aos basais. CONCLUSÃO: Identificamos uma mobilização transitória de CPE, com pico no terceiro dia após a intervenção com VEGF 165 em pacientes com angina refratária. Todavia, os níveis de CPEs apresentaram-se semelhantes

  7. Predictores de riesgo en cirugía coronaria sin circulación extracorpórea: análisis de 1.000 pacientes

    Directory of Open Access Journals (Sweden)

    Juan M. Vrancic

    2006-01-01

    Full Text Available Objetivo Analizar los resultados posoperatorios e identificar predictores de morbimortalidad a los 30 días en la cirugía de revascularización coronaria (CRM sin circulación extracorpórea (CEC. Material y métodos Se incluyeron en el estudio 1.000 pacientes consecutivos operados entre enero de 1997 y agosto de 2005, a quienes se les efectuó CRM sin CEC únicamente. Resultados El 86% eran hombres, con edad promedio de 64,7 ± 15,7 años. El 27% era mayor de 70 años. La mortalidad global fue del 3,3% (CRM electiva, del 1,8%; no electiva, del 6%; p < 0,001. La mortalidad según Euroscore fue la siguiente: riesgo bajo 1,42%, medio 2,5% y alto 8,04% (p < 0,001. En el análisis multivariado resultaron predictores independientes para mortalidad hospitalaria la edad (OR 1,01, p = 0,013, IC 95% 1,00-1,03, la CRM previa (OR 3,87, p = 0,01, IC 95% 1,33-11,28, la angina inestable (OR 4,97, p = 0,01, IC 95% 1,41-17,48, la cirugía no electiva (OR 2,36, p = 0,02, IC 95% 1,09-5,09, la conversión a cirugía con CEC (OR 5,91, p = 0,01, IC 95% 1,43-24,45. Las complicaciones mayores ocurrieron en el 5,4% de los pacientes. Se identificaron como predictores independientes para morbilidad la conversión a CRM con CEC (OR 15,96, p < 0,001, IC 95% 5,24-48,53, la angina inestable (OR 3,01, p = 0,01, IC 95% 1,30-7,03 y la presencia de mayor enfermedad coronaria (OR 1,39, p = 0,04, IC 95% 1-1,9. Conclusiones La CRM sin CEC presentó una incidencia baja de morbimortalidad posoperatoria. La presencia de angina inestable, cirugía no electiva, conversión a cirugía con CEC, CRM previa y la edad se identificaron como predictores de mortalidad. La presencia de mayor enfermedad coronaria, la conversión a cirugía con CEC y la angina inestable resultaron predictores de morbilidad posoperatoria.

  8. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left veraricular diastolic dysfunction on the pathogenesis of angina decubitus (AD).Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease.Results. Left ventricnlography (LVG) showed that left ventricnlar (LV) first 1/3 filling fraction (1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P <0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P < 0.05, P < 0.01). Left ventricular end-diastohc presstrre(LVEDP) was markedly inereased before and after LVGin group Ⅱ and Ⅲ as compared with group Ⅰ (beth P<0.05, beth P<0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD) before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P < 0.01, P < 0.001). Howevere, there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01).Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen-esis of angina decubitus.

  9. INFLUENCE OF MILDRONATE ON EFFICIENCY OF ANTIANGINAL THERAPY IN PATIENTS WITH STABLE BURDEN ANGINA

    Directory of Open Access Journals (Sweden)

    N. P. Kutishenko

    2005-01-01

    Full Text Available Aim. To study influence of mildronate (M on treatment efficiency of patients with ischemic heart disease (IHD, receiving standard antianginal therapy (AATMaterials and methods. Double-blind, randomized, placebo-controlled study was carried out in parallel groups. All patients continued the earlier prescribed AAT without changes. After control period (10-14 days was over, randomization of patients either to the treatment group (M 500mg twice per day, or to the control group (placebo (Pl twice per day was made for 6 weeks therapy. Criterion of treatment efficiency: increase in duration of trial with burden on treadmill (TB, decrease in angina attack frequency (AA and reduction in nitroglycerin taking (NTT. TB was carried out at the beginning (TB-1, at the end of the control period (TB-2, and at the end of the treatment (TB-3.Results. TB-1 and TB-2 had good reproducibility, their duration didn’t differ. At the end of the treatment additionally with M, growth in duration of TB-3 (p=0,002 was registered, while there was no growth of TB duration with the Pl treatment (p=0,07. During the treatment decrease in AA number both with M (p=0,002, and with Pl (p=0,02 was noted. With M treatment decrease in NTT treatment (p=0.02 was observed, while NTT with Pl didn’t change (p=0,7. Number of side effects, registered with M and Pl, didn’t differ.Conclusion. Mildronate provides additional benefits for patients with IHD with stable burden angina, when they do not reach desired effect with the prescribed AAT.

  10. Significance of silent ischemia in dipyridamole perfusion scintigraphy. Evaluation in patients with angina

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, Hiroaki; Takata, Jun; Yamada, Mitsutoshi; Seo, Hiromi; Doi, Yoshinori [Kochi Medical School, Nankoku (Japan)

    1995-07-01

    The significance of silent myocardial ischemia detected by dipyridamole perfusion scintigraphy was evaluated in 80 patients with stable angina and reversible defects (RD) but no infarction. The patients consisted of 26 patients with silent RD and 54 patients with painful RD. There was no significant difference in the incidence of coronary risk factors between the two groups, except for hyperlipidemia which was less frequently observed in patients with silent RD than in those with painful RD (8% vs 41%), Coronary angiography revealed a higher prevalence of insignificant lesions or single vessel disease in patients with silent RD than in those with painful RD (73% vs 39%). Dipyridamole perfusion scintigraphy revealed a lower degree of RD in patients with silent RD than in those with painful RD (4.4{+-}3.3 vs 9.0{+-}4.1 segments), though there was no significant difference in the localization of RD between these two groups. Treadmill stress testing revealed a lower incidence of chest pain in patients with silent RD than in those with painful RD (26% vs 65%), despite the mean exercise-duration being significantly longer in the former than in the latter (5.5{+-}1.7 vs 3.9{+-}11.7 min). Although initial percutaneous transluminal coronary angioplasty (PTCA) and/or coronary artery bypass grafting (CABG) were less frequently performed in patients with silent RD than in those with painful RD (12% vs 31%), there was no significant difference in the cardiac event rate during the mean follow-up period of 24{+-}14 months between the two groups. Patients with stable angina and silent RD on dipyridamole perfusion scintigraphy may have less extensive coronary lesions and smaller amounts of ischemic myocardium than patients with painful RD. Dipyridamole perfusion scintigraphy is useful for detecting and evaluating silent myocardial ischemia, even in those patients who cannot exercise adequately. (J.P.N.).

  11. Relationship between resistin level in serum and acute coronary syndrome or stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods: Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups:acute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum ofcreatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum oftroponin) were measured by standard laboratory methods. Results: The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and 1.12 folds in SAP patients than in the healthy controls (P<0.05). The resistin levels were also significantly different between AMI [(8.16±0.79) ng/ml], UAP [(5.59±0.75) ng/ml]and SAP [(3.45±0.56) ng/ml] groups (P<0.01); WBC, hsCRP, CKmax, CK-MBmax and cTnImax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427, P=0.037), CKmax, CK-MBmax and cTnImax (r=0.731, 0.678, 0.656; P<0.01). Conclusion:Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.

  12. SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

    Objective. To determine whether serum vascular endothelial growth factor (VEGF) concontrafions are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay (ELISA), serum VEGF concemra-tions were determined in anteotbital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarcfion (AMI) before and after thrombolytic therapy, and d 16 age- and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(98.60 ± 26.99pg/ml) and UAP ( 103.61 ± 24.89pg/ml) tended to be higher than those in control subjects(80.44 ± 24.57pg/ml), but the differences did notreach statistical significance ( P > 0.05 for each). Before thrombolyfie therapy, the concentrations of serum VEGF in patients with AM1 (285.92 ± 125.15pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects ( P < 0.01 ,respectively), and correlated with synchronous serum ereafine kinase (CK) and its MB iscenzyme (CK-MB) contents( r = 0.866, P < 0.001 and r = 0.948, P < 0.001 ;respectively). Three hours after thrombolysis,the concentrations of VEGF had fallen to 111.57 ± 31.29pg/ml ( P < 0.01 vs. before thrombelytie therapy and P <0. 05 vs. control subjects). Condusion. The present study shows that serum concentrafiom of VEGF in patients with AMI are markedly ele-vated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfnsion.

  13. SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

    Objective. To determine whether serum vascular endothelial growth factor(VEGF)concentrations are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay(ELISA), serum VEGF concentra tions were determined in antecubital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarction(AMI) before and after thrombolytic therapy, and of 16 age and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(98.60 ± 26.99pg/ml) and UAP (103.61 ± 24.89pg/ml) tended to be higher than those in control subjects(80.44 ± 24.57pg/ml), but the differences did not reach statistical significance (P > 0.05 for each). Before throm bolytic therapy, the concentrations of serum VEGF in patients with AMI (285.92 ± 125.15pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects ( P < 0.01 ,respectively), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents(r=0.866, P < 0.001 and r =0.948,P < 0.001;respectively). Three hours after thrombolysis, the concentrations of VEGF had fallen to 111.57 ± 31.29pg/ml ( P <0.01 vs. before thrombolytic therapy and P< 0.05 vs .control subjects). Conclusion. The present study shows that serum concentrations of VEGF in patients with AMI are markedly ele vated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfusion.

  14. [Correlation of heart rate variability with SYNTAX II on chronic angina].

    Science.gov (United States)

    Castro-de la Torre, Tatiana Chantal; Amador-Licona, Norma; Bernal-Ruíz, Enrique

    2017-01-01

    Introducción: la variabilidad de la frecuencia cardiaca (VFC) es un valor pronóstico de riesgo cardiovascular. Se desconoce su correlación con la severidad de la cardiopatía isquémica estable. El objetivo fue conocer la correlación de la VFC con la puntuación SYNTAX II en angina crónica. Métodos: estudio transversal en pacientes mayores de 18 años con angina estable e indicación de coronariografía diagnóstica que asistieron a un centro de tercer nivel. Mediante coronariografía se estableció la puntuación SYNTAX II y se obtuvo la VFC por Holter de 24 horas. La correlación de las mediciones se obtuvo con la prueba de Pearson. Un valor de SDNN valores de SDNN (73.77%) y solo 8 tenían disminución de los valores RMSSD (13.11%). No hubo correlación de ningún parámetro de VFC con SYNTAX II. Hubo mayor frecuencia de taquicardia ventricular en el grupo SDNN bajo en comparación con SDNN normal (15.5 frente a 0.0%; p = 0.04). Conclusiones: no identificamos correlación de parámetros de VFC con la severidad de cardiopatía isquémica crónica. Sin embargo, aquellos pacientes con menor VFC presentaron mayor proporción de taquicardia ventricular.

  15. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left ventricular diastohc dysfunction on the pathogenesis of angina decubitus (AD). Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease. Results. Left ventriculography (LVG) showed that left ventricular (LV) first 1/3 filling fraction(1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P < 0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P <0.05, P < 0.01). Left ventricular end-diastolic pressure(LVEDP)was markedly increased before and after LVG in group Ⅱ and Ⅲ as compared with group Ⅰ (bothP<0.05, both P< 0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD)before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P <0.01, P < 0.001). Howevere,there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01). Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen esis of angina decubitus.

  16. El inquisidor como profesor

    Directory of Open Access Journals (Sweden)

    Adriano PROSPERI

    2009-12-01

    Full Text Available Giovanni Botero, en una célebre página de su Ragion di stato, se detuvo sobre el tema de la fuerza de la religión en los gobiernos. Esta función de la religión cristiana —para Botero, católica— es garante del orden público y se presenta también como opuesta a la generadora de desorden de Lutero y Calvino, quienes siembran por todo cizañas y revoluciones de estados y ruinas de los reinos. Estamos en los orígenes del esquema historiografía de la periodización de la Edad Moderna que confió precisamente a la Reforma el papel de nodriza de las revoluciones que nacieron en Europa.

  17. Racismo como metaenquadre

    OpenAIRE

    2015-01-01

    RESUMO Este artigo pretende discutir questões relativas ao racismo tendo como lastro principalmente contribuições da psicologia social. Para tanto, faz menção a dois conceitos. São eles: enquadre e metaenquadre. O primeiro foi teorizado pelo psicólogo social José Bleger e o segundo é uma ampliação desse e foi conceituado por René Kaës, teórico da psicanálise dos laços sociais. O artigo finaliza-se com situações que envolvem processos socioculturais, histórico-educacionais que trazem à baila p...

  18. O ensaio como narrativa

    Directory of Open Access Journals (Sweden)

    Pedro Duarte

    2016-02-01

    Full Text Available O artigo tenta demonstrar que todos os textos, mesmo aqueles cuja natureza é teórica, têm alguma forma de narrativa. Nem sempre são personagens que os ocupam, podem ser ideias, mas mesmo assim há um enredo conceitual que se passa. Modernamente, a forma dessa narrativa foi sobretudo o sistema, com a pretensão totalizadora presente, por exemplo, na filosofia de Hegel. Contemporaneamente, porém, a forma do ensaio – surgida ainda na era moderna – ganha destaque por sua forma descontínua de narrar. O objetivo do artigo é apontar que, se o ensaio é uma forma, como explicitaram Lukács, Benjamin e Adorno, ele é também uma forma de narrar – ainda que de narrar conceitualmente objetos da cultura.

  19. La persona como creatura

    OpenAIRE

    Emmanuel Housset

    2010-01-01

    El artículo de Emmanuel Housset implica un esfuerzo de rehabilitación del concepto «persona» para la filosofía contemporánea y la fenomenología. Para ello el autor busca mostrar cómo poco a poco «persona» tomó otra significación que la de «personaje» o sujeto de derecho. Es en autores como san Agustín y santo Tomás de Aquino que se halla un acceso diferente que pone el énfasis más bien en su carácter relacional y responsivo de la persona, antes que en su dimensión autónoma y autotélica. Tal d...

  20. Variation in the use of coronary angiography in patients with unstable angina is related to differences in patient population and availability of angiography facilities, without affecting prognosis

    NARCIS (Netherlands)

    A.J.M. van Miltenburg-van Zijl (Addy); M.L. Simoons (Maarten); P.M.M. Bossuyt (Patrick); T.R. Taylor (Thomas); M.J. Veerhoek

    1996-01-01

    textabstractOBJECTIVES: Examination of the difference in management strategies with respect to coronary angiography in patients with unstable angina pectoris, and the consequences of this difference on prognosis. DESIGN: Prospective registration of consecutive patients admitted to two different hosp

  1. [The practice guideline 'Stable angina pectoris' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].

    Science.gov (United States)

    Mazel, J A

    2004-11-06

    The Dutch College of General Practitioners' (Dutch acronym: NHG) practice guideline 'Stable angina pectoris' (second revision) provides clear guidelines for the diagnosis and treatment of patients who experience chest pains as a result of angina pectoris, especially if coronary artery disease is the underlying cause of the complaints. The practice guideline clearly indicates for which complaints the general practitioner should suspect angina pectoris and which information from the anamnesis, family history and risk factors can contribute to distinguishing between stable and unstable angina pectoris. However, the physical examination should not be omitted because this can provide important indications for coronary or pulmonary dysfunction. According to the practice guideline, the treatment policy is determined by the estimated risk of significant coronary artery disease. However, additional tests can be useful even in the case of a small risk, as these can reassure patients. The indications and contraindications for medicinal substances are clearly presented.

  2. Analysis of angina pectoris after pacemaker implantation.%心脏起搏术后患者发生心绞痛的情况分析

    Institute of Scientific and Technical Information of China (English)

    高运来; 吴小庆; 郁志明; 王如兴; 王强

    2011-01-01

    目的 分析心脏起搏术后患者心绞痛的发生情况.方法 35例起搏器术后一年内并发心绞痛的为心绞痛组,选取同期的495例永久心脏起搏患者为非心绞痛组,比较两组的一般情况.并对不同起搏原因及不同起搏方式的心绞痛发作情况进行比较.结果 与非心绞痛组比较,心绞痛组年龄、吸烟、性别构成无差异,但合并高血压、糖尿病、高脂血症比例较高.因房室传导阻滞(AVB)行心脏起搏者较因病窦综合征起搏者术后发生心绞痛比例高(15.4% vs 1.8%,P<0.001),而安置VVI者与DDD者心绞痛发生率相似(6.7% vs 6.3%,P>0.05).结论 起搏术后发生心绞痛患者多合并多种冠心病危险因素,AVB者术后心绞痛发生率高.%Objective To observe the attack of angina pectoris after permanent pacemaker implantation. Methods Thirty-five patients with angina pectoris after pacemaker implantation within 1 year were allocated to angina pectoris group, while 495 patients without angina pectoris were allocated to non-angina pectoris group. General characters of both groups were compared. Incidence of angina pectoris in different pacing cause and different pacing mode were compared. Results There was no difference of age,smoking or sex constituent between two groups,but the angina pectoris group had more hypertension, diabetes mellitus or hyperlipidemia than non-angina pectoris group. The patients with atrioventricle block(AVB) had more occurrence of angina pectoris than the patients with sick sinus syndrome after pacemaker implantation(15.4% vs 1. 8% ,P 0.05). Conclusion Patients developing angina pectoris after pacemaker implantation usually accompany with several risk factors of coronary heart disease,patients with AVB often has coronary heart disease and develop angina pectoris easily.

  3. La persona como creatura

    Directory of Open Access Journals (Sweden)

    Emmanuel Housset

    2010-01-01

    Full Text Available El artículo de Emmanuel Housset implica un esfuerzo de rehabilitación del concepto «persona» para la filosofía contemporánea y la fenomenología. Para ello el autor busca mostrar cómo poco a poco «persona» tomó otra significación que la de «personaje» o sujeto de derecho. Es en autores como san Agustín y santo Tomás de Aquino que se halla un acceso diferente que pone el énfasis más bien en su carácter relacional y responsivo de la persona, antes que en su dimensión autónoma y autotélica. Tal dimensión aparece, según Housset, junto con la idea de persona como creatura y en oposición a la de individuo racional dueño de sí. La dimensión afectiva, la personalidad despertada por las diversas figuras de la alteridad son algunas de las dimensiones de la persona que examina el autor a partir del examen de la carne, las pasiones, la memoria, la historicidad y el amor alteridad.Emmanuel Housset's paper is an effort to revitalize the concept of 'person' for contemporary philosophy and phenomenology To this end the author looks to show how little by little the understanding of 'person' took on a different meaning to that of 'character' or "right bearing individual". It is in authors such as St. Augustine and St. Thomas Aquinas that a different approach is found, one that puts emphasis on the relational and responsive character of a person, rather than on the autonomous and auto telic dimension. According to Housset, such a dimension appears together with the idea of the person as a creation, and in opposition to the idea of the rational individual, that is his own master. The emotional dimension and the personality that is awoken by the many figures of alterity are some of the dimensions of the person that the author analyzes, based on examining the flesh, passions, memory historicity and love.

  4. An Unusual Presentation of Ludwig’s Angina Complicated by Cervical Necrotizing Fasciitis: A Case Report and Review of the Literature

    OpenAIRE

    Kristelle Chueng; Clinkard, David J.; Danny Enepekides; Yousef Peerbaye; Lin, Vincent Y. W.

    2012-01-01

    Ludwig’s angina can seldom be complicated by necrotizing fasciitis. Due to the rapidly progressing nature of this infection and the potential for airway compromise and death, it is important to be aware of different ways in which this disease process can present in order to recognize and treat it emergently. We report here an unusual presentation of a case of Ludwig’s angina complicated by necrotizing fasciitis in an elderly patient. The clinical features, diagnosis, and treatment are discuss...

  5. Symptoms of angina pectoris increase the probability of disability pension and premature exit from the workforce even in the absence of obstructive coronary artery disease

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrøm, Steen Z; Hvelplund, Anders

    2013-01-01

    To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals.......To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals....

  6. [Constant-frequency trans-esophageal electric atrial stimulation for evaluation of the severity of illness in patients with stenocardia and the anti-angina effect of erinit].

    Science.gov (United States)

    Gasilin, V S; Sidorenko, B A; Lazarev, I A; Smirnov, M Iu

    1990-12-01

    Constant-frequency transesophageal atrial pacing was used in 87 patients with coronary heart disease concurrent with stable angina pectoris of various functional classes (I-IV). This technique, as a bicycle ergometric test, allows one to assess the functional class of patients with angina and to ascertain the antianginal effect of agents, which was exemplified by erinit given in doses of 80 and 120 mg.

  7. Arte como espelho

    Directory of Open Access Journals (Sweden)

    Pedro Süssekind

    2016-12-01

    Full Text Available Este artigo tem como ponto de partida o exemplo da relação espelhada entre um livro e uma pintura de mesmo nome: o retrato que Lucian Freud fez do crítico de arte Martin Gayford e o diário que esse crítico escreveu sobre seu retratista, ambas as obras chamadas Homem com cachecol azul. A partir do exemplo, discuto a metáfora do espelho para caracterizar a arte, recorrendo para isso à teoria da representação artísticas elaborada pelo filósofo norte-americano Arthur Danto no artigo “O mundo da arte”, de 1964, e no primeiro capítulo do livro A transfiguração do lugar-comum, de 1981. Recorro, por fim, a dois exemplos artísticos de espelhamento na representação analisados por Danto em O abuso da beleza, de 2003, um quadro holandês do século dezessete e um poema de Rainer Maria Rilke.

  8. como fuentes mutuas

    Directory of Open Access Journals (Sweden)

    Gabriel Morales Hernández

    2006-01-01

    Full Text Available En este artículo, el autor analiza, a partir de la antropología filosófica de Martín Heidegger y de la filosofía ilustrada de Immanuel Kant, la postura del filósofo francés Étienne Balibar en torno a la categoría de ciudadanía como base para esbozar una antropología filosófica renovada. A partir de la concepción kantiana de ciudadanía, Balibar construye una propuesta de antropología filosófica estructurada alrededor de tres pares de polos: el par hombresujeto, el par subjectus-subjectum y el par cosmos-polis. El autor va mostrando, a lo largo del trabajo, la manera en que la categoría «ciudadanía» articula cada uno de estos pares de términos y concluye con algunas consideraciones sobre las ventajas de la propuesta balibariana.

  9. Endomarketing: como diferencial competitivo

    Directory of Open Access Journals (Sweden)

    Karin Birck

    2013-05-01

    Full Text Available Atualmente, com a profissionalização das empresas e com a grande concorrência no mercado, observa-se uma demanda cada vez maior de gestores comprometidos com o bem-estar pessoal e profissional de seus colaboradores. E, com esse intuito, de apresentar algumas idéias básicas de gestão voltadas à aplicação nas mais diversas técnicas de Endomarketing. Demonstra assim, a importância da utilização de feedback, tanto por parte dos colaboradores quanto dos gestores, destacando a importância de trabalhos de motivação, do clima organizacional favorável e de uma comunicação interna eficaz e a necessidade ímpar de tratar o colaborador como o diferencial dentro de uma empresa. Desta forma, foi realizada uma pesquisa bibliográfica que auxiliará e dará subsídios que lhe permitam retribuir em ações e atitudes de sucesso e, também, fazer um confronto de idéias, onde os autores apresentam suas mais diversas opiniões. Contudo, valendo-se, muitas vezes, de narrativas de experiências de outros gestores e até mesmo de suas próprias, tirando cada um suas próprias conclusões.

  10. El riesgo como oportunidad

    Directory of Open Access Journals (Sweden)

    Daniela Gargantini

    2003-01-01

    Full Text Available Durante los últimos años el crecimiento mundial de catástrofes naturales ha ido en franco aumento. Sin embargo, desde un enfoque sistémico puede verificarse que la gran mayoría de los desastres se origina en los países en desarrollo (entre ellos los latinoamericanos, siendo las pérdidas en ellos significativamente más altas que en los países industrializados. Bajo esta postura los desastres no son sólo naturales sino socio- naturales, enfatizando la estrecha relación de causalidad entre modelos de desarrollo y urbanización y procesos de generación de riesgos, al incrementar la vulnerabilidad de los sectores más desprotegidos. El desastre pone en evidencia así una situación (la pobreza y segregación urbana ya existente, pero no considerada hasta el momento de la catástrofe. Frente a este panorama el desastre aparece como oportunidad que precipita tres catalizadores de políticas habitacionales: tierra, asistencia técnica y financiamiento, incrementando la celeridad y la creatividad de las respuestas. El interrogante que surge es por qué esperar el desastre para ponerlos en marcha, cuando ninguno de ellos es estrictamente dependiente de la situación de riesgo, sino sujeto de luchas de poder.

  11. El signo como emblema

    Directory of Open Access Journals (Sweden)

    Sáez, Carlos

    2003-06-01

    Full Text Available The aim of this article is to study the signs and symbols that appear in the hispanic medieval documents and manuscripts. These signs and symbols have usually been considered simply as mere elements to validate the charters. However, these alements were useful as a mean of visual communication between the high classes, able to generate charters, and the rest of medieval society—the majority illiterate— who received those charters. Because of their inability of understand an alphabetical code, they needed the graphic help to comprehend the message. Besides this, the article deals with non diplomatic signs and their function.

    Este artículo se centra en los signos o símbolos presentes en los documentos y manuscritos medievales hispanos, que habitualmente han sido tratados como meros elementos de validación de los diplomas. Pero estos elementos servían también de nexos de comunicación visual entre las clases poderosas, capaces de producir escritos, y los demás miembros de la sociedad medieval, receptores y destinatarios de tales escritos, en su mayoría analfabetos. Precisamente por esta razón, su incapacidad de descifrar un código alfabético, necesitan de auxilio gráfico para acercarse a la comprensión del mensaje. Asimismo, tratamos de los signos no diplomáticos y de su función.

  12. Effect of compound danshen dropping pill on angina as well as serum c-reactive protein (CRP) and brain natriuretic peptide (BNP)

    Institute of Scientific and Technical Information of China (English)

    Jing Ye

    2016-01-01

    Objective:To study the effect of Compound Danshen Dropping Pill on angina as well as serum C-reactive protein (CRP) and brain natriuretic peptide (BNP) so as to provide reference for clinical treatment.Methods: Patients with angina treated in our hospital from February 2010 to August 2015 were enrolled in this research. The effect of Compound Danshen Dropping Pill on angina as well as serum C reaction protein (CRP) and brain natriuretic peptide (BNP) were analyzed. 110 cases of healthy subjects receiving physical examination in our hospital during the same period were taken as control.Results: After treatment, the duration of angina significantly decreased, the frequency of angina pectoris attack significantly decreased, and serum inflammatory factors IL1, IL2 and IL6 as well as Hcy, TG, TC and LDL levels significantly decreased while HDL, folic acid and vitamin B12 levels significantly increased, and compared with before treatment, differences were with notable statistical significance. Conclusion: Compound Danshen Dropping Pill can effectively treat angina, which is related to its regulation of serum C-reactive protein, brain natriuretic peptide and inflammatory factor levels.

  13. Innovative Strategy in Treating Angina Pectoris with Chinese Patent Medicines by Promoting Blood Circulation and Removing Blood Stasis: Experience from Combination Therapy in Chinese Medicine.

    Science.gov (United States)

    Xiong, Xing-Jiang; Wang, Zhong; Wang, Jie

    2015-01-01

    Coronary heart disease (CHD) is one of the leading causes of death worldwide. Moreover, angina pectoris is one of the most important types of CHD. Therefore, prevention and effective treatment of angina pectoris is of utmost importance in both China and western countries. However, undesirable effects of antianginal therapy do influence treatment adherence to a certain extent. Therefore, it's not surprising that, complementary and alternative medicine (CAM), including Chinese medicine (CM), are widely welcomed among patients with CHD, hoping that it might complement western medicine. In our previous studies, blood stasis syndrome (BSS) (Xueyu Zheng) was the main syndrome (Zheng-hou) of angina pectoris. Currently, China Food and Drug Administration authoritatively recommended more than 200 Chinese patent medicines (CPMs) as complementary or adjunctive therapies for symptom management and enhancing quality of life along with mainstream care on angina pectoris management in mainland China. This paper reviewed 4 kinds of most frequently-used CPMs by promoting blood circulation and removing blood stasis in the treatment of angina pectoris. It aims to evaluate the current evidence of CPMs in combination therapy for angina pectoris. This review indicated that CPMs as adjunctive treatment to routine antianginal therapy play an active role in reducing the incidence of primary endpoint events, decreasing anginal attack rate, and improving electrocardiogram. Additionally, CPMs have been proven relatively safe. Further rigorously designed clinical trials should be conducted to confirm the results.

  14. LO PINTORESCO COMO CATEGORÍA ESTÉTICA EN EL ARTE DE VIAJEROS: APUNTES PARA LA OBRA DE RUGENDAS

    Directory of Open Access Journals (Sweden)

    Pablo Diener

    2007-12-01

    Full Text Available La categoría estética de lo pintoresco fue incorporada en el repertorio conceptual de artistas y teóricos del arte hacia las últimas décadas del siglo XVIII. Su contenido ha tenido siempre un carácter inestable. De un significado inicial que aludía a una forma de ver y aprehender la naturaleza siguiendo los cánones de composición de artistas clásicos, pasó a ser utilizado con un sentido considerablemente más amplio, como una forma de percepción y registro de la realidad en todos los ámbitos. Tomando como ejemplo la obra de J.M. Rugendas, en este artículo se estudian las connotaciones que lo pintoresco adquirió para los artistas viajeros seguidores de la tradición de Alexander von Humboldt. Se observa que esta categoría estética jugó un papel esencial para vincular el quehacer artístico a los proyectos de reconocimiento científico del continente americano en el curso del siglo XIXThe aesthetic category of "picturesque" was incorporated in the conceptual repertoire of artists and art theorists during the last decades of the eighteenth century. Its content has always had an unstable character. Initially, its meaning alluded to a particular way of seeing and seizing nature, following classic artists' composition canons. Later, it was used in a more comprehensive sense as a form of perception and recording of reality in different fields. This article studies the different connotations that "picturesque" had for travelers that followed the tradition of Alexander von Humboldt. By examining the work of J.M. Rugendas, it is possible to observe that aesthetic categories played an essential role in linking art work and scientific exploration projects in the American continent during the nineteenth century

  15. Direct intramyocardial mesenchymal stromal cell injections in patients with severe refractory angina - one year follow-up

    DEFF Research Database (Denmark)

    Haack-Sørensen, Mandana; Friis, Tina; Mathiasen, Anders B;

    2013-01-01

    Aims: In patients with stable coronary artery disease (CAD) and refractory angina we performed direct intra-myocardial injections of autologous mesenchymal stromal cells (MSCs) and followed the safety and efficacy of the treatment for 12 months. Methods and Results: A total of 31 patients...... with stable CAD, moderate to severe angina, normal left ventricular ejection fraction and no further revascularization options, were included. Bone marrow MSCs were isolated and culture expanded for 6 - 8 weeks and then stimulated with vascular endothelial growth factor (VEGF) for one week.The 12 months...... follow-up demonstrated, that it was safe to culture expand MSCs and use the cells for clinical treatment. The patients maximal metabolic equivalent (MET) during exercise increased from 4.23 MET at baseline to 4.72 MET at 12 months follow-up (p...

  16. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    A. I. Kondratiev

    2011-01-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  17. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    A. I. Kondratiev

    2014-07-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  18. O direito como imperativo

    Directory of Open Access Journals (Sweden)

    Cloter Miglioriani

    1988-08-01

    Full Text Available We have examined one of the facets which Law presents to society, looking at the theme through a brief history of Law, in which Roman Law stands out, up to modem times, comparing current juridical systems such as the Continental System, Common Law, and Soviet Law. We have looked at Law from the viewpoint of society 's need to have basic mies for living together, with the juridical ruZe being one of the most important. We have highlighted the views of Hart and Kelsen on the foundations of the validity of Law. We have also considered the obligatoriness of Law; giving the point of view of tadbruch who, explaining his ''Theory of the Obligatoriness of Law ", concluded that the obligatoriness of Law can only be withdraw when there is a Clash between morals, law, use and social conventions. We have looked at the notion of the imperativeness of Law the central theme of the work -drawing on the views of Miguel Reale, for whom the juridical nonn cannot be reduced to a "command of a volitional nature", but rather the obligatory character of the juridical nonn arises from the pressure of social values. Del Vecchio, who is also quoted, recognized that imperativeness exists in the juridical norm, whether it is preceptive (a positive command or permissive. Also mentioned is the opinion of Tercio Sampaio Ferraz, for whom the juridical norm has imperativeness to the extent that the imposition of behaviour is unconditionally guaranteed. Foi feita a abordagem de uma das facetas com que o Direito se apresenta à sociedade, enfocando o tema a partir de um brevíssimo histórico do Direito, onde revela a fase romana, até os períodos modernos, com comparações dos sistemas jurídicos hodiernos, como o sistema continental, o da Commum Law e o soviético. Foi enfocado o Direito em face da necessidade sociedade em ter básicas de convivência, despontando a regra jurídica como das mais importantes. Foi dado destaque às posições de Hart e Kelsen, sobre os

  19. Anomalous Origin of a Stenosed Left Circumflex Coronary Artery in a Patient Presenting with Unstable Angina: A Case Report

    OpenAIRE

    Vakili Hossein; Khaheshi Isa; Memaryan Mehdi; Naderian Mohammadreza

    2016-01-01

    73 year-old man presented to our emergency department with complaint of retrosternal chest pain since 2 day and admitted with diagnosis of unstable angina. He underwent diagnostic coronary angiography in which left circumflex artery (LCX) was not visualized during injection of the left coronary artery; indeed, it was originated, with common origin with RCA, from right coronary sinus of Valsalva. This case report is one of the uncommon cases with aberrant coronary arteries who presented with u...

  20. Electrocardiogram Diagnosis of Unstable Angina Pectoris%不稳定型心绞痛心电图诊断

    Institute of Scientific and Technical Information of China (English)

    董红晶

    2014-01-01

    目的:探讨不稳定型心绞痛患者心电图及动态心电图表现。方法选取2012年~2013年收治的不稳定型心绞痛患者心电图诊断资料进行分析。结果心绞痛发作时可出现暂时性心肌缺血引起的ST段压低(≥0.1 mV)。心电图负荷实验及24 h动态心电图可显著提高缺血性心脏病的检出率。结论心电图检查是发现心肌缺血、诊断心绞痛最常用的检查方法。%Objective The electrocardiogram and dynamic electrocardiogram of the patients with the unstable angina pectoris are to be investigated.Methods Electrocardiogram diagnosis data of patients with angina pectoris in this hospital from 2012 to 2013 are selected for analysis.ResultsWhen the angina pectoris happens, ST segment depresion (≥0.1 mV) can be caused by transient myocardial ischemia. Electrocardiogram stres test and 24h dynamic electrocardiogram can significantly improve the detection rate of ischemic heart disease.Conclusion Electrocardiogram examination is the most widely used inspection method to detect the myocardial ischemia and diagnose the angina pectoris.

  1. Association of low levels of vitamin D with chronic stable angina: A prospective case-control study

    Directory of Open Access Journals (Sweden)

    Ab Hameed Raina

    2016-01-01

    Full Text Available Background: Coronary artery disease (CAD is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. A low level of vitamin D is associated with chronic stable angina. Aim: This study was aimed at supporting or refuting this hypothesis in our population. Materials and Methods: The study was a prospective case-control study. We studied 100 cases of chronic stable angina and compared them with 100 matched controls. Vitamin D deficiency was defined as <20 ng/mL, vitamin D insufficiency as 20-30 ng/mL and normal vitamin D level as 31-150 ng/mL. Results: The prevalence of vitamin D deficiency among cases and controls was 75% and 10%, respectively. 75% of the cases were vitamin D-deficient (<20 ng/mL; 12% were vitamin D-insufficient (20-30 ng/mL, and 13% had normal vitamin D levels (31-150 ng/mL. None had a toxic level of vitamin D. Among the controls, 10% were vitamin D-deficient, 33% were vitamin D-insufficient, and 57% had normal vitamin D levels. The mean vitamin level among cases and controls was 15.53 ng/mL and 40.95 ng/mL, respectively, with the difference being statistically significant (P ≤ 0.0001. There was no statistically significant relation between the disease severities, i.e., on coronary angiography (CAG with vitamin D level. Among the cases, we found that an increasing age was inversely related to vitamin D levels (P = 0.027. Conclusion: Our study indicates a correlation between vitamin D deficiency and chronic stable angina. Low levels may be an independent, potentially modifiable cardiovascular risk factor.

  2. Prognostic value of fatty acid imaging in patients with angina pectoris without prior myocardial infarction: comparison with stress thallium imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsuki, Takayuki; Doi, Atsushi; Takahashi, Hiroshi; Iwata, Michihiro; Sakamoto, Takashi; Yamauchi, Kazuaki; Shimazaki, Masaru [Shin-Nittetsu Muroran General Hospital, Department of Cardiology, Muroran (Japan); Tamaki, Nagara; Morita, Koichi [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan); Nakata, Tomoaki; Shimamoto, Kazuaki [Sapporo Medical University, Second Department of Internal Medicine, School of Medicine, Sapporo (Japan)

    2004-12-01

    A fatty acid analogue, {sup 123}I-labelled {beta}-methyl iodophenyl pentadecanoic acid (BMIPP), has been used to identify ischaemic and metabolically impaired myocardium. However, the prognostic value of BMIPP imaging, particularly in relation to stress myocardial perfusion imaging, remains unclear. Data from 167 consecutive patients with angina pectoris but without prior myocardial infarction (MI) who had undergone both BMIPP and stress {sup 201}Tl (sTL) imaging were analysed. Tracer uptake was graded using a 13-segment, 4-point scoring model. Patients were followed up for 48 months with primary end points (cardiac death, non-fatal MI) as hard cardiac events and with secondary end points (late revascularisation, recurrent angina and heart failure) as soft events. For overall cardiac events (5 hard and 29 soft events), Kaplan-Meier analysis revealed significantly lower event rates in subgroups with normal BMIPP uptake, a summed difference score of sTL (SDS) of <3 or absence of diabetes mellitus when compared to each counterpart. Multivariate Cox's analysis revealed reduced BMIPP uptake, SDS {>=}3, diabetes and reduced ejection fraction to be significant predictors. Negative predictive values of normal BMIPP and SDS <3 for all events were 91% and 84%, respectively. No hard event occurred in 66 patients with normal BMIPP uptake, whereas two patients with SDS <3 but impaired BMIPP uptake had hard events. In conclusion, normal BMIPP imaging is an excellent prognostic sign, independently of stress myocardial perfusion imaging, in patients with angina pectoris without prior MI. (orig.)

  3. Submandibular cellulitis (Ludwig's angina) associated to a complex odontoma erupted into the oral cavity. Case report and literature review.

    Science.gov (United States)

    Bertolai, R; Acocella, A; Sacco, R; Agostini, T

    2007-01-01

    The clinical presentation of Ludwig's angina consists in a severe expanding cellulitis causing swelling of the floor of the mouth, tongue and submandibular region, thus resulting in a possible obstruction of the airway and in a rapid progress in deep neck soft tissue infection and mediastinitis with potentially fatal consequences. Frequently, submandibular cellulitis develops from an acute infection spreading from the lower molar teeth. Mandibular fractures, traumatic laceration of the floor of the mouth, and peritonsillar abscesses are other concomitant clinical features. A case of Ludwig's angina associated with a large erupted odontoma and with a deeply impacted third molar displaced to the border of the mandible is described. The patient was affected by enlargement of submandibular space, marked face swelling causing an evident face deformity, tenderness and redness of the neck and limited movement of the neck and mouth. In the past, Ludwig's angina was frequently fatal, however aggressive surgical and medical therapy have significantly reduced the mortality rate. The reported case can be considered as important, not only because of the rarity of the odontoma eruption in the oral cavity, but mainly for the extent of the clinical manifestation of a lesion usually described in literature as asymptomatic.

  4. Impaired myocardial perfusion reserve in microvascular angina (syndrome X): Assessment by vasodilation {sup 99m}Tc-MIBI-SPECT; Einschraenkung der myokardialen Perfusionsreserve bei Mikrovaskular-Angina (Syndrom X): Nachweis durch {sup 99m}Tc-MIBI-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Langes, K. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie; Beuthien-Baumann, B. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Luebeck, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Fuchs, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Schneider, M.A. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie; Volk, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie; Nienaber, C.A. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie

    1996-12-01

    Aim: In 22 patients with typical chest pain and normal coronary arteries (microvascular angina, syndrome X) {sup 99m}Tc-MIBI-SPECT was examined in regard to assess impairment of myocardial perfusion reserve. Method: The study was performed with {sup 99m}Tc-MIBI-SPECT at rest and under vasodilation with dipyridamole. The findings were compared with a normal database. A normal perfusion reserve was said to be an increase >20% of the {sup 99m}Tc-MIBI-activity. Results: In 2/22 (9%) of the patients the perfusion reserve lay >20% i.e. 37%. In 91% of the patients a diminution or even decrease of the perfusion was to be seen. From these 9/22 (41%) of the patients showed a diminution of the {sup 99m}Tc-MIBI by 6%. 11/22 patients had a decrease of the perfusion under vasodilation with dipyridamole i.e. a lower activity of 99mTc-MIBI 13%. Conclusion: Vasodilation {sup 99m}Tc-MIBI-SPECT offers good imaging quality and enables semiquantitative assessment of myocardial perfusion reserve in patients with microvascular angina. (orig.) [Deutsch] Ziel: An 22 Patienten mit typischer Angina pectoris und normalen Koronararterien (Mikrovaskular-Angina, Syndrom X) wurde geprueft, ob mit {sup 99m}Tc-MIBI-SPECT eine Einschraenkung der myokardialen Perfusionsreserve nachweisbar ist. Methode: Die Untersuchung mit {sup 99m}Tc-MIBI-SPECT erfolgte in Ruhe und unter Vasodilatation nach einer Infusion mit Dipyridamol im Vergleich zu einer normalen Datenbank. Eine normale myokardiale Perfusionsreserve wurde bei einer differenziellen {sup 99m}Tc-MIBI-Aufnahme von {>=}20% angesehen. Ergebnisse: 2/22 (9%) der Patienten wiesen eine Perfusionsreserve >20% mit im Mittel 37% auf, 91% der Patienten wiesen eine relativ oder absolut verminderte {sup 99m}Tc-MIBI-Aufnahme unter Vasodilatation auf. Bei 9/22 (41%) Patienten war die Perfusionsreserve relativ gemindert mit einer Zunahme der {sup 99m}Tc-MIBI-Aktivitaet von 6%, bei 11/22 wurde eine Abnahme der {sup 99m}Tc-MIBI-Aktivitaet um 13% unter

  5. Casamento como contrato. Brasil - Portugal

    OpenAIRE

    Souza, Carla Giselle Neves

    2014-01-01

    O casamento como contrato, trata-se de um dos negócios jurídicos mais celebrados, assim como, também é dos negócios jurídicos mais minuciosos, e que, por algumas vezes, ou mais que isso, é, de certa forma, ignorado os efeitos que advém do mesmo contrato. O casamento como contrato, assim como os demais negócios jurídicos, também domina o princípio da autonomia privada. Contudo, existe uma certa imperatividade na lei, uma vez que, no contrato de casamento pode-se escolher o regim...

  6. Resting {sup 123}I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Yamabe, Hiroshi; Abe, Hiroaki; Yokoyama, Mitsuhiro [Kobe Univ. (Japan). School of Medicine; Shiotani, Hideyuki; Kajiya, Sadashi; Mori, Takao; Hashimoto, Yasunori

    1998-06-01

    This study was undertaken to assess the diagnostic value of resting {sup 123}I-BMIPP scintigraphy in patients with effort angina pectoris. One hundred and four patients underwent scintigraphic and angiographic examinations. The subsets of the patients were stable effort angina pectoris (stable type) in 27 cases, new onset of effort angina pectoris (new onset type) in 21 cases, and worsening effort angina pectoris (worsening type) in 35 cases. The remaining 21 cases were subjects without evidences of coronary artery disease (non-CAD). {sup 123}I-BMIPP was injected under resting and pain free condition, then data for single photon emission tomography (SPECT) were acquired. The positive regional {sup 123}I-BMIPP defects in three coronary territories were visually judged on the tomographic images. The overall sensitivity to diagnose the patients was 62.6% (52/83) and the overall specificity to exclude non-CAD subjects was 95.2% (20/21). The detection rate in each subset of the disease was 48.1% (13/27) in stable type, 47.6% (10/21) in new onset type and 77.1% (27/35) in worsening type (p<0.05 versus two other types). For detection of stenosed vessels, the overall sensitivity was 41.4% (56/148) and the overall specificity was 93.8% (152/164). The rate of detection of stenosed vessels was 31.7% (13/41) in stable type, 31.4% (11/35) in new onset type, and 55.6% (40/72) in worsening type (p<0.05 versus two other types). Vessels with 75% stenosis were more sensitively detected in the worsening type (33.3%; 4/12) compared to the remaining two types (8.3%; 1/12) even though the difference was not significant. The resting {sup 123}I-BMIPP scintigraphy was therefore valuable in diagnosing patients with effort angina pectoris and involved coronary arteries especially in the subset of patients with worsening type. (author)

  7. Gender difference of clinical characteristics in Chinese patients with spontaneous variant angina

    Institute of Scientific and Technical Information of China (English)

    ZHU Cheng-gang; GUO Yuan-lin; GAO Zhan; ZHENG Xin; LI Jian-jun; XU Yan-lu; YUAN Jin-qing; QIN Xue-wen; YANG Yue-jin; QIAO Shu-bin; CHEN Ji-lin; CHEN Zai-jia

    2010-01-01

    Background Spontaneous attack of variant angina (VA) is a unique component of coronary artery disease (CAD), and associated with severe cardiac events. However, no data are available regarding sex differences in Chinese patients with spontaneous attacks of VA. Accordingly, the present retrospective study was initiated to evaluate the Clinical characteristics of Chinese female patients with spontaneous attacks of VA.Methods From January 2003 to January 2008, a total of 209 patients were diagnosed to have had a spontaneous attack of VA at Fu Wai Hospital. Of them, 27 were female, and their clinical findings were collected and compared with male patients for aspects of risk factors, clinical features and angiographical findings.Results Spontaneous attacks of VA was relatively uncommon in female (12.9%) compared with male patients. The female patients were less likely to have a history of smoking (14.8% vs. 79.7%, P <0.001), more likely to have a family history of CAD (33.3% vs. 11.0%, P<0.01), and to have had a greater incidence of ventricular fibrillation during attack (11.1% vs. 2.2%, P<0.05). There were no significant differences in other characteristics between the two groups.Conclusion Chinese female patients who experienced a spontaneous attack of VA had the characteristics of less smoking history, more family history of CAD and higher occurrence of ventricular fibrillation than male patients.

  8. Deep Vein Thrombosis, Raynaud's Phenomenon, and Prinzmetal Angina in a Patient with Glanzmann Thrombasthenia.

    Science.gov (United States)

    Nurden, Alan; Mercié, Patrick; Zely, Pascal; Nurden, Paquita

    2012-01-01

    Patients with Glanzmann thrombasthenia fail to form large platelet thrombi due to mutations that affect the biosynthesis and/or function of the αIIbβ3 integrin. The result is a moderate to severe bleeding syndrome. We now report unusual vascular behaviour in a 55-year-old woman with classic type I disease (with no platelet αIIbβ3 expression) and a homozygous ITGA2B missense mutation (E324K) affecting the terminal β-propeller domain of αIIb. While exhibiting classic bleeding symptoms as a child, in later life this woman first developed deep vein thrombosis after a long air flight then showed vascular problems characteristic of Raynaud's phenomenon, and finally this year she presented with chest pains suggestive of coronary heart disease. Yet while coronary angiography first showed a stenosis, this was not seen on a second examination when she was diagnosed with coronary spastic angina and Prinzmetal phenomenon. It is significant that the absence of platelet aggregation with physiologic agonists had not prevented any of the above cardiovascular or vascular diseases.

  9. Hemodynamic effects of metoprolol and nifedipine in angina pectoris measured by isotope technique

    Energy Technology Data Exchange (ETDEWEB)

    Bostroem, P.A.

    1988-01-01

    In order to evaluate the therapeutic effects of metoprolol, nifedipine, and their combination, 11 patients with secondary angina pectoris and with thallium tomographic findings indicating coronary artery disease were studied before and after these three treatment regimes in a single-blind cross-over study. The therapeutic effect was measured by standardized working test and isotope angiocardiography, which enabled evaluation of left ventricular ejection fraction, stroke volume, and phase analysis of left ventricular contraction. Treatment with metoprolol and combination therapy increased work performance. Ejection fraction did not differentiate the treatment regimes, whereas stroke volume was significantly lower at work and heart rate higher at rest and at work during nifedipine treatment compared to either metoprolol or combination treatment (p less than 0.05). Cardiac output was significantly reduced during nifedipine and metoprolol treatment during work (p less than 0.05). Phase improved after all therapeutic regimes, but reached significance only during the metoprolol treatment period at rest (p less than 0.05).

  10. Deep Vein Thrombosis, Raynaud's Phenomenon, and Prinzmetal Angina in a Patient with Glanzmann Thrombasthenia

    Directory of Open Access Journals (Sweden)

    Alan Nurden

    2012-01-01

    Full Text Available Patients with Glanzmann thrombasthenia fail to form large platelet thrombi due to mutations that affect the biosynthesis and/or function of the αIIbβ3 integrin. The result is a moderate to severe bleeding syndrome. We now report unusual vascular behaviour in a 55-year-old woman with classic type I disease (with no platelet αIIbβ3 expression and a homozygous ITGA2B missense mutation (E324K affecting the terminal β-propeller domain of αIIb. While exhibiting classic bleeding symptoms as a child, in later life this woman first developed deep vein thrombosis after a long air flight then showed vascular problems characteristic of Raynaud’s phenomenon, and finally this year she presented with chest pains suggestive of coronary heart disease. Yet while coronary angiography first showed a stenosis, this was not seen on a second examination when she was diagnosed with coronary spastic angina and Prinzmetal phenomenon. It is significant that the absence of platelet aggregation with physiologic agonists had not prevented any of the above cardiovascular or vascular diseases.

  11. Effect of Salvia miltiorrhiza on cytokines in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Shi-Lian Chen; Sheng-Bing Huang

    2016-01-01

    Objective:To investigate the effect of Salvia miltiorrhiza (SM) on cytokines in patients with unstable angina pectoris (UAP).Methods: A total of 50 cases of UAP patients from October 2014 to October 2015 as the research object, randomly divided into treatment group and control group, two groups were treated with conventional bed rest, oxygen inhalation, ECG, nitroglycerin intravenous infusion, beta blockers, aspirin, statins, antiplatelet drug therapy, the treatment group on the basis of salvianolate 200 mg+5% glucose 250 mL (neutralization amount of 0.9% sodium chloride was used in patients with diabetes or glucose insulin) intravenous drip, 1 times/d, two groups were treated for 2 weeks; detected before and after treatment of plasma pregnancy associated plasma protein A (PAPP-A), soluble cell differentiation antigen ligand (sCD40L) and the level of serum interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) level.Results: after the end of treatment, the treatment of PAPP-A and sCD40L levels decreased than the control group, which had statistical significance; treatment group IL-1, IL-6, TNF-α level lower than control group, which had statistical significance.Conclusion:On the basis of conventional treatment combined with salvianolate in treatment of UAP, can inhibit platelet aggregation, control inflammatory reaction, stabilize atherosclerotic plaque, reduce risk of cardiovascular events in therapeutic effect, it is worth clinical promotion.

  12. Does surgical sympathectomy improve clinical outcomes in patients with refractory angina pectoris?

    Science.gov (United States)

    Holland, Luke C; Navaratnarajah, Manoraj; Taggart, David P

    2016-04-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: In patients with angina pectoris refractory to medical therapy, does surgical sympathectomy improve clinical outcomes? A total of 528 papers were identified using the search protocol described, of which 6 represented the best evidence to answer the clinical question. There were 5 case series and 1 prospective cohort study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All 5 of the case series demonstrated an improvement in symptoms, exercise tolerance or quality of life in patients undergoing surgical sympathectomy. An early case series investigating an open approach had a high morbidity and mortality rate, but the 4 other series used a minimally invasive technique and had low morbidity and zero perioperative mortality rates. The cohort study compared surgical sympathectomy with transmyocardial laser revascularization (TMR) and concluded TMR to be superior. However, this study looked only at unilateral sympathectomy, whereas all 5 case series focused on bilateral surgery. We conclude that the best currently available evidence does suggest that patients report an improvement in their symptoms and quality of life following surgical sympathectomy, but the low level of this evidence does not allow for a statistically proved recommendation.

  13. Effects of Nicorandil on the Clinical and Laboratory Outcomes of Unstable Angina Patients after Coronary Angioplasty

    Directory of Open Access Journals (Sweden)

    Homa Falsoleiman

    2016-09-01

    Full Text Available Introduction: Ischemic preconditioning mediated by potassium channels is a physiological protective mechanism, . It is hypothesized that Nicorandil, which is a potassium channel activator, could protect the heart via preconditioning. Materials and Methods:This clinical trial was conducted on 162 patients undergoing percutaneous coronary intervention (PCI in Quem hospital, from Jan2013 to Jan 2014,patients  divided into two groups. The first group received standard treatment plus Nicorandil (10 mg, twice daily for three days before and after angioplasty. The second group received standard treatment after PCI. Results: Cardiac enzyme levels were significantly lower in the Nicorandil group at 6 and 12 hours after angioplasty,(p value=0.001 while no significant differences were observed in the symptoms and four-month prognosis of the study groups(p value=0.8. Conclusion:It is recommended that a randomized clinical trial be conducted for the close evaluation of the effects of Nicorandil on unstable angina patients.

  14. Optimizing Prescription of Chinese Herbal Medicine for Unstable Angina Based on Partially Observable Markov Decision Process

    Directory of Open Access Journals (Sweden)

    Yan Feng

    2013-01-01

    Full Text Available Objective. Initial optimized prescription of Chinese herb medicine for unstable angina (UA. Methods. Based on partially observable Markov decision process model (POMDP, we choose hospitalized patients of 3 syndrome elements, such as qi deficiency, blood stasis, and turbid phlegm for the data mining, analysis, and objective evaluation of the diagnosis and treatment of UA at a deep level in order to optimize the prescription of Chinese herb medicine for UA. Results. The recommended treatment options of UA for qi deficiency, blood stasis, and phlegm syndrome patients were as follows: Milkvetch Root + Tangshen + Indian Bread + Largehead Atractylodes Rhizome (ADR=0.96630; Danshen Root + Chinese Angelica + Safflower + Red Peony Root + Szechwan Lovage Rhizome Orange Fruit (ADR=0.76; Snakegourd Fruit + Longstamen Onion Bulb + Pinellia Tuber + Dried Tangerine peel + Largehead Atractylodes Rhizome + Platycodon Root (ADR=0.658568. Conclusion. This study initially optimized prescriptions for UA based on POMDP, which can be used as a reference for further development of UA prescription in Chinese herb medicine.

  15. Optimizing prescription of chinese herbal medicine for unstable angina based on partially observable markov decision process.

    Science.gov (United States)

    Feng, Yan; Qiu, Yu; Zhou, Xuezhong; Wang, Yixin; Xu, Hao; Liu, Baoyan

    2013-01-01

    Objective. Initial optimized prescription of Chinese herb medicine for unstable angina (UA). Methods. Based on partially observable Markov decision process model (POMDP), we choose hospitalized patients of 3 syndrome elements, such as qi deficiency, blood stasis, and turbid phlegm for the data mining, analysis, and objective evaluation of the diagnosis and treatment of UA at a deep level in order to optimize the prescription of Chinese herb medicine for UA. Results. The recommended treatment options of UA for qi deficiency, blood stasis, and phlegm syndrome patients were as follows: Milkvetch Root + Tangshen + Indian Bread + Largehead Atractylodes Rhizome (ADR = 0.96630); Danshen Root + Chinese Angelica + Safflower + Red Peony Root + Szechwan Lovage Rhizome Orange Fruit (ADR = 0.76); Snakegourd Fruit + Longstamen Onion Bulb + Pinellia Tuber + Dried Tangerine peel + Largehead Atractylodes Rhizome + Platycodon Root (ADR = 0.658568). Conclusion. This study initially optimized prescriptions for UA based on POMDP, which can be used as a reference for further development of UA prescription in Chinese herb medicine.

  16. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

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    Murat Yuksel

    2014-01-01

    Full Text Available Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

  17. Prevalence of linked angina and gastroesophageal reflux disease in general practice

    Institute of Scientific and Technical Information of China (English)

    Hirohito Kato; Takamasa Ishii; Tatsuo Akimoto; Yoshihisa Urita; Motonobu Sugimoto

    2009-01-01

    AIM: To evaluate the association between gastroesophageal reflux diseases (GERD) and coronary heart diseases. METHODS: One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as Stsegment depression based on the Minnesota code. RESULTS: Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients). CONCLUSION: The present study suggested that ischemic heart disease might be found although apatient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.

  18. Screening and identification of microRNA involved in unstable angina using gene-chip analysis

    Science.gov (United States)

    Li, Si; Sun, Ya-Nan; Zhou, Yun-Tao; Zhang, Chun-Lai; Lu, Feng; Liu, Jia; Shang, Xiao-Ming

    2016-01-01

    Increasing evidence has suggested that microRNA (miRNA) may play a role in the pathogenesis of cardiovascular disease, which has led to a greater understanding of the complex pathophysiological processes underlying unstable angina (UA). The present study aimed to investigate changes in the miRNA expression profiles of patients with UA using gene-chip analysis, in order to further elucidate the pathogenesis of UA. Total RNA was extracted and purified from plasma samples collected from patients with UA and healthy controls. The samples underwent microarray analysis using an Exiqon miRCURY LNA™ microRNA Array. Differentially expressed miRNAs were identified by volcano plot filtering, and were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In addition, functional annotation of the differentially expressed miRNAs involved gene ontology analyses. Among the 212 miRNAs differentially expressed between the two groups, 82 were upregulated and 130 were downregulated. Notably, the results of the RT-qPCR were consistent with the gene-chip results. The miRNAs identified in the present study may be potential novel biomarkers for the prevention and early diagnosis of UA. Furthermore, the results of the present study suggested that UA occurs as a result of complex and dynamic processes regulated by numerous factors, including multiple miRNAs.

  19. El CO2 como disolvente y como reactivo

    OpenAIRE

    La Franca Pitarresi, Vincenzo Rosario

    2016-01-01

    Existen numerosas ventajas asociada con el uso de CO2 , tanto como disolvente que como reactivo, y todas se pueden resumir en cuatro categorías generales: beneficios ambiental, beneficios de salud y seguridad, beneficios en el procedimiento y beneficios químicos. Los procesos que implican el CO2 como disolvente no aumentaría las emisiones de CO2, más bien proporcionaría una oportunidad para el reciclaje de CO2 residual. Además, los esfuerzos para secuestrar el CO2 producido de los gases de co...

  20. El monumento como un todo. El plan director de restauración

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    Latorre, P.

    2012-12-01

    Full Text Available The aim of this paper is to present the problems that poses in the restoration works the study of historical architecture following the mechanistic paradigm and causal that understands its structure as a stable and closed system, with a linear and predictable behaviour, that is imagined immutable, timeless and reversible; we propose, in contradistinction, to undertake its study together with its users and the natural and social environment in which it is immersed, as an open, complex and dynamic system, with a non linear and holistic behaviour of the elements and parts that make it up in continuous interaction, transformation and evolution of its configuration and construction and definitely, unstable and irreversible. Some of these ideas were elaborated during the redaction and execution of the restoration master plan of the Santa Maria Cathedral of Vitoria- Gasteiz, from which the images that illustrate this article have been taken.

    El objetivo del artículo es exponer los problemas que plantea en el trabajo de restauración el estudio de la arquitectura histórica siguiendo el paradigma mecanicista y causal, que entiende su estructura como un sistema cerrado y estable, con un comportamiento lineal y predecible, que se imagina acabado, intemporal y reversible; en contraposición, se propone acometer su estudio conjuntamente con el de sus usuarios y el medio natural y socio cultural en el que se sitúan como un sistema abierto, complejo y dinámico, con un comportamiento no lineal y holístico de los elementos y partes que lo componen, en continua interacción, transformación y evolución de su configuración y construcción y, en definitiva inestable e irreversible. Algunas de estas ideas se elaboraron durante la redacción y ejecución del plan director de restauración de la Catedral de Santa María de Vitoria-Gasteiz del que se han extraído las imágenes que ilustran el artículo.

  1. Urban angina in the mountains: effects of carbon monoxide and mild hypoxia on subjects with chronic stable angina; Angine de poitrine dans les villes de montangne: effets du monoxyde de carbone et d'une hypoxie legere chez des patients atteints d'angor stable

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, M.T.; Leaf, D.A.; Kelly, E.; Caiozzo, V.; Osann, K.; O' Neill, T.

    2001-01-01

    The aim of this study is the effects of a carbon monoxide exposure and the altitude on the coming of pectoris angina during physical exercise and on the cardiopulmonary functions for coronary disease patients. (A.L.B.)

  2. Pharmacokinetic comparison of the vasorelaxant compound ferulic acid following the administration of Guanxin II to healthy volunteers and patients with angina pectoris.

    Science.gov (United States)

    Li, Yun-Hui; Huang, Xi; Wang, Yang; Fan, Rong; Zhang, Hong-Min; Ren, Ping; Chen, Yao; Zhou, Hong-Hao; Liu, Zhao-Qian; Liang, Yi-Zeng; Lu, Hong-Mei

    2013-11-01

    Coronary heart disease (CHD) is the leading cause of mortality worldwide. The Chinese medicinal formula Guanxin II has been shown to have a favorable effect in the attenuation of angina. The aim of this study was to compare the pharmacokinetics of ferulic acid (FA), which is a vasorelaxant compound present in Guanxin II, in healthy volunteers and patients with angina pectoris following the administration of Guanxin II. Ex vivo experiments were performed in order to investigate the vasorelaxant effect of FA on the human internal mammary artery (IMA) to provide evidence that it is a bioactive component of Guanxin II. Following the oral administration of Guanxin II, the FA levels in the serum were quantified by a simple and rapid high-performance liquid chromatography (HPLC) method. Treatment with FA (10(-8)-10(-3) M) caused a concentration-dependent relaxation of endothelial IMA rings following precontraction with KCl. Statistically significant differences were identified between the pharmaco-kinetic parameters Cmax, t1/2α, t1/2β and t1/2Ka of the healthy volunteers and the patients with angina pectoris following the oral administration of Guanxin II. FA is a bioactive compound absorbed from Guanxin II that attenuates angina pectoris, a condition that may modify the pharmacokinetics of FA. Not only do the pharmacokinetic parameters direct the clinical use of Guanxin II, but they may also be useful for exploring the pathology of angina pectoris.

  3. Las organizaciones educativas como instituciones

    OpenAIRE

    1999-01-01

    Caracterizar los centros educativos como instituciones o como organizaciones institucionalizadas tiene connotaciones precisas y de gran relevancia en cuanto a su comprensión, diseño. funcionamiento y cambio. Se abordan los conceptos de cultura, institución y organización institucionalizada, prestando especial atención al papel desempeñado por las estructuras organizativas, en conexión con el ambiente. Abstract: The portrait of schools as institutions and institutionalized organizatio...

  4. Correlation between Timi Risk Score and Clinical Outcome in Patients with Unstable Angina Pectoris

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    Savovic Zorica

    2016-06-01

    Full Text Available Given Taking that the TIMI score is a major predictor of MACE, this study aimed to determine the value of the TIMI risk score in predicting poor outcomes (death, myocardial infarction, recurrent pain in patients presenting with unstable angina pectoris in short-term observation. A total of 107 patients with APns were examined at the Clinical Centre Kragujevac and were included in the investigation. The TIMI score was determined on the first day of hospitalization. During hospitalization, the following factors were also observed: troponin, ECG evolution, further therapy (pharmacologic therapy and/or emergency PCI or CABG, age, hypertension and hyperlipidaemia. The low-risk group (TIMI 0 - 2 included 30.8% of patients, whereas 47.6% of patients were in the intermediate-risk group (TIMI 3 - 4, and 21.5% of patients were in the high-risk group (TIMI 5 - 7. Good outcomes (without adverse event and poor outcomes (death, myocardial infarction, and recurring chest pain were dependent on the TIMI risk score. The increase in TIMI risk score per one unit increased the risk of a poor outcome by 54%. Troponin and TIMI risk score were positively correlated. Our results suggest that the TIMI risk score may be a reliable predictor of a poor outcome (MACE during the short-term observation of patients with APns. Moreover, patients identified as high-risk benefit from early invasive PCI, enoxaparin and Gp IIb/IIIa inhibitors. Th us, routine use of the TIMI risk score at admission may reduce the number of patients not recognized as high-risk.

  5. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

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    N. S. Krylova

    2015-01-01

    Full Text Available Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC developing under the "mask" of the ischemic heart disease not diagnosed for a long period.Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG, echocardiography (EchoCG, Holter ECG monitoring, coronary angiography (CAG, ventriculography.Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6, EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg., CAG (stenotic lesions of coronary arteries were found, ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicatesexpressed apical hypertrophy of the LV myocard. AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

  6. Reprising Ramadan-Related Angina Pectoris: A Potential Strategy for Risk Reduction.

    Science.gov (United States)

    Siegel, Arthur J; Bhatti, Nasir A; Wasfy, Jason H

    2016-11-10

    BACKGROUND A preponderance of evidence supports short-term aspirin usage to reduce transiently increased cardiovascular risk in clinical conditions that promote acute myocardial ischemia. CASE REPORT We report on the case of a 69-year-old male of Muslim Indian heritage with multiple cardiovascular risk factors who experienced the onset of angina pectoris while fasting for Ramadan for more than 16 hours daily for 30 days in July 2015. While symptom free for 2 months on medical management after ending his fast, he underwent quadruple coronary artery bypass surgery for severe 4-vessel disease following an acute anterior myocardial infarction. A percutaneous coronary intervention with stent placement was subsequently required for persistent myocardial ischemia on stress-MIBI testing due to occlusion of the graft to left anterior descending artery. Presently asymptomatic, he decided to forgo fasting for Ramadan in June 2016. CONCLUSIONS Based on this case, measures for primary cardiovascular prevention among the 1.2 billion susceptible males at similar high short-term cardiac risk while fasting for Ramadan are proposed. The value of aspirin for attenuating high short-term cardiovascular risk in clinical conditions conferring transient inflammatory stress is considered. Low-dose aspirin usage at evening meals while fasting for Ramadan is prudent for primary cardiovascular protection of males who may have non-obstructive coronary atherosclerosis to mitigate the risk for rupture of potentially vulnerable plaques. Based in part on conclusive evidence for protection of middle-aged males from first myocardial infarction in a randomized prospective primary prevention trial, this measure is concordant with recommendations from sub-specialty societies for primary cardiovascular prevention for persons at above-average risk demonstrated by validated biomarkers and from the United States Preventive Services Task Force.

  7. Effects of Salvia miltiorrhiza on Hemorheology and vascular endothelial function in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Shi-Lian Chen; Sheng-Bing Huang

    2016-01-01

    Objective:To investigate the effect of Salvia miltiorrhiza (SM) on vascular endothelial function and hemorheology in patients with unstable angina pectoris (UAP).Methods: A total of 60 cases of UAP patients from October 2014 to October 2015 as the research object, randomly divided into treatment group and control group; the two groups were treated with conventional bed rest, ECG monitoring, oxygen inhalation, application of nitroglycerin, beta blockers, aspirin and antiplatelet, statin therapy, the treatment group based on the use of salvianolate 200 mg+5% glucose 250 mL (neutralization amount of 0.9% sodium chloride was used in patients with diabetes or glucose insulin) intravenous drip, 1 times/d, two groups were treated for 2 weeks; the two groups before and after treatment and take venous blood in the morning fasting peripheral blood viscosity, plasma viscosity, measured by automatic blood rheometer (low and middle shear and high shear rate), hematocrit and erythrocyte aggregation index, serum endothelin (ET) and nitric oxide (NO) level was measured by nitrate reductase Set.Results:after the treatment, the treatment group, the plasma viscosity, whole blood viscosity (low shear, cut and high shear rate), red blood cell hematocrit and red blood cell aggregation index decreased than the control group, there is statistical significance; after treatment, in treatment group, the serum NO level, et reduce degree is significantly better than the contrast group, there is statistical significance.Conclusion: Salvia miltiorrhiza can effectively improve blood rheology, improve microcirculation, regulate vascular endothelial function, effectively reduce the risk of cardiovascular events in UAP patients, it is worthy of clinical application.

  8. Predictive factors of recurrent angina after acute coronary syndrome: the global registry acute coronary events from China (Sino-GRACE)

    Institute of Scientific and Technical Information of China (English)

    ZHAO Fu-hai; CHEN Yun-dai; SONG Xian-tao; PAN Wei-qi; JIN Ze-ning; YUAN Fei; LI Yong-bin; Ren Fang; L(U) Shu-zheng

    2008-01-01

    Background Many patients with acute coronary syndrome (ACS) develop recurrent angina (RA) during hospitalization. The aim of this non-randomized, prospective study was to investigate the predictive factors of RA in unselected patients with ACS enrolled in the global registry acute coronary events (GRACE) during hospitalization in China. Methods Between March 2001 and October 2004, enrolled were 1433 patients with ACS, including ST segment elevation myocardial infarction (662, 46.2%), non-ST segment elevation myocardial infarction (239, 16.7%) and unstable angina (532, 37.1%). The demographic distribution, medical history and clinical data were collected to investigate the predictive factors of RA by Logistic regression.Results During hospitalization 275 (19.2%) patients were documented with RA including unstable angina (53.2%), non-ST segment elevation myocardial infarction (27.5%), ST segment elevation myocardial infarction (19.3%). A comorbidity of dyslipidemia, prior angina, percutaneous coronary Intervention (PCI) within 6 months was more common in patients with RA, P<0.05. In the patients with RA, a significantly higher proportion of patients with acute pulmonary edema was observed, 23 (8.4%) versus 43 (3.7%), P=0.001. Acute renal failure was present in 8 (2.9%) of patients with RA versus 19 (1.6%) of patients without RA,P=0.165. Hemorrhagic events were present in 6 (2.2%) of patients with RA versus 8 (0.7%) of patients without RA, ventricular tachycardia/ ventricular fibrillation events in 12 patients (4.3%) versus 22 patients (1.9%), congestive heart failure in 69 patients (25.0%) versus 94 patients (8.1%), myocardial re-infarction in 28 patients (10.1%) versus 15 patients (1.3%), P<0.05, respectively. A lower proportion of patients with RA underwent in-hospital PCI, 687 (59.3%) versus 114 (41.5%), P=0.000. A higher proportion of patients with RA received heparin, 260 (94.5%) versus 1035 (89.4%), P=0.006; and beta-blockers 176(64.0%) versus 864 (74

  9. Influence of nifedipine on left ventricular perfusion and function in patients with unstable angina: Evaluation with radionuclide techniques

    Energy Technology Data Exchange (ETDEWEB)

    Wall, E.E. van der; Kerkkamp, H.J.; Simoons, M.L.; Rijk, P.P. van; Reiber, J.H.C.; Bom, N.; Lubsen, J.C.; Lie, K.I.

    1986-04-01

    In 1981, a large, double-blind, randomized trial was started in The Netherlands to evaluate the therapeutic effects of nifedipine and/or metoprolol in patients with unstable angina. This study has been called the Holland Interuniversity Nifedipine/metoprolol Trial (HINT) and required several hundred patients to establish potential therapeutic effects. From December 1982 to January 1984 the effects of nifedipine on left ventricular (LV) performance in a subgroup of 52 HINT patients were studied using radionuclide techniques. All patients (23 on nifedipine, 29 controls) underwent thallium-201 scintigraphy or radionuclide angiography just before and 48 h after the start of experimental medication. The radionuclide angiographic studies were also performed at 1 and 4 h after treatment. Nifedipine did not influence the incidence of disapperance of perfusion defects on the 48-h thallium images. No significant differences in overall LV ejections fraction (EF) were seen at any time between nifedipine-treated patients and controls. However, paired observations in 37 patients showed improvement of LVEF after 48 h in 8 patients on nifedipine and in only 1 control patient. Scintigraphic measurements on admission were not related to clinical outcome after 48 h. Concomitant administration of metoprolol did not influence LVEF in either group. It is concluded that nifedipine improves LVEF after 48 h in a subset of patients with unstable angina without affecting myocardial perfusion. This finding indicates that nifedipine has a predominant effect on afterload reduction in patients with unstable angina. Also, early scintigraphic measurements had no significant predictive value for subsequent cardiac events.

  10. Limitations of spontaneous reperfusion and conventional medical therapy to afford myocardial protection through antecedent angina pectoris in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Akiyoshi; Nakata, Tomoaki; Wakabayashi, Takeru; Yuda, Satoshi; Eguchi, Mariko; Sasao, Hisataka; Tsuchihashi, Kazufumi; Shimamoto, Kazuaki [Sapporo Medical Univ. (Japan)

    1999-10-01

    Despite the cardioprotective effect of rapid coronary reperfusion, the effects of spontaneous recanalization on myocardial viability and metabolism are unknown. We studied whether preinfarction angina affords cardioprotection when spontaneous coronary reperfusion occurred in acute infarct patients. Myocardial tomographies with thallium and I-123-labeled-{beta}-methyl-p-iodophenyl penta-decanoic acid (BMIPP) were performed in 27 acute myocardial infarct patients treated medically: 15 patients had preexisting angina before infarction (group A) and 12 did not (group B). Thallium and BMIPP abnormalities and regional function were quantified by a polar map and contrast ventriculography, respectively. There was no significant difference between thallium and BMIPP in the severity index in groups A and B (89{+-}97 vs. 85{+-}68, 97{+-}28 vs. 95{+-}27, respectively), and no significant difference between the groups in the thallium or BMIPP severity index. The ratio of the thallium severity index to that of BMIPP and the regional wall-motion abnormality index were identical in groups A and B. Both patient groups were divided into 2 subgroups based on the presence or absence of spontaneous coronary reperfusion: subgroups A1 and A2, and subgroups B1 and B2, respectively. There were no significant differences among the 4 subgroups in severity indexes for both tracers, the thallium/BMIPP ratio, or the asynergy score. The BMIPP severity index correlated significantly with that of thallium in all subgroups, but no significant difference between the regression lines was found. It is therefore unlikely that spontaneous coronary recanalization affords beneficial effects through preservation of myocardial viability in an ischemia-related zone, suggesting that the cardioprotective effect of preinfarction angina is a limited phenomenon in patients undergoing rapid coronary reperfusion. (author)

  11. N-acetylcysteine modifies the acute effects of isosorbide-5-mononitrate in angina pectoris patients evaluated by exercise testing

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Klarlund, K; Aldershvile, J

    1989-01-01

    , given together with a single oral dose of the long-acting nitrate, isosorbide-5-mononitrate (5-ISMN, 60 mg), would modify the nitrate effect evaluated by exercise testing before and after additional sublingual doses of nitroglycerin (NTG). Ten patients with angina pectoris and angiographically proven...... significant coronary artery disease were included. All patients received a baseline therapy with beta blockers. None of the patients had developed nitrate tolerance at inclusion. NAC/5-ISMN treatment significantly prolonged the total exercise time as compared with placebo/5-ISMN (7.7 +/- 2.1 min vs. 6.8 +/- 1...

  12. THE ASSESSMENT OF NICORANDIL EFFECT ON THE QUALITY OF LIFE IN PATIENTS WITH STABLE ANGINA IN THE "KVAZAR" STUDY

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    S. Yu. Martsevich

    2016-01-01

    Full Text Available Aim. To assess the effect of nicorandil added to the standard therapy of patients with stable ischemic heart disease (IHD on the quality of life (QoL.Material and methods. Patients with verified IHD (stable angina; n=120 were included into double-blind, placebo-controlled, parallel group study. All patients in the study received metoprolol tartrate (100 mg daily. Nicorandil was added (10 mg BID, and then after 2 weeks 20 mg BID to the treatment of patients of the main group. Placebo was added to treatment of patients in the control group. The study duration was 6 weeks. QoL was assessed by theSeattle questionnaire (SAQ and visual analogue scale (VAS at baseline and at the end of the study.Results. A significant decrease in the number of angina attacks was found in the nicorandil group compared to baseline [from 3.0 (2.0, 5.0 to 1.2 (0.7, 2.0; p<0.01] and compared to the placebo group [2.0 (1.0, 3.0; p=0.02]. The positive dynamics of QoL and functionality of patients with IHD was observed in the nicorandil group at the end of the study. It was demonstrated by significant improvement in all SAQ scales compared to baseline. Positive dynamics in the control group was found only in three scales (limitation of physical activity, frequency of angina attacks and patient attitude to the disease. VAS data revealed a significant increase in the integral index in patients of the main group (from 65.0±14.5 to 69.3±15.1; p=0.07, that was significantly higher than this in control group (64.6±15.1; p=0.02 at the end of the study.Conclusion. Nicorandil addition to the standard therapy of patients with IHD (stable angina demonstrated improvement in the QoL, assessed by SAQ questionnaire and VAS.

  13. 冠心病稳定性心绞痛与微血管性心绞痛中医证候要素调查%Expert Investigation of Traditional Chinese Medical Syndrome Elements of Microvascular Angina Pectoris and Stable Angina Pectoris Induced by Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    毕颖斐; 毛静远

    2012-01-01

    [目的]对冠心病稳定性心绞痛与微血管性心绞痛的中医证候要素进行专家调查.[方法]运用专家调查( Delphi)法在全国范围内对冠心病稳定性心绞痛与微血管性心绞痛的中医证候要素及证候类型进行专家咨询和调查.[结果]冠心病稳定性心绞痛与微血管性心绞痛的中医证候要素及证候类型分布基本一致,但也存在一定差异,微血管性心绞痛较稳定性心绞痛多见气滞、血虚等证素及气滞心胸证.[结论]本调查结果可为冠心病稳定性心绞痛与微血管性心绞痛的中医临床辨证提供一定的参考.%Objective To investigate the traditional Chinese medical syndrome elements of microvascular angina pectoris and stable angina pectoris induced by coronary artery disease. Methods Delphi method was adopted for the investigation of traditional Chinese medical syndrome elements and syndrome patterns of microvascular angina pectoris and stable angina pectoris induced by coronary artery disease by experts overall the country. Results Syndrome elements and syndrome patterns were similar in patients with microvascular angina pectoris and stable angina pectoris induced by coronary artery disease. However, some differences existed in the two kinds of angina pectoris, microvascular angina pectoris patients were characterized with syndrome elements of Qi stagnation and blood deficiency, and with syndrome pattern of Qi stagnation in heart and chest. Conclusion The results of the investigation will supply certain evidence for syndrome differentiation of microvascular angina pectoris and stable angina pectoris induced by coronary artery disease.

  14. Therapeutic effects of nicorandil on stubborn angina pectoris%尼可地尔治疗顽固性心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    沈鹃琴; 屈百鸣

    2011-01-01

    目的 观察口服尼可地尔治疗顽固性心绞痛的临床效果.方法 采用随机、临床对照实验方法.选择确诊为顽固性心绞痛的32例患者作为研究对象.随机分为2组,即尼可地尔治疗组、对照组,每组各16例,2组患者均接受心绞痛的常规治疗,其中治疗组在常规治疗基础上加用尼可地尔.研究主要终点为治疗后心绞痛发生情况.结果 治疗组与对照组比较有较低的心绞痛发生率(P<0.05).结论 对顽固性心绞痛患者,在常规治疗的同时加服尼可地尔可获得良好的疗效.%Objective To observe the effects of taking nicorandil on stubborn angina pectoris. Methods Random and clinical control experiment were applied. Thirty - two patients who were diagnosed stubborn angina pectoris were divided into two groups according to whether or not oral nicorandil therapy including therapy group and control group. Each group had 16 cases. All patients were treated with routine treatments of stubborn angina pectoris. The nicorandil therapy group took not only the normal therapy but also nicorandil. The primary end point of the study was to measure the incidence of angina pectoris after therapy. Results The incidence of angina pectoris in the group of nicorandil was lower than control group ( P < 0. 05 ) . Conclusions Stubborn angina pectoris can be relieved by taking nicorandil combing with routine treatments.

  15. 浅谈心绞痛患者的临床护理体会%Study on clinical nursing experience of patients with angina

    Institute of Scientific and Technical Information of China (English)

    尹燕红

    2014-01-01

    目的:分析心绞痛患者的临床护理体会。方法回顾性分析116例心绞痛患者的临床资料,将其随机分为观察组与对照组,各58例,对照组采用常规护理方法,观察组在对照组的基础上针对心绞痛进行护理干预,比较两组患者心绞痛的发作减少程度。结果观察组总有效率显著高于对照组,差异具有统计学意义(P<0.05)。结论针对心绞痛患者加强环境护理、心理护理、健康指导及饮食护理可有效减少患者心绞痛发作次数。%Objective To analyze the clinical experience of nursing care of patients with angina pectoris. Methods Retrospective analysis of the clinical data of 116 cases of angina patients, randomly divided them into observation group and control group, 58 cases in each group, the control group using conventional methods of nursing, the observation group in the control group on angina pectoris of nursing intervention to reduce the degree of seizure, compared two groups of patients with angina pectoris. Results Total effective rate of observation group was signiifcantly higher than that of the control group, the difference has statistical signiifcance (P<0.05). Conclusion For the patients with angina pectoris and strengthen environmental nursing, psychological nursing, health guidance and diet nursing care can effectively reduce the number of episodes in patients with angina pectoris.

  16. Treatment with verapamil and trandolapril in patients with congestive heart failure and angina pectoris or myocardial infarction. The DAVIT Study Group. Danish Verapamil Infarction Trial

    DEFF Research Database (Denmark)

    Hansen, J F; Hagerup, L; Sigurd, B

    1997-01-01

    In a double-blind, randomized trial in a consecutive group of postinfarct patients in treatment with diuretic agents for congestive heart failure, the 3 month rate of cardiac events (i.e., death, repeat infarction, unstable angina pectoris, or repeat admission because of heart failure) was 14......% in patients treated with verapamil and trandolapril and 35% in patients treated with trandolapril (p = 0.01). In another study of patients with angina pectoris and left ventricular ejection fraction less than 40%, trandolapril plus verapamil improved exercise duration and left ventricular ejection fraction...

  17. GAMMAGRAFÍA DE PERFUSIÓN MIOCÁRDICA EN MUJERES POSMENOPÁUSICAS CON ANGINA Y CORONARIAS EPICÁRDICAS ANGIOGRÁFICAMENTE NORMALES / Myocardial perfusion scintigraphy in postmenopausal women with angina and angiographically normal epicardial coronary

    Directory of Open Access Journals (Sweden)

    Sherien Sixto Fernández

    2011-03-01

    Full Text Available Introduction and Objectives: Microvascular angina is common in postmenopausal women. Myocardial ischemia was induced by stress testing, and reports have been published about the relationship between endothelial dysfunction and myocardial perfusion. The objective of this research was to determine whether myocardial ischemia can be evidenced by abnormalities in perfusion and function, as detected by myocardial scintigraphy in women with typical angina, normal coronary angiography and endothelial dysfunction. Methods: 59 women underwent lipid and endothelial function measurements by brachial artery ultrasound, in addition, a 24-hour ECG study (Holter. During the scintigraphy a stress-rest protocol was applied. Patients were divided into two groups according to presence (group I or absence (group II of myocardial perfusion defects. Results: 21 patients showed perfusion defects. 57 % of group I exhibited greater endothelial dysfunction. Only twelve patients showed reversible perfusion defects, and 75 % of the cases was associated with a reduction of post-stress left ventricular ejection fraction, greater than 5 %, and regional abnormalities of wall motion. Three patients in group I showed evidence of ischemia compared with four in Group II. Conclusions: The stress-induced ischemia was associated with a reduced post-stress ejection fraction and endothelial dysfunction in the studied women, and no ischemic changes in the Holter were found.

  18. Valor preditivo da angina em detectar doença coronariana em pacientes com estenose aórtica grave a partir da quinta década de vida Predictive value of angina to detect coronary artery disease in patients with severe aortic stenosis aged 50 years or older

    Directory of Open Access Journals (Sweden)

    Aline Alves Vargas Gonçalves

    2006-12-01

    Full Text Available OBJETIVO: O objetivo deste estudo é verificar o valor de previsão da angina de peito no diagnóstico da DAC em pacientes portadores de EA, a partir da quinta década de vida. MÉTODOS: A população estudada foi constituída por 186 pacientes consecutivos com EA e idade e" 50 anos, referidos para cirurgia de troca valvar aórtica entre junho de 1989 e setembro de 2004. Cinecoronariografia de rotina foi realizada em todos os pacientes. Cento e um eram homens (54,3% e 85, mulheres (45,7%, com idade de 66±8 anos. Angina estava presente em 124 pacientes (66,7%. O gradiente máximo transvalvar aórtico foi de 89,4±27,6 mmHg e a área valvar aórtica de 0,59±0,17 cm2. Calculamos a sensibilidade, a especificidade, o valor de previsão positivo e negativo e a razão de verossimilhança positiva da angina na predição da presença de DAC. RESULTADOS: DAC estava presente em 93 pacientes (50%. Dos 124 pacientes com angina, 68 (54,8% apresentavam DAC; enquanto dos 62 sem angina, 25 apresentavam DAC (40,3%. Portanto, a sensibilidade da angina para DAC foi de 73,1%, a especificidade de 39,7%, valor preditivo positivo de 54,8%, valor preditivo negativo de 59,6% e razão de verossimilhança positiva de 1,6. CONCLUSÃO: A angina de peito não é bom preditor da presença de DAC em pacientes com EA a partir da quinta década de vida.OBJECTIVE: The objective of this study is to evaluate the value of angina pectoris as a predictor of CAD (coronary artery disease in patients with AS (aortic stenosis during and beyond the 5th decade of life. METHODS: The study population consisted of 186 consecutive patients with AS and e" 50 years of age, referred for surgical aortic valve replacement (AVR between June 1989 and September 2004. Routine coronary angiography was performed for all patients. One hundred and one patients were males (54.3% and 85 were females (45.7%, and the mean age was 66±8 years. One hundred and twenty-four patients (66.7% had angina. The maximum

  19. El museo como espacio educativo

    OpenAIRE

    2013-01-01

    El Trabajo Fin de Grado titulado "El museo como espacio educativo" tutelado por D. Jesús Féliz Pascual Molina, trata sobre el estudio acerca de cómo se usan los museos como espacios lúdicos y como mediadores de enseñanza. Para su realización se ha tenido en cuenta la legislación vigente y sobre todo el Decreto 122/2007 de 27 de Diciembre, por el que se establece el currículo de Educación Infantil en Castilla y León. En él se hace mención a la evolución de los museos, los diferentes tipos exis...

  20. Montagem e Imagem como Paradigma

    Directory of Open Access Journals (Sweden)

    Cesar Huapaya

    2016-01-01

    Full Text Available O pensar como montagem e imagem tornou-se um método revelador nos processos de estudos práticos e teóricos do artista e dos pesquisadores nos séculos XX e XXI. Este artigo procura articular três formas de pensar por montagem: nas obras de Bertolt Brecht, Sergei Eisenstein e Georges DidiHuberman. O filósofo e historiador da arte Georges Didi-Huberman reinaugura o debate e o exercício de pensar a antropologia da imagem e a montagem como metalinguagem e forma de conhecimento.

  1. Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; L(U) Shu-zheng; ZHANG Wei-jun; SONG Xian-tao; CHEN Hui; ZHANG Li-jie

    2011-01-01

    Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque.Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.Methods Patients with newly diagnosed unstable angina pectoris from clinical presentation and ECG, who were undergoing coronary angiography from April 2007 to April 2009, were included in this study. A total of 170 subjects were enrolled in the study. Before angiography, the baseline clinical data (mainly including conventional risk factors) was collected.These patients were divided into two groups, a non-plaque group (G1) which included 55 patients with no significant stenosis or less than 20% stenosis in at least one of the major coronary artery branches, and a plaque group (G2) which included 115 patients with at least one of the major coronary artery branches unstable angina pectoris with at least 50% stenosis of one major coronary artery. The patients presenting with calcified nodules of a major coronary artery were excluded from this study.We examined the serum levels of MMP-9 for all cases by multi-effect enzyme-linked immunosorbent assay.Results There was a significant difference in the serum levels of MMP-9 between the two groups (P<0.001). The percentage of patients with hypertension, diabetes and current smokers were significantly different between the two groups (P=0.034, P=0.031, and P=0.044 respectively). The univariate Logistic regression analyses of risk factors showed that smoking was the main risk factor for angina in the non-plaque group with the OR being 1.95 (95% Cl 1.02-3.75).Hypertension, diabetes mellitus

  2. Transient transmural reduction of myocardial blood flow, demonstrated by thallium-201 scintigraphy, as a cause of variant angina

    Energy Technology Data Exchange (ETDEWEB)

    Maseri, A.; Parodi, O.; Severi, S.; Pesola, A.

    1976-08-01

    In previous studies we demonstrated that variant angina could not be attributed to increased myocardial demands. In order to investigate whether a reduction of regional myocardial blood supply could be responsible for these ischemic episodes, we studied regional myocardial perfusion in six patients admitted to our coronary care unit. Myocardial scintigrams, obtained 5-7 min following i.v. injection of 1 mCi of thallium-201, performed during an episode of ST-segment elevation, showed transmural deficits of tracer uptake in the heart wall corresponding to the leads showing ST-segment elevation. These regional deficits had disappeared by 2 hours because of late uptake in previously ischemic myocardium. One week later, following injections performed in the absence of acute ischemia, no deficit was apparent. Tracer uptake in ischemic areas was 60 percent to 85 percent of that observed a week later. After adjusting for thallium-201 kinetics and counting geometry problems, these scintigrams actually represent large underestimations of actual flow reduction. Thus variant angina appears to be caused by massive transmural reduction of myocardial blood supply.

  3. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Weverton Ferreira, E-mail: wfleite@cardiol.br [Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP (Brazil); Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP (Brazil); Ramires, José Antonio Franchini; Moreira, Luiz Felipe Pinho; Strunz, Célia Maria Cassaro [Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP (Brazil); Mangione, José Armando [Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP (Brazil)

    2015-03-15

    High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable angina (UA). This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Forty patients with CAD (20 with SA and 20 with UA) were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001) and UA (r = 0.976, p < 0.001) and for the entire sample (r = 0.985, p < 0.001). Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA.

  4. Exogenous nitric oxide inhibits Rho-associated kinase activity in patients with angina pectoris: a randomized controlled trial.

    Science.gov (United States)

    Maruhashi, Tatsuya; Noma, Kensuke; Fujimura, Noritaka; Kajikawa, Masato; Matsumoto, Takeshi; Hidaka, Takayuki; Nakashima, Ayumu; Kihara, Yasuki; Liao, James K; Higashi, Yukihito

    2015-07-01

    The RhoA/Rho-associated kinase (ROCK) pathway has a key physiological role in the pathogenesis of atherosclerosis. Increased ROCK activity is associated with cardiovascular diseases. Endogenous nitric oxide (NO) has an anti-atherosclerotic effect, whereas the exogenous NO-mediated cardiovascular effect still remains controversial. The purpose of this study was to evaluate the effect of exogenous NO on ROCK activity in patients with angina pectoris. This is a prospective, open-label, randomized, controlled study. A total of 30 patients with angina pectoris were randomly assigned to receive 40 mg day(-1) of isosorbide mononitrate (n=15, 12 men and 3 women, mean age of 63±12 years, isosorbide mononitrate group) or conventional treatment (n=15, 13 men and 2 women, mean age of 64±13 years, control group) for 12 weeks. ROCK activity in peripheral leukocytes was measured by western blot analysis. ROCK activities at 4 and 12 weeks after treatment were decreased in the isosorbide mononitrate group (0.82±0.33 at 0 week, 0.62±0.20 at 4 weeks, 0.61±0.19 at 12 weeks, n=15 in each group, Pangina pectoris.

  5. Circulating CD36 and fractalkine levels are associated with vulnerable plaque progression in patients with unstable angina pectoris.

    Science.gov (United States)

    Li, Rui Jian; Yang, Ming; Li, Ji Fu; Xue, Li; Chen, Yu Guo; Chen, Wen Qiang

    2014-11-01

    The chemokine, fractalkine, independently enhances the vulnerability of coronary atherosclerotic plaques. The present study investigated the combined effects of CD36 and fractalkine on coronary plaque progression in patients with unstable angina pectoris. In the present study, 120 unstable angina pectoris patients undergoing coronary angiography and intravascular ultrasound were divided into two groups: an intermediate lesion group (lumen diameter stenosis 50-70%, 80 patients) and a severe lesion group (at least one lesion with lumen diameter stenosis > 70%, 40 patients). The control group consisted of 40 healthy age- and sex-matched subjects. Concentrations of CD36 and fractalkine were measured by enzyme-linked immunosorbent assay. Major adverse cardiovascular events were monitored over a 2-year follow up. Intravascular ultrasound showed that patients with severe lesions had more calcified and mixed plaques, and a larger plaque area and plaque burden than patients with intermediate lesions (P < 0.05-0.01). More patients with severe lesions underwent stent deployment (P < 0.05) than those with intermediate lesions. CD36 and fractalkine concentrations were significantly higher in the severe lesion patients (P < 0.05), and both had significant positive correlations (P < 0.05) with the plaque burden of atherosclerotic lesions. Using the matched nested case-control study, we found that CD36 and fractalkine levels were higher in patients with recurrent major adverse cardiovascular events than controls (P < 0.05). In conclusion, CD36 and fractalkine both promote, and might synergistically enhance, the progression of coronary atherosclerotic plaques.

  6. Effects of XUEZHIKANG on Oxidized Low Density Lipoprotein,C- Reactive Protein, Fibrinogen in Unstable Angina Pectoris Patients

    Institute of Scientific and Technical Information of China (English)

    姚青海; 崔长琮; 王军奎; 姚晓伟

    2003-01-01

    Objectives To study the effects of XUEZHIKANG on lipid modulating and thelevel of oxidized low density lipoprotein (OX - LDL),C -reactive protein(CRP), fibrinogen(FIB) in serum.Methods XUEZHIKANG was given to patientswith unstable angina pectoris and hyperlipidemia at adose of 0.6 gram bid for 2 months and with half-dose for another 2 months. Vitamin E was given tounstable angina pectoris patients with normal lipid atthe dose of 0.1 gram bid for 4 months respectively.Then compared the level of lipid and OX - LDfL, CRP,FIB in serum at beginning, first -month and second -month. Results XUEZHIKANG can reduce theserum level of total cholesterol, low density lipoproteinin 1 month , and gained better effect in 2 months. Itcan also reduce triglyceride and increase high densitylipoprotein in 2 months. Compared with vitamin EXUEZHIKANG can reduce the level of OX- LDL,CRP, FIB significantly after treatment for 2 months.Conclusions XUEZHIKANG has significant effectin lipid modulating , and it can also inhibit the de-velopment of inflammation in coronary plaque.

  7. A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (CHD-AP) with Xin-blood stagnation syndrome (XBSS).Methods: Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine(TCM) symptoms as well as the safety of the treatment. Results: The significantly effective rate and total effective rate in the tested group were 60.06% (194/323) and 91.02% (294/323) respectively; those in improvement of TCM symptoms were 40.18% (129/321) and 75.23% (243/323) respectively, which were better than those in the control group (P<0.01). Conclusion: SYI Injection is effective and safe in treating CHD-AP-XBSS.

  8. Effect of the platelet membrane GP Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Yonghui Zhao; Changcong Cui; Yanni Wang; Jiaqing Zhu

    2005-01-01

    Objective: To investigate the effect of platelet membrane glycoprotein(GP) Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris (UAP) in Chinese people. Methods: Collagen type Ⅰ -induced platelet aggregation was measured in 33healthy subjects in vitro. Plasma level of α-granule membrane protein (GMP-140) was measured in both the above 33 healthy subjects during fasting and 35 patients with recent onset effort anina during rest onset within 24 h after hospitalization. Furthermore, the platelet membrane GP Ⅰ a gene 807C/T polymorphism was checked in all subjects with polymerase chain reaction-sequence specific primers(PCR-SSP)technique. Results: The lag time before 30% platelet aggregation was significantly longer in healthy subjects with CC genotype than with TC genotype ( P <0.01). However, there was no significant difference in the maximal platelet aggregation between healthy subjects with the above two genotypes. Plasma level of GMP-140 was significantly higher in TC genotypic patients with recent onset effort angina than in CC genotypic patients with the same type of UAP( P < 0.05) and healthy subjects ( P < 0.01), furthermore, there was also significant difference between the latter two groups( P < 0.05). Conclusion: The rapid initiation of collagen-induced platelet aggregation may be associated with platelet membrane GP Ⅰ a T807 allele, which may play an important role in the pathogenesis of UAP.

  9. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    Directory of Open Access Journals (Sweden)

    Weverton Ferreira Leite

    2015-03-01

    Full Text Available Background: High sensitivity C-reactive protein (hs-CRP is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. Objective: To assess the correlation between serum hs-CRP levels (mg/L in a peripheral vein in the left forearm (LFPV with those in the coronary sinus (CS of patients with coronary artery disease (CAD and a diagnosis of stable angina (SA or unstable angina (UA. Methods: This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Results: Forty patients with CAD (20 with SA and 20 with UA were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001 and UA (r = 0.976, p < 0.001 and for the entire sample (r = 0.985, p < 0.001. Conclusion: Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA.

  10. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hui Zhao; Hong Liu; Lin Chai; Ping Xu; Lu Hua; Xiao-Yuan Guan; Bing Duan

    2015-01-01

    Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P < 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P < 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95% confidence interval [CO:1.020-1.054,P < 0.001) and a high GS (OR =1.087,95% CI:1.051-1.124,P < 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95% CI:0.788-0.929,P < 0.001) than that of hsCRP (AUC =0.665,95% CI:0.557-0.773,P =0.006; Z =2.9363,P < 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3%,specificity:68.2%).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  11. Alternative complement pathway activation during invasive coronary procedures in acute myocardial infarction and stable angina pectoris.

    Science.gov (United States)

    Horváth, Zsófia; Csuka, Dorottya; Vargova, Katarina; Kovács, Andrea; Leé, Sarolta; Varga, Lilian; Préda, István; Tóth Zsámboki, Emese; Prohászka, Zoltán; Kiss, Róbert Gábor

    2016-12-01

    The effect of invasive percutaneous coronary procedures on complement activation has not been elucidated. We enrolled stable angina patients with elective percutaneous coronary intervention (SA-PCI, n=24), diagnostic coronary angiography (CA, n=52) and 23 patients with ST segment elevation myocardial infarction and primary PCI (STEMI-PCI). Complement activation products (C1rC1sC1inh, C3bBbP and SC5b-9) were measured on admission, 6 and 24h after coronary procedures. The alternative pathway product, C3bBbP significantly and reversibly increased 6h after elective PCI (baseline: 7.81AU/ml, 6h: 16.09AU/ml, 24h: 4.27AU/ml, p<0.01, n=23) and diagnostic angiography (baseline: 6.13AU/ml, 6h: 12.08AU/ml, 24h: 5.4AU/ml, p<0.01, n=52). Six hour C3bBbP values correlated with post-procedural CK, creatinine level and the applied contrast material volume (r=0.41, r=0.4, r=0.3, p<0.05, respectively). In STEMI-PCI, baseline C3bBbP level was higher, compared to SA-PCI or CA patients (11.33AU/ml vs. 7.81AU/ml or 6.13AU/ml, p<0.001). Similarly, the terminal complex (SC5b-9) level was already elevated at baseline compared to SA-PCI group (3.49AU/ml vs. 1.87AU/ml, p=0.011). Complement pathway products did not increase further after primary PCI. Elective coronary procedures induced transient alternative complement pathway activation, influenced by the applied contrast volume. In STEMI, the alternative complement pathway is promptly activated during the atherothrombotic event and PCI itself had no further detectable effect.

  12. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Hui Zhao

    2015-01-01

    Full Text Available Background: As an acute phase protein, α1-antitrypsin (AAT has been extensively studied in acute coronary syndrome, but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP. The purpose of the present study was to investigate the association between AAT plasma levels and SAP. Methods: Overall, 103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study. Plasma levels of AAT, high-sensitivity C-reactive protein (hsCRP, lipid profiles and other clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the Gensini score (GS assessed by coronary angiography. Results: Positively correlated with the GS (r = 0.564, P < 0.001, the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs. 125.50 ± 19.67 mg/dl, P < 0.001. The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] = 1.037, 95% confidence interval [CI]: 1.020-1.054, P < 0.001 and a high GS (OR = 1.087, 95% CI: 1.051-1.124, P < 0.001 in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, plasma AAT level was found to have a larger area under the curve (AUC for predicting a high GS (AUC = 0.858, 95% CI: 0.788-0.929, P < 0.001 than that of hsCRP (AUC = 0.665, 95% CI: 0.557-0.773, P = 0.006; Z = 2.9363, P < 0.001, with an optimal cut-off value of 137.85 mg/dl (sensitivity: 94.3%, specificity: 68.2%. Conclusions: Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  13. La ciudad como ecosistema urbano

    OpenAIRE

    Higueras García, Esther

    2013-01-01

    LA CIUDAD COMO ECOSISTEMA URBANO .- La ecología y los ecosistemas .- El ecosistema urbano, definición, alcance y oportunidad .- El metabolismo urbano .- Los síntomas de la patología urbana .- Los objetivos del nuevo ecosistema urbano .- Las aportaciones de los ecobarrios

  14. Angina pré-infarto na evolução intra-hospitalar de pacientes idosos com infarto agudo do miocárdio Preinfarction angina and in-hospital outcome of elderly patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Chiu Wen Shian

    2007-12-01

    Full Text Available FUNDAMENTO: A angina pré-infarto (API pode ser um marcador de pré-condicionamento isquêmico. Foi demonstrada redução da área infartada, do remodelamento ventricular, da incidência de insuficiência cardíaca, choque cardiogênico ou morte, quando a API estava presente. Esses resultados foram mais evidentes em adultos, porém, não em idosos. OBJETIVO: Avaliar a relação entre API e a evolução clínica de pacientes idosos com infarto agudo do miocárdio (IAM. MÉTODOS: Estudo tipo série de casos com grupo de comparação. Foram incluídos 36 pacientes com diagnóstico de IAM com elevação do segmento ST. Os pacientes foram distribuídos em grupo A (21 pacientes com API e grupo B (15 pacientes sem API. RESULTADOS: A idade média da população estudada foi 70,5 anos. A maioria (73% dos pacientes era do sexo masculino. O índice de massa corpórea médio foi 25,3 kg/m2. A amostra era constituída por 77,8% de hipertensos, 27,8% de diabéticos e 32,4% de dislipidêmicos. Dor torácica tipo A foi relatada por 71,4% dos estudados. A maioria (72,2% dos idosos foi classificada em Killip I. Os desfechos clínicos nos grupos A e B foram: angina pós-infarto 9,5% versus 20%, p=0,630; insuficiência cardíaca 23,8% versus 13,3%, p=0,674; revascularização de urgência 4,8% versus 6,7%, p=1; arritmia cardíaca 0% versus 6,7%, p=0,417. Não foi constatado nenhum caso de reinfarto, choque cardiogênico e morte até 30 dias em ambos os grupos. CONCLUSÃO: A presença da angina pré-infarto não se associou com uma melhor evolução clínica em idosos acometidos por IAM nesta série de casos.BACKGROUND: Preinfarction angina (PIA may be a marker of ischemic preconditioning. A decrease in infarct size, ventricular remodeling, congestive heart failure, cardiogenic shock or death was demonstrated in the presence of preinfarction angina. These findings were more evident in adults, but not in the elderly. OBJECTIVE: To assess the relationship between PIA

  15. Coronary angioplasty for unstable angina: immediate and late results in 200 consecutive patients with identification of risk factors for unfavorable early and late outcome

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); J.J. Tijssen; A.J. Azar (Aida); P.G. Hugenholtz (Paul); R.T. van Domburg (Ron)

    1988-01-01

    textabstractTwo hundred patients (mean age 56 years, range 36 to 74) with unstable angina (chest pain at rest, associated with ST-T changes) underwent coronary angioplasty. In 65 patients with multivessel disease, only the "culprit" lesion was dilated. The initial success rate was 89.5% (179 of 200

  16. Relationship between angina pectoris and outcomes in patients with heart failure and reduced ejection fraction : an analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)

    NARCIS (Netherlands)

    Badar, Athar A.; Perez-Moreno, Ana Cristina; Jhund, Pardeep S.; Wong, Chih M.; Hawkins, Nathaniel M.; Cleland, John G. F.; van Veldhuisen, Dirk J.; Wikstrand, John; Kjekshus, John; Wedel, Hans; Watkins, Stuart; Gardner, Roy S.; Petrie, Mark C.; McMurray, John J. V.

    2014-01-01

    Aim Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure

  17. Interindividual and intraindividual variability in plasma fibrinogen, TPA antigen, PAI activity, and CRP in healthy, young volunteers and patients with angina pectoris

    NARCIS (Netherlands)

    Maat, M.P.M. de; Bart, A.C.W. de; Hennis, B.C.; Meijer, P.; Havelaar, A.C.; Mulder, P.G.H.; Kluft, C.

    1996-01-01

    We compared intraindividual and interindividual variability in the plasma levels of fibrinogen, tissue-type plasminogen activator (TPA) antigen, plasminogen activator inhibitor (PAI) activity, and C-reactive protein (CRP) in 20 healthy, young individuals and 26 patients with stable angina pectoris (

  18. Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery

    NARCIS (Netherlands)

    Jessurun, GAJ; Tio, RA; De Jongste, MJL; Hautvast, RWM; Den Heijer, P; Crijns, HJGM

    1998-01-01

    To study the effect of transcutaneous electrical nerve stimulation (TENS) on coronary vasomotion, patients with New York Heart Association class III angina pectoris and significant single-vessel left coronary artery disease and who were also scheduled for elective percutaneous transluminal coronary

  19. Diagnostic and prognostic value of a careful symptom evaluation and high sensitive troponin in patients with suspected stable angina pectoris without prior cardiovascular disease

    DEFF Research Database (Denmark)

    Madsen, Debbie M; Diederichsen, Axel C P; Hosbond, Susanne E

    2017-01-01

    BACKGROUND AND AIMS: Typical angina pectoris (AP) and high-sensitive troponin I (hs-TnI) are independently associated with coronary artery disease (CAD) and future cardiovascular events (CVE). This study aimed to assess the individual and combined diagnostic and prognostic impact of symptoms and hs...

  20. [Dengzhan Xixin injection as an adjuvant treatment for angina pectoris: a systematic review and Meta-analysis of randomized controlled trials].

    Science.gov (United States)

    Wang, Feng-jiao; Xie, Yan-ming; Liao, Xing; Jia, Min

    2015-08-01

    The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.

  1. Dietary factor VII activation does not increase plasma concentrations of prothrombin fragment 1+2 in patients with stable angina pectoris and coronary atherosclerosis

    DEFF Research Database (Denmark)

    Bladbjerg, E-M; Münster, A M; Marckmann, P

    2000-01-01

    tissue factor, the cofactor of FVII, to circulating blood; therefore, thrombin formation in response to FVII activation is more likely to occur in such patients. This hypothesis was tested in a randomized crossover study of 30 patients (aged 43 to 70 years) with stable angina pectoris...

  2. 不稳定型心绞痛的临床治疗方法%Clinical Treatment of Unstable Angina Pectoris TIAN Xue-feng

    Institute of Scientific and Technical Information of China (English)

    田学峰

    2013-01-01

    目的:探讨不稳定型心绞痛的内科治疗。方法:选取我院2011年12月~2012年12月收治的100例不稳定型心绞痛患者。对其进行一般治疗及药物治疗。结果:临床治愈效果明显。结论:不稳定型心绞痛患者经一般治疗及药物治疗均好转出院。有研究表明不稳定心绞痛患者在发病最初的几周内心肌梗死的发生率为10%,死亡率为4%。%Objective:To investigate the Department of internal medicine in the treatment of unstable angina pectoris .Methods:Se-lected in our hospital from 2011 December to 2012 December was treated 100 cases of patients with unstable angina pectoris , General treatment and drug therapy .Results:the clinical cure effect .Conclusion:Unstable angina pectoris patients after general treatment and drug treatment were improved and discharged .Studies have shown thatpatients with unstable angina pectoris myocardial incidence in the early week infarction incidence rate was 10%, mortality was 4%.

  3. Predictive value of local and core laboratory echocardiographic assessment of cardiac function in patients with chronic stable angina: The ACTION study

    NARCIS (Netherlands)

    A.M. Dart (Anthony); J.E. Otterstad (Jan Erik); B.A. Kirwan (Bridget Anne); J.D. Parker (John); S. de Brouwer (Sophie); P. Poole-Wilson (Philip); J. Lubsen (Jacobus)

    2007-01-01

    textabstractAims: To evaluate the relationship between echocardiographic cardiac function and outcome in patients with stable symptomatic angina. Methods: Baseline echo left ventricular ejection fraction and volume data measured in a central laboratory was available for 7016 patients (92% of the tot

  4. beta-blocker Therapy is Not Associated with Reductions in Angina or Cardiovascular Events After Coronary Artery Bypass Graft Surgery : Insights from the IMAGINE Trial

    NARCIS (Netherlands)

    Booij, Harmen G.; Damman, Kevin; Warnica, J. Wayne; Rouleau, Jean L.; van Gilst, Wiek H.; Westenbrink, B. Daan

    2015-01-01

    To evaluate whether beta-blockers were associated with a reduction in cardiovascular events or angina after Coronary Artery Bypass Graft (CABG) surgery, in otherwise stable low-risk patients during a mid-term follow-up. We performed a post-hoc analysis of the IMAGINE (Ischemia Management with Accupr

  5. Increased expression and plasma levels of myeloperoxidase are closely related to the presence of angiographically-detected complex lesion morphology in unstable angina

    NARCIS (Netherlands)

    Naruko, T.; Furukawa, A.; Yunoki, K.; Komatsu, R.; Nakagawa, M.; Matsumura, Y.; Shirai, N.; Sugioka, K.; Takagi, M.; Hozumi, T.; Itoh, A.; Haze, K.; Yoshiyama, M.; Becker, A.E.; Ueda, M.

    2010-01-01

    Background Myeloperoxidase (MPO) is a leucocyte enzyme that catalyses the formation of a number of reactive oxidant species. Objective The purpose of this study is to evaluate the relationship between angiographic coronary plaque morphology in patients with unstable angina pectoris (UAP) or stable a

  6. Markers of fibrinolytic potency and clotting activation in stable angina pectoris : Role of urokinase, assessment of atrioventricular differences and correlation with coronary patency

    NARCIS (Netherlands)

    Páramo, U.A.; Panizo, C.; Montes, R.; Orbe, J.; Alegría, E.; Martínez-Caro, D.; Dooijewaard, G.

    1999-01-01

    To characterize the extent of activation of the hemostatic system and to detect local alterations which may favour thrombus formation we obtained samples from the right atrium (RA) and left ventricle (LV) of 60 stable angina patients (mean age 59 years, M/F: 49/11) during the cardiac catheterization

  7. Non-invasive diagnostic workup of patients with suspected stable angina by combined computed tomography coronary angiography and magnetic resonance perfusion imaging

    NARCIS (Netherlands)

    S.W.M. Kirschbaum (Sharon); K. Nieman (Koen); T. Springeling (Tirza); A.C. Weustink (Annick); S. Ramcharitar (Steve); C.A.G. van Mieghem (Carlos); A.G. Rossi (Adriano); E. Duckers (Eric); P.W.J.C. Serruys (Patrick); H. Boersma (Eric); P.J. de Feyter (Pim); R.J.M. van Geuns (Robert Jan)

    2011-01-01

    textabstractBackground: To evaluate additional adenosine magnetic resonance perfusion (MRP) imaging in the diagnostic workup of patients with suspected stable angina with computed tomography coronary angiography (CTCA) as first-line diagnostic modality. Methods and Results: Two hundred and thirty sy

  8. El singular como diferencia divina

    Directory of Open Access Journals (Sweden)

    Maria Jose Binetti

    2012-01-01

    Full Text Available Mucho se ha hablado sobre la posición de la diferencia como motor dialéctico de la existencia singular kierkegaardiana. El pecado, el otro o el Otro fisuran la subjetividad humana y la obligan a una identidad que guardará siempre la herida. El sujeto de la escisión es, en este sentido, el existente mismo, y tal debe ser el caso si la perspectiva se concentra en la individualidad. No obstante, y desde el punto de vista especulativo, creemos que los mismos principios utilizados por Kierkegaard para explicar el dinamismo de la existencia singular nos llevan más lejos, a saber, nos conducen al absoluto mismo como sujeto último de toda alteridad, respecto del cual el singular hace la diferencia.

  9. El arte como posible conocimiento

    Directory of Open Access Journals (Sweden)

    Janitzio Alatriste Tobilla

    2010-01-01

    Full Text Available Este artículo es producto de una investigación que intenta construir un modelo metodológico para concebir la producción artística como una forma de conocimiento e incorporar el quehacer imaginario del artista dentro de los esquemas que regulan la investigación académica tanto en México como en el mundo. La construcción de esta propuesta metodológica ha sido creada desde tres posiciones con respecto al conocimiento: la semiótica de Charles S. Peirce, la teoría psicoanalítica de Jacques Lacan y la práctica artística visual.

  10. Side effects of using nitrates to treat heart failure and the acute coronary syndromes, unstable angina and acute myocardial infarction.

    Science.gov (United States)

    Thadani, Udho; Ripley, Toni L

    2007-07-01

    Nitrates are potent venous dilators and anti-ischemic agents. They are widely used for the relief of chest pain and pulmonary congestion in patients with acute coronary syndromes and heart failure. Nitrates, however, do not reduce mortality in patients with acute coronary syndromes. Combination of nitrates and hydralazine when given in addition to beta-blockers and angiotensin-converting enzyme (ACE) inhibitors reduce mortality and heart failure hospitalizations in patients with heart failure due to left ventricular systolic dysfunction who are of African-American origin. Side effects during nitrate therapy are common but are less well described in the literature compared with the reported side effects in patients with stable angina pectoris. The reported incidence of side effects varies highly among different studies and among various disease states. Headache is the most commonly reported side effect with an incidence of 12% in acute heart failure, 41-73% in chronic heart failure, 3-19% in unstable angina and 2-26% in acute myocardial infarction. The reported incidence of hypotension also differs: 5-10% in acute heart failure, 20% in chronic heart failure, 9% in unstable angina and < 1-48% in acute myocardial infarction, with the incidence being much higher with concomitant nitrate therapy plus angiotensin-converting enzyme inhibitors. Reported incidence of dizziness is as low as 1% in patients with acute myocardial infarction to as high as 29% in patients with heart failure. Severe headaches and/or symptomatic hypotension may necessitate discontinuation of nitrate therapy. Severe life threatening hypotension or even death may occur when nitrates are used in patients with acute inferior myocardial infarction associated with right ventricular dysfunction or infarction, or with concomitant use of phosphodiesterase-5 inhibitors or N-acetylcysteine. Despite the disturbing observational reports in the literature that continuous and prolonged use of nitrates may lead to

  11. Correlation between Serum High Sensitivity CRP Level and Inhospital Cardiac Events in the Patients with Unstable Angina

    Directory of Open Access Journals (Sweden)

    H. Kazerani

    2007-10-01

    Full Text Available Introduction & Objective: Several studies have been performed to evaluate correlation of serum high sensitivity CRP (hs-CRP level with the prognosis of the patients with diagnosis of unstable angina, and by now different results were reported. The aim of this study was to assess correlation between serum hs-CRP level and inhospital prognosis and cardiac events in the patients with unstable angina. Materials & Methods: This descriptive analytic study was performed from Sep 2004 till Feb 2006 in Shahid Beheshti hospital. Kermanshah, Iran. Sera were collected from 250 patients for hs-CRP measurement. Exclusion criteria were: acute ST elevation MI, non ST elevation MI, patients with history of recent infection, patients with recent trauma and patients with serum high sensitive CRP level more than 10 mg/lit. Patients were divided into two groups, first group whose serum hs-CRP level was less than 3 mg/lit and second group whose serum hs-CRP level was between 3 and 10 mg/lit. They were followed for recurrent chest pain, arrhythmias, pulmonary edema, acute myocardial infarction and in hospital death. Results were analyzed using x² and t-test. Results: Mean age were 57±7.8 and 58±11.5 years in first group and second group respectively. There was statistically significant difference in some cardiac complications such as dyspnea, duration of hospitalization, recurrent chest pain, CCU admission (p<0.001 and in hospital myocardial infarction (p=0.03, between two groups. Some complications did not have significant difference such as pulmonary edema, cardiogenic shock, arrhythmia, S3, S4 and pulmonary rates .There was no mortality in both groups. Conclusion: According to the results, we can use serum hs-CRP level for risk stratification in the patients with diagnosis of unstable angina. Obviously the patients with high serum hs-CRP level need more attention whether early invasive management help these patients, may be the matter of later studies.

  12. The impact of lipoprotein apheresis in patients with refractory angina and raised lipoprotein(a): Objectives and methods of a randomised controlled trial.

    Science.gov (United States)

    Khan, Tina Z; Pottle, Alison; Pennell, Dudley J; Barbir, Mahmoud S

    2015-05-01

    It is well established that Lipoprotein(a) [Lp(a)] is an independent cardiovascular risk factor and predictor of major adverse cardiovascular events. Lipoprotein apheresis is currently the most effective approved treatment available, with minimal effect conferred by conventional lipid lowering agents. A growing body of evidence suggests that aggressively lowering raised Lp(a) may improve cardiovascular and clinical outcomes, although more prospective research is required in this field. Angina which is refractory to conventional medical therapy and revascularisation is extremely challenging to manage. There is a significant unmet need to establish therapeutic options. Our goal is to determine the impact of lipoprotein apheresis on clinical parameters and symptoms of patients with refractory angina secondary to advanced coronary disease and raised Lp(a). Determining whether we should aggressively lower Lp(a) in such patients remains a very important question, which could potentially impact on the management of a large population. We will also gain insight into how this treatment works and the mechanisms via which Lp(a) increases cardiovascular risk. We are currently conducting a prospective, randomised controlled crossover study of patients with refractory angina and raised Lp(a), randomised to undergoing three months of weekly lipoprotein apheresis or sham apheresis. Patients will then crossover to the opposite study arm after a 1 month wash-out phase. We will assess myocardial perfusion, carotid atherosclerosis, endothelial vascular function, thrombogenesis, oxidised LDL and their antibodies, exercise capacity, angina and quality of life at the beginning and end of treatment, to determine the net true treatment effect on the above parameters. This is a novel area of research, as previous studies have not assessed the role of lipoprotein apheresis in patients with refractory angina and raised Lp(a) in a prospective randomised controlled manner.

  13. Progress on Ivabradine in Treating Stable Angina Pectoris%伊伐布雷定治疗稳定性心绞痛的研究进展

    Institute of Scientific and Technical Information of China (English)

    江明芳; 张家美

    2015-01-01

    Increasing of heart rate is an important risk factor of cardiovascular diseases,also is the main cause of angina pectoris. Ivabradine is one kind of I( f) channel inhibitors,can effectively slow down the heart rate of patients with stable angina pectoris, reduce myocardial oxygen consumption and the attack frequency of angina pectoris, relieve the clinical symptoms. At present,it is not very sure about that whether ivabradine can improve the long-term prognosis or quality of life of patients with stable angina pectoris or not. This paper reviewed the mechanism,related clinical evidences and adverse reactions of ivabradine,to investigate the feasibility of ivabradine in treating stable angina pectoris.%心率增快是心血管疾病的重要危险因素,也是导致心绞痛发作的重要原因。伊伐布雷定是一种I( f)电流通道抑制剂,能有效减慢稳定性心绞痛患者心率,进而减低心肌耗氧量、改善临床症状、减少心绞痛发作次数。但目前关于伊伐布雷定能否改善稳定性心绞痛患者远期预后及提高患者生活质量等方面的研究仍存在争议。本文从伊伐布雷定作用机制、相关临床证据及不良反应等方面进行综述,以探讨伊伐布雷定治疗稳定性心绞痛的可行性。

  14. A literatura como antropologia especulativa

    Directory of Open Access Journals (Sweden)

    Alexandre Andre Nodari

    2015-11-01

    Full Text Available Se décadas atrás, Lyotard identificou a crise de legitimação política e do conhecimento de então como a crise dos grandes relatos, talvez se possa dizer que a crise atual é uma crise do grande Relator: a crise das humanidades seria, assim, parte mais geral da crise do Humano. Diante do Antropoceno, as ciências do homem (as antropologias têm como um dos seus desafios converterem-se em humanidades, isto é, especular sobre as definições de homem e mundo, descobrindo outras humanidades e mundos. Aqui, a literatura, entendida a partir de Juan José Saer como uma “antropologia especulativa”, pode revelar-se uma linha de fuga: diante do contingenciamento econômico das humanidades, ela apresenta a contingência ecológica desse modelo de mundo.     This work is licensed under a Creative Commons Attribution 3.0 License.

  15. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents.

    Science.gov (United States)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe; Aquino, Melissa; Stone, Gregg W; Sartori, Samantha; Steg, Philippe Gabriel; Wijns, William; Smits, Pieter C; Jeger, Raban V; Leon, Martin B; Windecker, Stephan; Serruys, Patrick W; Morice, Marie-Claude; Camenzind, Edoardo; Weisz, Giora; Kandzari, David; Dangas, George D; Mastoris, Ioannis; Von Birgelen, Clemens; Galatius, Soren; Kimura, Takeshi; Mikhail, Ghada; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo-Soo; Valgimigli, Marco; Kastrati, Adnan; Chieffo, Alaide; Mehran, Roxana

    2015-09-15

    The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p <0.01). Conversely, no differences in crude mortality rates were observed between 1 and 3 years across clinical presentations. After multivariable adjustment, STEMI was independently associated with greater risk of 3-year mortality (hazard ratio [HR] 3.45; 95% confidence interval [CI] 1.99 to 5.98; p <0.01), whereas no differences were observed between UAP or NSTEMI and SAP (HR 0.99; 95% CI 0.73 to 1.34; p = 0.94). In women with ACS, use of new-generation DES was associated with reduced risk of major adverse cardiac events (HR 0.58; 95% CI 0.34 to 0.98). The magnitude and direction of the effect with new-generation DES was uniform between women with or without ACS (pinteraction = 0.66). In conclusion, in women across the clinical spectrum of CAD, STEMI was associated with a greater risk of long-term mortality. Conversely, the adjusted risk of mortality between UAP or NSTEMI and SAP was similar. New-generation DESs provide improved long-term clinical outcomes irrespective of the clinical presentation in women.

  16. Clinical analysis of the 76 cases of coronary heart disease with stable angina pectoris and unstable angina%冠心病稳定型心绞痛与不稳定型心绞痛76例临床分析

    Institute of Scientific and Technical Information of China (English)

    朱国安

    2015-01-01

    目的:分析和探究稳定性心绞痛与不稳定型心绞痛的发病规律、诱因、临床表现、差异性和治疗措施。方法:回顾性分析76例心绞痛患者的临床特点和治疗措施,实验室及其他检查,研究稳定型心绞痛与不稳定型心绞痛的临床表现和治疗方法。结果:冠心病心绞痛常见的症状为发作性胸痛,疼痛部位主要在胸骨体中段或上段之后,稳定型心绞痛表现为阵发性的前胸压榨性疼痛,主要治疗以休息和舌下含服硝酸酯制剂。不稳定型心绞痛表现为原有劳力性心绞痛恶化,出现静息心绞痛及梗死后心绞痛,治疗以止痛、抗栓、抗凝、急诊冠状动脉介入治疗。结论:稳定型心绞痛根据临床表现以控制和减轻症状为主。不稳定型心绞痛以抗凝、防止心肌梗死为主。%Objective:To analyze and explore pathogenesis regularity,inducement,clinical manifestations,difference and treatment measures of stable angina and unstable angina.Methods:A retrospective analysis of 76 cases of angina patients clinical features and treatment measures,laboratory and other tests,studying the clinical manifestations and treatment with stable angina unstable angina.Results:Common symptoms of angina pectoris is chest pain episodes,pain in the middle part of the main body of the sternum or after the previous paragraph,stable angina showed paroxysmal crushing chest pain,the main treatment is rest and sublingual nitrates.Unstable angina is characterized by the deterioration of the existing angina pectoris,appear resting and post-infarction angina pectoris,treatment of pain,antithrombotic,anticoagulant,percutaneous coronary intervention.Conclusion:According to the clinical manifestations of stable angina in order to control and alleviate symptoms.Unstable angina with anticoagulation,prevention of myocardial infarction based.

  17. The pro- and anti-inflammatory markers in patients with acute myocardial infarction and chronic stable angina.

    Science.gov (United States)

    Wojakowski, Wojciech; Maslankiewicz, Katarzyna; Ochala, Andrzej; Wyderka, Rafal; Zuk-Popiolek, Izabela; Flak, Zbigniew; Mroz, Iwona; Tendera, Michal

    2004-08-01

    The aim of this study was to assess the plasma levels of VEGF and interleukin-10 in patients with acute myocardial infarction (AMI) and stable chronic angina (SA) and correlate the values with traditional CHD risk factors, left ventricular ejection fraction (LVEF) and established inflammatory marker hsCRP. Fifty patients with AMI and 30 with SA were enrolled. IL-10 levels in AMI patients were lower than in SA patients (9.81 +/- 5.0 versus 22.63 +/- 8.38 pg/ml, p 40% and Killip class I-II (338.8 +/- 51.59 versus 271.8 +/- 50.51 pg/ml; p 6 h versus inflamatory markers and CHD risk factors and the function of the left ventricle on admission.

  18. Coronary flow reserve evaluated by {sup 201}Tl myocardial perfusion SPECT after coronary artery bypass grafting (CABG) for angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ishino, Yoichi; Nakata, Hajime [Univ. of Occupational and Environmental Health, Kitakyusyu, Fukuoka (Japan)

    2000-11-01

    We compared the flow reserves of the coronary bypass vessels between arterial and venous grafts by {sup 201}Tl myocardial perfusion SPECT on the patients with angina pectoris who had no past history of myocardial infarction or intervention therapy such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and 66 of them were proved to be patent at postoperative CAG. Reversible defects were observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11 of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative reversible defects was higher in the areas grafted by artery but this had no relation with the severity of coronary artery stenosis before CABG. This reversible defect is most likely to be caused by the character of artery graft itself and this should not be considered to highly suggest the restenosis or occlusion of the graft vessel. (author)

  19. The evaluation of B-type Natriuretic Peptide and Troponin I in acute myocardial infarction and unstable angina

    Directory of Open Access Journals (Sweden)

    Nafija Serdarevic

    2014-09-01

    Full Text Available Introduction: The diagnostic utility of B-type natriuretic peptide (BNP has prompted interest in its use as an aid in the detection of early heart failure and assessment of diseases. The first objective of this study was measurement of BNP and troponin I (TnI blood levels in patients with acute myocardial infarction (AMI and unstable angina. The second objective of this study was to find a correlation between TnI and BNP in blood.Methods: The concentrations of BNP and TnI in 150 blood levels were determined using CMIA (chemiluminescent microparticle immunoassay Architect and 2000 (Abbott diagnostics. The retrospective study included 100 patients who were hospitalized at the Department of Internal Medicine of the University Clinical Center Sarajevo and 50 healthy control. The reference blood range of BNP is 0-100 pg/mL and TnI is 0.00-0.4 ng/mL.Results: In the patients with AMI the mean value of BNP is 764.48 ± 639.52 pg/mL and TnI is 2.50 ± 2.28ng/mL. The patients with unstable angina have BNP 287.18 ± 593.20 pg/mL and TnI 0.10 ± 0.23 ng/mL. Our studies have shown that the correlation between BNP and TnI was statistically significant for p< 0.05 using Student t test with correlation coefficient r = 0.36. Conclusions: BNP and TnI levels can help to identify the patients with a high risk for cardiovascular diseases.

  20. A literature review to evaluate the economic value of ranolazine for the symptomatic treatment of chronic angina pectoris.

    Science.gov (United States)

    Vellopoulou, Katerina; Kourlaba, Georgia; Maniadakis, Nikos; Vardas, Panagiotis

    2016-05-15

    To conduct a systematic review of the evidence regarding the economic value of ranolazine relative to standard-of-care (SOC) for the treatment of symptomatic chronic stable angina (CSA). Electronic databases were searched using relevant keywords. The identified studies were independently reviewed by two investigators against pre-determined inclusion and exclusion criteria. Their data were extracted using a relevant form and consequently were synthesized. Studies were also evaluated using the Quality of Health Economic Studies scale. The main outcomes considered were the cost and effectiveness for each comparator and the incremental cost per quality-adjusted-life year (QALY) gained. Six studies were included in the review. Five of these assessed the cost-utility of ranolazine added to SOC, compared to SOC alone, using decision trees or Markov models whereas one was a retrospective cost evaluation study. The analysis was conducted from a payer perspective in five studies and from a societal perspective in one study with the time horizon varying between six months and a year. The incremental cost-effectiveness ratio (ICER), ranged from €4000 to €15,000 per QALY gained. Ranolazine appears to be dominant or cost-effective, mainly due to its ability to decrease angina-related hospitalizations and also due to a marginal improvement in quality of life. The acquisition cost of ranolazine was the variable with the greatest impact upon the ICER. The existing evidence, although limited, indicates that ranolazine may be a dominant or cost-effective therapy option, for the treatment of patients with symptomatic CSA. Further research is required to evaluate the cost-effectiveness of ranolazine.

  1. Norepinephrine, ANP, BNP and {sup 123}I-MIBG scintigraphy in patients with cardiomyopathy or angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ochiai, Yukie; Kodama, Makoto; Aizawa, Yoshifusa [Niigata Univ. (Japan). School of Medicine; Watanabe, Kenichi; Kusano, Yoriko; Miyajima, Seiichi; Nagatomo, Takafumi

    1998-06-01

    The relationship of blood concentration of norepinephrine (NE), A-type (atrial) natriuretic peptide (ANP) and B-type (brain) natriuretic peptide (BNP) and {sup 123}I-metaiodobenzyl guanidine ({sup 123}I-MIBG) scintigraphy was examined in patients with heart failure. The patients were grouped as follows; 13 of dilated cardiomyopathy (DCM) group, 13 of hypertrophic cardiomyopathy (HCM) group and the 8 of stable effort angina. The control group was of 18 cases with normal {sup 201}TlCl (Tl) cardiac scintigraphy and chest pain. The blood was collected before the exercise tolerance by the ergometer, and the concentration of ANP, BNP and NE in blood was measured by the RIA method and the HPLC method, respectively. Patients were intravenously administrated 111Mbq of {sup 123}I-MIBG at rest and early images of the {sup 123}I-MIBG scintigraphy were taken after 15 min and late images after 3 hours. Washout rate (WR) and heart-mediastinal uptake rate (H/M) were obtained from late images. Compared with the control group, the DCM group showed the high levels of ANP and BNP (p<0.01) and the low level of NE (p=0.025). The HCM group showed the high level of BNP (p<0.001) and the low level in H/M. There were no differences in ANP, NE, H/M and WR between angina pectoris and the control. The correlations among BNP and H/M or WT were significant in all cases. BNP may be a remarkable index for sympathetic dysfunction. (K.H.)

  2. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  3. Evaluation of pharmacokinetics and pharmacodynamics relationships for Salvianolic Acid B micro-porous osmotic pump pellets in angina pectoris rabbit

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    Shu-Ling Kan

    2014-06-01

    Full Text Available The work aims to investigate the in vitro release, pharmacokinetics (PK, pharmacodynamics (PD and PK–PD relationships of Salvianolic Acid B micro-porous osmotic pump pellets (SalB-MPOPs in angina pectoris New Zealand White (NZW rabbits, compared with those of SalB immediate-release pellets (SalB-IRPs. The SalB plasma concentrations and Superoxide dismutase levels (PD index were recorded continuously at predetermined time interval after administration, and the related parameters were calculated by using WinNonlin software. The release profile of MPOPs was more sustained than that of IRPs. PK results indicated that the mean Cmax was significantly lower, the SalB plasma concentrations were steadier, both area under concentration-time curve from 0 to 24 h (AUC0–24 h and from 0 to infinity (AUC0–∞ were presented larger, and both the peak concentration time (Tmax and mean residence time (MRT were prolonged for MPOPs, as compared with those of IRPs. PD results suggested that peak drug effect (Emax was lower and the equilibration rate constant (ke0 between the central compartment and the effect compartment was higher of MPOPs vs. those of IRPs. PK–PD relationships demonstrated that the effect-concentration-time (ECT course of MPOPs was clockwise hysteresis loop, and that of IRPs was counter-clockwise hysteresis loop. Collectively, those results demonstrated that MPOPs were potential formulations in treating angina pectoris induced by atherosclerosis.

  4. La cronicidad como concepto contratransferencial.

    OpenAIRE

    Josep Vidal Otero

    1998-01-01

    Durante años, el discurso de la reforma psiquiátrica -tanto el institucional como el reivindicativo-ha venido utilizando una serie de expresiones y conceptos que hoy parecen gastados, convertidos en meros referentes formales de la retórica de dicho discurso. Fenómeno éste que en parte está relacionado con la actual mengua conceptual dentro de los campos ideológico y epistemológico. En parte, también, con la deficiente concreción práctica de las reformas que dichos conceptos sugerían. Pero que...

  5. Confiabilidade de sintomas sugestivos de angina em pacientes com doença pulmonar obstrutiva crônica Confiabilidad de síntomas sugestivos de angina en pacientes con enfermedad pulmonar obstructiva crónica Reliability of symptoms suggestive of angina in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yilmaz Gunes

    2009-05-01

    baseline clinical characteristics who had undergone diagnostic coronary angiography for the first time were reviewed retrospectively. RESULTS: The frequency of significant CAD was significantly lower in COPD patients than in the control group (52.8% vs. 80.2%, p<0.001. Frequencies of CAD risk factors (older age, hypertension, diabetes, smoking history were significantly more frequent among COPD patients having significant CAD. Among patients reporting stable angina pectoris, significant CAD was detected in 32.7% of COPD patients and 71.0% of non-COPD patients (p<0.001. However, among the patients with a diagnosis of unstable angina pectoris, significant CAD was detected in 87.5% of COPD patients and 90.2% of non-COPD patients (p=0.755. CONCLUSION: Diagnosis of CAD in COPD patients by symptomatology may be difficult. However, clinical diagnosis of CAD in the setting of unstable angina is accurate in most of the COPD patients. Therefore, further noninvasive diagnostic methods or careful follow up may be more appropriate for COPD patients reporting stable angina pectoris.

  6. 催眠针法治疗心绞痛的疗效及血浆ET、NO改变的研究%A Study on Hypnotic Acupuncture Therapy for Angina Pectoris and Its Effects on Plasma ET and NO

    Institute of Scientific and Technical Information of China (English)

    李献; 郑强荪; 宋胜云; 高军军; 尼珍; 袁秀兰; 张录兴

    2002-01-01

    Objective: To evaluate the treatment effects of hypnotic acupuncture therapy on angina pectoris. Methods: 40 cases of angina pectoris treated by hypnotic acupuncture therapy were compared with 31 cases of angina pectoris treated by pure acupuncture. Results: Symptom relief rate and change of ECG were found to be more desirable in the Hypnotic acupuncture therapy group than in the pure acupuncture group (P<0.01,P<0.05). Pre-post treatment comparisons on levels of anxiety, depression, ET and NO also showed that hypnotic acupuncture therapy was superior to the pure acupuncture group (P<0.05).Conclusion:The present study provides strong support for hypnotic acupuncture therapy for angina pectoris, in terms of its treatment effects on both mental and physical improvement.

  7. La paz como proyecto constitucional

    Directory of Open Access Journals (Sweden)

    Leonardo García Jaramillo

    2013-01-01

    Full Text Available A pesar de la históricamente alegada estabilidad democrática de Colombia, se trata de un país que ha oscilado desde hace más de 50 años entre indicadores desfavorables respecto de la violencia y la inestabilidad institucional, en algunas ocasiones particularmente negativos. A finales de 1980 una serie de factores políticos, jurídicos, económicos y sociales, agravados por la confrontación entre el Estado y el cartel de Medellín, así como por el surgimiento de nuevas guerrillas y luego de los paramilitares, confluyeron en la necesidad imperativa de cambiar el texto constitucional. No solo se consignó en la nueva Constitución que "la paz es un derecho y un deber de obligatorio cumplimiento", sino que tras 20 años de desarrollo legislativo y judicial de esta disposición la paz se ha procurado alcanzar aumentando la seguridad pero con cada vez mayor consciencia de la necesidad de implementar políticas de justicia social. En pocos contextos como el colombiano se ha procurado reivindicar la idea de Bobbio: "Una constitución es un pacto de paz".

  8. Terroristas como pessoas no direito?

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    Günther Jakobs

    2009-03-01

    Full Text Available A punição de terroristas, em larga medida preliminar, ou os severos interrogatórios, não se adequam a um perfeito Estado de direito. Pertencem ao direito de exceção. Um Estado de direito que tudo abarque não poderia travar esta guerra, pois ele deveria tratar seus inimigos como pessoas e, conseqüentemente, não poderia tratá-las como fonte de perigo. Em Estados de direito que operam na prática de modo ótimo procede-se de outra maneira, e isso lhes dá a chance de não se quebrarem durante o ataque a seus inimigos.The preemptive punishment of terrorists and the use of harsh interrogation techniques are not within the classical standards of the Rule of Law. They belong rather to a state of exception. A State committed to all the usually accepted requirements of the Rule of Law would not be allowed to carry such a war, because it would have the duty to treat its enemies as persons. Therefore, it would not be authorized to treat them as a source of danger. Nevertheless, these classical standards have been challenged in the last two decades by major institutional changes that are now being discussed both in theoretical as in practical levels.

  9. Manual Thrombus Aspiration and the Improved Survival of Patients With Unstable Angina Pectoris Treated With Percutaneous Coronary Intervention (30 Months Follow-Up).

    Science.gov (United States)

    Yildiz, Bekir S; Bilgin, Murat; Zungur, Mustafa; Alihanoglu, Yusuf I; Kilic, Ismail D; Buber, Ipek; Ergin, Ahmet; Kaftan, Havane A; Evrengul, Harun

    2016-02-01

    The clinical effect of intracoronary thrombus aspiration during percutaneous coronary intervention in patients with unstable angina pectoris is unknown. In this study, we aimed to assess how thrombus aspiration during percutaneous coronary intervention affects in-hospital and 30-month mortality and complications in patients with unstable angina pectoris.We undertook an observational cohort study of 645 consecutive unstable angina pectoris patients who had performed percutaneous coronary intervention from February 2011 to March 2013. Before intervention, 159 patients who had culprit lesion with thrombus were randomly assigned to group 1 (thrombus aspiration group) and group 2 (stand-alone percutaneous coronary intervention group). All patients were followed-up 30 months until August 2015.Thrombus aspiration was performed in 64 patients (46%) whose cardiac markers (ie, creatinine kinase [CK-MB] mass and troponin T) were significantly lower after percutaneous coronary intervention than in those of group 2 (CK-MB mass: 3.80 ± 1.11 vs 4.23 ± 0.89, P = 0.012; troponin T: 0.012 ± 0.014 vs 0.018 ± 0.008, P = 0.002). Left ventricular ejection fraction at 6, 12, and 24 months postintervention was significantly higher in the group 1. During a mean follow-up period of 28.87 ± 6.28 months, mortality rates were 6.3% in the group 1 versus 12.9% in the group 2. Thrombus aspiration was also associated with significantly less long-term mortality in unstable angina pectoris patients (adjusted HR: 4.61, 95% CI: 1.16-18.21, P = 0.029).Thrombus aspiration in the context of unstable angina pectoris is associated with a limited elevation in cardiac enzymes during intervention that minimises microembolization and significantly improves both of epicardial flow and myocardial perfusion, as shown by angiographic TIMI flow grade and frame count. Thrombus aspiration during percutaneous coronary intervention in unstable angina pectoris patients has better

  10. Recent advances in the management of chronic stable angina I: Approach to the patient, diagnosis, pathophysiology, risk stratification, and gender disparities

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-07-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas 77054 USAAbstract: The potential importance of both prevention and personal responsibility in ­controlling heart disease, the leading cause of death in the USA and elsewhere, has attracted renewed ­attention. Coronary artery disease is preventable, using relatively simple and inexpensive lifestyle changes. The inexorable rise in the prevalence of obesity, diabetes, dyslipidemia, and ­hypertension, often in the risk cluster known as the metabolic syndrome, drives the ­ever-increasing incidence of heart disease. Population-wide improvements in personal health habits appear to be a fundamental, evidence based public health measure, yet numerous barriers prevent implementation. A common symptom in patients with coronary artery disease, classical angina refers to the typical chest pressure or discomfort that results when myocardial oxygen demand rises and coronary blood flow is reduced by fixed, atherosclerotic, obstructive lesions. Different forms of angina and diagnosis, with a short description of the significance of pain and silent ischemia, are discussed in this review. The well accepted concept of myocardial oxygen imbalance in the genesis of angina is presented with new data about clinical pathology of stable angina and acute coronary syndromes. The roles of stress electrocardiography and stress myocardial perfusion scintigraphic imaging are reviewed, along with the information these tests provide about risk and prognosis. Finally, the current status of gender disparities in heart disease is summarized. Enhanced risk stratification and identification of patients in whom procedures will meaningfully change management is an ongoing quest. Current guidelines emphasize efficient triage of patients with suspected coronary artery disease. Many experts believe the predictive value of current decision protocols for coronary artery disease still needs improvement in order to

  11. Bloqueo de Ganglio Estrellado en el tratamiento de angina de pecho refractaria: un posible tratamiento coadyuvante

    OpenAIRE

    Isaías Salas Herrera; Luis Carlos Huertas Gabert

    2002-01-01

    El presente trabajo corresponde una revisión bibliográfica de los estudios clínicos realizados en síndromes anginosos refractarios al tratamiento convencional, utilizando como tratamiento el bloqueo de ganglio estrellado. Se realizó una búsqueda de literatura publicada entre los años 1.900 al 2.000 en las bases de datos MDConsult, Medline y ProQuest. A su vez se revisaron las publicaciones en la Biblioteca del Hospital Rafael Ángel Calderón Guardia y en la Biblioteca del BINASSS (Biblioteca N...

  12. 常见心绞痛病因及临床表现对ICD-10编码的影响%The Effect of Different Causes and Clinical Manifestation of Angina Pectoris on ICD-10 Classification

    Institute of Scientific and Technical Information of China (English)

    赵桐

    2011-01-01

    目的 探讨心绞痛的病因,以利于对心绞痛进行分型,作出正确的ICD-10编码.方法 对2009年至2010间各种原因引起的心绞痛资料进行回顾性分析.结果 心绞痛根据不同的病因及临床表现可分为不同类型心绞痛,其对应的ICD-10的编码也不同.结论 了解心绞痛的病因及临床表现,正确细分各型心绞痛,是正确进行ICD-10编码最关键环节.%Objective To discuss the causes of angina pectoris, and classify the angina pectoris correctly by ICD-10.Methods The different causes of angina pectoris from 2009 to 2010 were retrospectively analyzed.Results Angina Pectoris can be classified by different causes and clinical manifestation.Therefore, the code of angina pectoris are different.Conclusion Understanding the different causes and clinical manifestation of angina pectoris,and classifying the disease correctly are the key points of ICD-10 classification.

  13. Como Lo Hago Yo: Myelomeningocele

    Science.gov (United States)

    Lazareff, Jorge

    2014-01-01

    Fortificación con ádico fólico es efectiva, pero aún falta conciencia en los jóvenes. La legalidad del aborto aumenta la importancia de la consulta prenatal. Realizo la cirugía bajo microcoscopio por razones didácticas. Irrigación continua para reducir la temperatura del tejido. Trato a la plaqueta como tejido viable. No suturo la plaqueta. No cierro músculo. ATB por una semana después de cirugía. Hidrocefalia: Válvula en todos los casos de ventriculomegalia. Médula anclada: Desanclar una sola vez. Chiari II: Revisar la válvula. Incluir en el seguimiento rendimiento escolar, puede indicar obstrucción de la válvula o médula anclada. PMID:24791217

  14. Vivencias afectivas como discurso virtual

    Directory of Open Access Journals (Sweden)

    Mijaíl Málishev

    2011-01-01

    Full Text Available El discurso virtual expresa nuestras vivencias afectivas tanto en el futuro -esperanza- como en el pasado -culpa y venganza-. La esperanza es un estímulo que nos alienta a alcanzar nuestras metas. A diferencia del futuro, el pasado es irreversible y, sin embargo, el pluscuamperfecto es un "mago" que "transforma" lo irreparable en lo virtual. Nuestra conciencia nos hace sentir culpables, haciéndonos creer que lo indebido que hemos cometido, hubiéramos podido hacerlo de otra manera. El pluscuamperfecto expresa la venganza que nos hace "lavar la ofensa" causada por nuestro adversario, pero el discurso virtual en el pluscuamperfecto nos ayuda a sublimar nuestros rencores sin causar algún daño a nuestro adversario y a nuestra propia reputación.

  15. administra como anticonceptivo de emergencia

    Directory of Open Access Journals (Sweden)

    Horacio Croxatto

    2007-01-01

    Full Text Available La anticoncepción hormonal de emergencia (AHE es uno de los pocos recursos que la mujer puede usar para prevenir un embarazo no deseado después de haber tenido una relación sexual en la que no usó método anticonceptivo o el que usó presentó una falla. Actualmente, el método preferido para la AHE es la píldora que contiene solamente levonorgestrel (LNG. Según la OMS, puede prevenir embarazos si se usa hasta 120 horas después del acto sexual, pero su eficacia disminuye drásticamente desde 85% a 31% mientras más se posterga su administración. La introducción de la AHE ha generado controversia en muchos países latinoamericanos por la percepción errónea de que induce aborto y la oposición de los sectores más conservadores de la sociedad que temen que favorezca la promiscuidad. Con el propósito de dar a conocer la evidencia científica producida por las investigaciones diseñadas para dilucidar como el LNG previene el embarazo cuando se administra como AHE, y su correcta interpretación, este artículo analiza críticamente dichos estudios y explica además en que circunstancias este método no logra prevenir el embarazo. El conjunto de la evidencia indica que LNG previene el embarazo solamente cuando impide la fecundación y descarta que el prevenga el embarazo interfiriendo con la implantación del embrión, por lo que la creencia de que es abortivo no tiene sustento científico.

  16. El investigador como educador musical y como divulgador

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    Suárez-Pajares, Javier

    2000-05-01

    Full Text Available La presente ponencia trataba de plantear en la Mesa redonda "Investigación aplicada a la educación musical" una serie de problemas que surgen no tanto a quienes se dedican profesionalmente a la educación musical, sino a quienes, dedicados a la investigación y al estudio de temas relacionados con la historia de la música desde perspectivas diversas, tienen finalmente que transmitirlos a una audiencia determinada, ya sea otros colegas, alumnos de universidad, u otros públicos en los que se centra el concepto "divulgación" aludido en el título.Se incide particularmente en los problemas de la educación musical universitaria para no especialistas y en la divulgación científica aplicada a la música, un campo casi yermo sobre el que hay mucho que reflexionar: desde las nuevas posibilidades para la explicación de la música que ofrecen soportes nuevos como el CD-Rom, hasta las tradicionales formas de relación con un público melómano a través de notas a programas y críticas de conciertos.

  17. Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation

    Directory of Open Access Journals (Sweden)

    Ivanović Miloš

    2013-01-01

    Full Text Available Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS. Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability. Objective. Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound - Virtual Histology in patients with stable angina and subjects in acute phase of ACS without ST segment elevation. Methods. The study comprised of 40 patients who underwent preintervention IVUS examination. Tissue maps were reconstructed from radio frequency data using IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions, while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions. In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs. 0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05 respectively. Conclusion. IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.

  18. Treatment Realize of 45 Cases of Unstable Angina%45例不稳定性心绞痛治疗体会

    Institute of Scientific and Technical Information of China (English)

    韩威

    2014-01-01

    目的:探讨不稳定性心绞痛患者的药物治疗。方法选取临床2013年6月~2014年6月收治的45例不稳定性心绞痛患者药物治疗方法资料进行分析。结果45例患者经治疗,无心绞痛发作26例,心绞痛发作次数或胸痛持续时间减少17例,无效2例,总有效率95.55%。结论立即开始抗心肌缺血治疗,急性期应卧床休息,在治疗发生效应时,可适当放宽病人的活动。%Objects Medication of the patients with unstable angina is to be investigated.Methods The medication data of 45 cases of patients with unstable angina who were treated in this hospital from June of 2013 to June of 2014 were selected for analysis.Results After treatment, among 45 cases of patients, there are 26 cases without angina attacks, 17cases in which the frequency of angina or the duration of chest pain reduced and 2 ineffective cases, with total effective rate of 95.55%.Conclusions The treatment of anti-myocardial ischemia should be adopted immediately. During the acute period, the patients should rest in bed. When the treatment starts its effect, activity area can be relaxed for the patients.

  19. Evaluation value of real-time three-dimensional adenosine stress echocardiography and coronary angiography for patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Ya-Li Wu; Nan-Jue Jiang; Yan Cai

    2016-01-01

    Objective:To study the evaluation value of real-time three-dimensional adenosine stress echocardiography and coronary angiography for patients with stable angina pectoris. Methods:A total of 45 patients diagnosed with stable angina pectoris in our hospital between May 2014 and December 2015 were selected as the stable angina pectoris group (SAP group) of the study and 50 healthy subjects receiving physical examination in our hospital during the same period were selected as control group. Real-time three-dimensional adenosine stress echocardiography was performed to measure coronary flow reserve (CFR), serum was collected to determine lipid metabolism indexes and inflammation indexes, and peripheral blood mononuclear cells were collected to determine the expression levels of inflammatory regulatory molecules.Results:CFR of SAP group was significantly lower than that of control group and the more the number of coronary lesions, the lower the CFR of SAP group; serum Lp(a), LDL-C, ApoB, MIF-1α, ICAM-1, VCAM-1, CD40 and CD40L content as well as the fluorescence intensity of peripheral blood mononuclear cell surface TLR4 and NF-κB of SAP group were significantly higher than those of control group and negatively correlated with CFR level while serum HDL-C and ApoA1 content as well as the fluorescence intensity of peripheral blood mononuclear cell surface TIPE2 and BACH2 were significantly lower than those of control group and positively correlated with CFR level.Conclusion:CFR measured by real-time three-dimensional adenosine stress echocardiography significantly reduces in patients with stable angina pectoris and is correlated with lipid metabolism state and the degree of inflammation.

  20. Serum high-sensitivity C-reaction protein and heart fatty acid binding protein level and cardiac accidents in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    朱红秋

    2006-01-01

    Objective To investigate the relationship between serum high-sensitivity C-reaction protein (hs-CRP) and heart fatty acid binding protein (h-FABP) on cardiac accidents in patients with unstable angina pectoris (UAP). Methods Serum levels of hs-CRP, h-FABP, cardiac troponin-Ⅰ(cTn-Ⅰ) and creatine kinase MB isoenzyme (CK-MB) were measured and cardiac accidents within 2 weeks after the test were observed in 74 patients (male

  1. [Relations of the duration of pre-existing angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction].

    Science.gov (United States)

    Juillière, Y; Danchin, N; Grentzinger, A; Suty-Selton, C; Perrin, O; Guenoun, P; Pernot, C; Cherrier, F

    1990-10-01

    The aim of this retrospective study was to determine the relationship between the duration of preceding angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction. Coronary angiography of 138 consecutive patients showed isolated and complete occlusions of the left anterior descending (58 patients) or right coronary artery (80 patients). One hundred and four patients had myocardial infarction with (Group A, n = 21) or without (Group B, n = 83) preceding angina pectoris and 34 had angina without myocardial infarction (Group C). The left ventricular ejection fraction was measured by ventriculography in the 30 degrees right anterior oblique projection. The collateral circulation was assessed by coronary angiography and evaluated as follows: no flow or flow limited to collateral branches (subgroup 1) and partial or complete filling of the epicardial arterial segment (subgroup 2). In the global population the left ventricular ejection fraction was higher and the duration of preceding angina pectoris was longer in the subgroups with a well developed collateral circulation. There was no difference in ejection fraction between Groups A and B (presence of myocardial infarction), on the other hand, within each of the groups, a good collateral circulation (subgroup 2) was associated with a significantly higher ejection fraction. Group C (without infarction) patients had better ejection fractions than Groups A or B, especially when the collateral circulation was poorly developed. Within Group C, the quality of the collateral circulation did not seem to affect the ejection fraction. The left ventricular ejection fraction is lower in patients with isolated coronary occlusion and myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Relationship between coronary artery remodeling and cumulative incidence of coronary angiographic lesions with vulnerable characteristics in patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    SUN Ling; L(U) Shu-zheng; JIN Ze-ning; SONG Xian-tao

    2010-01-01

    ackground Development of vulnerable lesions is not limited to the target lesions, but a pan-coronary process. Such lesions are identified by positive remodeling (intravascular ultrasound (IVUS) and complex lesions (angiography)). The prevalence of lesions with vulnerable characteristics in patients with stable angina was not well known. The purpose of the present study was to evaluate the relationship between coronary artery remodeling and incidence of angiographic complex lesions and its calcification in stable angina patients.Methods One hundred and sixty-one stable angina patients (95 males, aged (68±11) years) with 161 de novo target lesions were studied using pre-interventional IVUS. Remodeling index was defined as the lesion divided by reference vessel area; positive remodeling was defined as remodeling index >1.05. Besides the 161 target lesions, there were 613 angiographic lesions with >30% diameter stenoses, classified as complex or smooth. Multiple complexes were defined as more than one complex lesion in one patient. Stenoses of at least 70% were described as tight. Calcium arc area was used as a new method to quantify coronary calcification.Results Fifty-six patients had positive remodeling target lesion, while 105 did not. The overall number of lesions with a diameter stenoses >30% was similar in patients with or without positive remodeling, and the frequency of angiographically complex lesions was higher in positive remodeling patients, especially at non-target site. Calcium arc area was smaller in patients with positive remodeling.Conclusions Positive remodeling on intravascular ultrasound was associated with more complex lesions angiographic findings, especially at non target site. Positive remodeling was found less calcified in patients with stable angina.

  3. Association between ACE Gene I/D Polymorphism and Unstable Angina in Uzbek Patients with Family History of Coronary Heart Disease

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    Feruza M. Bekmetova*, PhD

    2012-12-01

    Full Text Available Objective: To study the distribution of I/D polymorphic marker of the ACE gene in Uzbek patients with unstable angina, depending on the presence of family history of CHD compared with healthy individuals. Materials and methods: There were examined 125 Uzbek patients with unstable angina (class IIB by E. Braunwald et al., 1989. In patients with unstable angina 63 patients (the 1st group had and 62 patients (the 2nd group had no a family history of CHD. Control group included 45 healthy Uzbek subjects without CHD and family history of CHD. The genomic DNA was isolated from the peripheral blood lymphocytes following standard protocol using the DiatomTM DNA Prep 200 kit (produced by LLC "Laboratory IsoGene". I/D polymorphism of the ACE gene was detected according to Cambian F. et al. (1992. Results: In a comparative analysis of both groups, patients showed similarity in the baseline clinical, hemodynamic and biochemical parameters; however, the 1st group had significant higher IMC thickness of the carotid arteries and hsCRP levels. Simultaneously, patients with a family history of CHD, compared with the healthy group of individuals, were noted to have a significantly higher prevalence of the D/D genotype [OR: 3.46 (95% CI: 1.18-8.11; P=0.035] and "damaging" D-allele [OR: 2.47 (95% CI: 1.40-4.34; P=0.002]. Conclusion: The presence of a family history of the coronary heart disease among Uzbek patients with unstable angina was associated with the higher frequency of the "damaging” D-allele of the ACE I/D gene polymorphism, accompanied by an increase in the thickness of the intima-media complex of the carotid arteries and level of high-sensitivity C-reactive protein.

  4. Comparative study between patients with infarction and angina about the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility

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    Bakella P.

    2010-10-01

    Full Text Available Background: To examine the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility between patients with infarction and angina. Method: Subjects were 104 patients with infarction or angina, who completed the Hostility and Direction of Hostility Questionnaire, the Symptom Checklist-90-R, Cardiac Anxiety Questionnaire, the Pain Anxiety Symptoms Scale-20 and the Fear of Pain Questionnaire – III. Results: For all patients higher levels of fear and anxiety of pain, heart-focused anxiety psychopathology, and a tendency to develop a hostile attitude were observed. For angina group higher levels of fearfull thinking and total PASS-20, avoidance CAQ, somatization and anxiety (SCL-90. In addition, all patients were found to be significantly correlated (P< .005 with sex, fearfull PASS-20, physiological responses PASS-20, total PASS-20, avoidance CAQ, somatization SCL-90, anxiety SCL-90 Conclusion: There is a variety of general factors that may promote the development of cardiophobia. These processes are likely nonspecific in the sense that they increase the chance of negative emotional responding and poor affect regulatory strategies. For persons exposed to cardiac-related illnesses or persons who model the potential dangers of cardiac-related sensations, there may be an enhanced specificity to that general vulnerability.

  5. Resolution of Angina Pectoris and Improvement of the Coronary Flow Reserve after Ranolazine Treatment in a Woman with Isolated Impaired Coronary Microcirculation

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    Alessandro Santoro

    2013-01-01

    Full Text Available In a 61-year-old woman with well controlled arterial hypertension, hypercholesterolemia, and smoke and suffering from recurrent angina pectoris despite angiographically normal epicardial coronary vessels and maximal therapy, the replacement of nitrates with novel antiangina drug ranolazine, after 6-month therapy, induced a complete relief of angina and a relevant rising of the transthoracic Doppler-derived coronary flow reserve (CFR. The present clinical case underlines therefore how in patients with chronic ischemic heart disease without epicardial coronary stenosis ranolazine can induce an improvement till the complete solution of the angina symptoms and a substantial increase of CFR as expression of the enhancement of the microvascular coronary function. The improvement of both symptoms and coronary microvascular function is strictly linked to the mechanism of action of the drug. Ranolazine induces in fact a reduction of the intracellular late sodium current that leads to a reduction of the intracellular calcium concentration thus producing a better myocardial diastolic relaxation process which in its turns enhances the myocardial perfusion. The ranolazine acts therefore as a lusitropic drug that improves the diastolic dysfunction and the segmental ischemia thus affecting one of the first steps of the ischemic cascade.

  6. Effect of PCI on inflammatory factors, cTnI, MMP-9 and NT-pro BNP in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Ke-Tong Liu; Xin Wang; Di Zhao

    2016-01-01

    Objective:To investigate the effect of PCI on inflammatory factors, cTnI, MMP-9and NT-pro BNP in patients with unstable angina pectoris.Methods:A total of 80 unstable angina pectoris patients were divided into observation group (40 cases) and control group (40 cases). The observation group was given the therapy of PCI, and the control group was given coronary angiography. To observe the of inflammatory factors, cTnI, MMP-9 and NT-pro BNP were tested and compared before and after operation.Results:At 24 h after operation, CRP and IL-18 levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups; At 24 h after operation, cTnI, MMP-9 and NT-pro BNP levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups.Conclusion: PCI therapy can induce inflammation and myocardial injury in patients with unstable angina pectoris.

  7. 从络病学说论治冠心病心绞痛%Treatment on Coronary Heart Disease and Angina Pectoris form Doctrine of Luo

    Institute of Scientific and Technical Information of China (English)

    吴以岭

    2001-01-01

    As a kind of frequently encountered disease in clinic,coronary heart disease and angina pectoris belongs to the scope of “Qi obstruction in the chest and pericardial pain” in TCM theory. The author of this article made research on the pathogenesis and treatment of coronary heart disease and angina pectoris from Luo theory of TCM and thought that the disease focus should be located in the Luo pulse and its main pathogenesis lies in insufficiency of the heart-qi and stasis of luo pulse,and then designed the treatment method of supplementing qi,promoting blood circulation and relieving pain as well as created Tongxinluo capsules composed of insect herbs and the herbs with the function of supplementing qi,which got marked effect in treating coronary heart disease and angina pectoris.%从中医络病学说探讨冠心病心绞痛的中医病机和治疗,认为冠心病心绞痛病位在心之络脉,主要病机为心气虚乏、络脉瘀阻、绌急而痛,制定了补益心气、活血通络、解痉止痛的治疗大法,并组成益气药和虫类药为主的通心络胶囊,用于治疗冠心病心绞痛疗效显著。

  8. Effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Liang Wen; Yi Xie; Xian-Jun Wu; Rui-Feng Wang; Jian Cao

    2016-01-01

    Objective:To analyze the effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris. Methods:A total of 98 cases of coronary heart disease patients with stable angina pectoris who received treatment in our hospital from March 2014 to August 2015 were selected as research subjects and randomly divided into observation group 49 cases and control group 49 cases. Control group received conventional clinical treatment, observation group received folic acid adjuvant therapy, and then differences in levels of Hcy, lipid metabolism, endothelial injury and adhesion molecules were compared between two groups after treatment. Results:Hcy, TC, LDL-C and ApoB values of observation group were lower than those of control group while HDL-C and ApoA1/ApoB values were higher than those of control group;Flow-vel and FMD values of observation group after treatment were higher than those of control group;serum E-selectin, ICAM-1, VCAM-1 and sICAM-1 values of observation group after treatment were lower than those of control group. Conclusion:Folic acid adjuvant therapy for coronary heart disease patients with stable angina pectoris can reduce plasma Hcy level and optimize lipid metabolism, further protects vascular endothelium, and has positive clinical significance.

  9. Frequency of angina pectoris and secondary events in patients with stable coronary heart disease (from the Heart and Soul Study).

    Science.gov (United States)

    Beatty, Alexis L; Spertus, John A; Whooley, Mary A

    2014-10-01

    The extent to which angina pectoris (AP) predicts secondary cardiovascular events beyond independent of measures of disease severity is unknown. We evaluated the association between AP frequency and secondary events in patients with stable coronary heart disease (CHD). We administered the Seattle Angina Questionnaire to 1,023 participants with stable CHD enrolled from September 2000 to December 2002 and followed for a median of 8.9 years. We used Cox proportional hazards to evaluate the association of AP frequency with death and subsequent hospitalization for AP, revascularization, myocardial infarction (MI), or heart failure. At enrollment, 633 (62%) participants reported no AP, 279 (27%) reported monthly AP, and 111 (11%) reported daily or weekly AP. During follow-up, 396 participants died, 204 were hospitalized for AP, 194 for revascularization, 140 for MI, and 188 for heart failure. Compared with participants without AP, participants with daily or weekly AP were more likely to be hospitalized for AP (hazard ratio [HR] 3.3; 95% confidence interval [CI] 2.3 to 4.7; p<0.001), revascularization (HR 2.0; 95% CI 1.3 to 2.9; p=0.001), or heart failure (HR 1.6; 95% CI 1.0 to 2.5; p=0.03) and more likely to die (HR 1.5; 95% CI 1.1 to 2.0; p=0.01). AP was not independently associated with MI (HR 1.3; 95% CI 0.8 to 2.3; p=0.29). After adjusting for demographics, co-morbidities, treadmill exercise capacity, ejection fraction, and inducible ischemia, frequency of AP remained independently associated with hospitalization for AP (HR 2.4; 95% CI 1.6 to 3.6; p<0.001), revascularization (HR 1.7; 95% CI 1.1 to 2.7; p=0.02), and death (HR 1.4; 95% CI 1.0 to 2.0; p=0.045). In conclusion, in outpatients with stable CHD, AP frequency predicts higher rates of secondary cardiovascular events and death, independent of objective measures of disease severity.

  10. La Justicia como valor Constitucional

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    Lavilla Alsina, Landelino

    2003-07-01

    Full Text Available La Constitución Española, sin menoscabo de su carácter prescriptivo, atiende a la necesidad de poner un vigoroso acento —y mejor si lo hace en términos jurídicos— sobre las notas identificadoras del aliento político que más y mejor expresan el fundamento y orientación de la voluntad constituyente. Pero, con independencia de tal aseveración, es definitiva la interpretación del precepto, según criterios y métodos jurídicos, en cuanto enuncia unos «valores» que el Estado constituido «propugna», que se califican como «superiores» y que se predican, precisamente, del «ordenamiento jurídico». La justicia es, desde luego y en sí misma, un valor, al que conviene la nota de clásico en la determinación de los que han de regir una convivencia política estable. Uno u otro sentido de la justicia ha latido con fuerza en la conciencia humana y en toda pretensión racional de ordenación de la convivencia.

  11. El plomo como contaminante alimentario

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    C. Rubio

    2004-01-01

    Full Text Available El plomo es un metal pesado caracterizado por ocasionar efectos tóxicos sobre el tracto gastrointestinal, sobre el sistema renal y sobre el SNC y periférico, así como interferencias con sistemas enzimáticos implicados en la síntesis del grupo hemo. A pesar de que en los últimos diez años, los contenidos de plomo de los productos alimenticios se han reducido sensiblemente gracias a los esfuerzos realizados para reducir la emisión de plomo en su origen y por los progresos en la garantía de calidad de los análisis químicos, la dieta sigue siendo una fuente importante de exposición de plomo. Es por ello que, el objetivo a largo plazo de las autoridades sanitarias es el de continuar reduciendo los contenidos medios de plomo en los productos alimenticios con el fin de que las ingestas medias dietéticas de Pb de las poblaciones cumplan con la PTWI (Provisional Tolerable Weekly Intake de 25 µg Pb/Kg/semana establecida por el Comité Mixto FAO/OMS

  12. 冠心病心绞痛内科治疗临床分析%Clinical analysis of medical treatment of angina pectoris

    Institute of Scientific and Technical Information of China (English)

    郗承莉

    2013-01-01

    目的:研究分析冠心病心绞痛内科治疗中应用不同药物所产生的临床疗效。方法抽取我院60例冠心病心绞痛患者,随机分为观察组与对照组,对照组使用磷酸酯类、阿司匹林、消心痛等进行常规内科治疗,观察组在此基础上加用曲美他嗪进行治疗。结果观察组治疗总有效率明显高于对照组,治疗后心绞痛发作频率、持续时间及硝酸甘油用量均明显少于对照组,差异有统计学意义(P﹤0.05)。结论在对冠心病心绞痛患者的内科治疗中加用曲美他嗪,能够更为有效的减少心绞痛的发作频率及持续时间,明显提高临床治疗效果。%Objective To analyze the clinical effects of different medications in the medical treatment of angina pectoris. Methods Sixty patients with angina pectoris selected from our hospital were randomly divided into observation group and control group. Both groups received conventional medical treatment with phosphate, aspirin, and isosorbide dinitrate, and the observation group received trimetazidine as an addition. Results Compared with the control group , the observation group had a significantly increased overall response rate and significantly decreased frequency and duration of angina pectoris and consumption of nitroglycerin after treatment (P<0.05). Conclusion Additional use of trimetazidine in medical treatment can further decrease the frequency and duration of angina pectoris in patients with angina pectoris, thus significantly improving the treatment outcome.

  13. Clinical usefulness of delayed exercise images on {sup 99m}Tc-tetrofosmin myocardial SPECT in the diagnosis of vasospastic angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki; Zen, Kan; Hikosaka, Takatou; Adachi, Yoshihiko; Yoneyama, Satoshi; Katoh, Shuuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki; Nakamura, Tomoki; Azuma, Akihiro

    2000-05-01

    This study was designed to evaluate the clinical usefulness of delayed exercise images in {sup 99m}Tc-tetrofosmin (TF) myocardial SPECT in the diagnosis of vasospastic angina pectoris. We studied 30 patients with vasospastic angina, 10 of 30 patients (group A) had both effort and rest angina, 20 of 30 patients (group B) had rest angina. A 370 MBq of TF was intravenously injected at peak exercise, and initial (EX-I) and delayed exercise (EX-D) images were obtained at 30 min and 180 min after the injection. An additional 740 MBq of TF was intravenously reinjected after EX-D image acquisition, and rest images were obtained 30 min after the reinjection. The left ventricular wall was divided into 9 segments. Regional myocardial uptakes of TF were scored by 4-point defect score (0=normal, 1=mildly reduced, 2=moderately reduced, and 3=severely reduced). Total defect score (TDS) was calculated from the sum of defect scores in 9 segments. Reverse redistribution (RR) was defined as increase of more than 2 in TDS on EX-D images. In group A, 4 of 10 cases (40%) showed decreased uptake on EX-I images, 6 of 10 cases (60%) revealed RR on EX-D images, and none of the patients showed decreased uptake on rest images. In group B, no one showed decreased uptake on EX-I and rest images, 11 of 20 cases (55%) revealed RR on EX-D images. The mean{+-}SD of TDS were 2.9{+-}3.4, 5.1{+-}4.5, 0.5{+-}0.5 on EX-I, EX-D, rest images in group A, and serially 0.4{+-}0.5, 3.3{+-}3.6, 0.4{+-}0.5 in group B. Regional wall motion abnormality was reduced in regions with RR. RR on EX-D images may reflect ischemic damaged but viable myocardium in vasospastic angina. The clinical usefulness of exercise-rest TF imaging in detection of organic coronary artery disease has been well established. Therefore, exercise-rest TF imaging with additional delayed exercise image could evaluate not only organic coronary artery disease but also coronary artery vasospasm. (author)

  14. Effects of nicardipine on coronary blood flow, left ventricular inotropic state and myocardial metabolism in patients with angina pectoris.

    Science.gov (United States)

    Rousseau, M F; Vincent, M F; Cheron, P; van den Berghe, G; Charlier, A A; Pouleur, H

    1985-01-01

    The effects of intravenous nicardipine (2.5 mg) on the left ventricular (LV) inotropic state, LV metabolism, and coronary haemodynamics were analysed in 22 patients with angina pectoris. Measurements were made at fixed heart rate (atrial pacing), under basal state, and during a cold pressor test. After nicardipine, coronary blood flow and oxygen content in the coronary sinus increased significantly. The indices of inotropic state increased slightly, and the rate of isovolumic LV pressure fall improved. Myocardial oxygen consumption was unchanged despite the significant reduction in pressure-rate product, but LV lactate uptake increased, particularly during the cold pressor test. When nicardipine was administered after propranolol, the indices of inotropic state were unaffected. The lack of direct effect of nicardipine on LV inotropic state was further confirmed by intracoronary injection of 0.1 and 0.2 mg in a separate group of 10 patients. It is concluded that the nicardipine-induced coronary dilatation seems to improve perfusion and aerobic metabolism in areas with chronic ischaemia, resulting in reduced lactate production and augmented oxygen consumption.

  15. Effects of nicardipine and nisoldipine on myocardial metabolism, coronary blood flow and oxygen supply in angina pectoris.

    Science.gov (United States)

    Rousseau, M F; Vincent, M F; Van Hoof, F; Van den Berghe, G; Charlier, A A; Pouleur, H

    1984-12-01

    The effects of the calcium antagonists nicardipine and nisoldipine on left ventricular (LV) metabolism were analyzed in 32 patients with angina pectoris. Measurements were made at a fixed heart rate under the basal state and during a cold pressor test (CPT). After administration of the drugs, coronary blood flow increased significantly and the mean aortic pressure decreased by 10% (p less than 0.01) in the basal state and by 11% (p less than 0.01) during CPT. Despite the reduction in pressure-rate product, myocardial oxygen consumption was unchanged in the basal state (18 +/- 4 vs 19 +/- 4 ml/min, difference not significant) and during CPT (21 +/- 5 vs 21 +/- 5 ml/min, difference not significant); this discrepancy between a reduced pressure-rate product and an unchanged oxygen consumption was also noted when nicardipine was given after propranolol (0.1 mg/kg; 12 patients). Both agents also increased LV lactate uptake, particularly during CPT (+13 mumol/min, p less than 0.05 vs control CPT) and reduced LV glutamine production. In 10 patients in whom 14C-lactate was infused, the chemical LV lactate extraction ratio increased more than the 14C-lactate extraction ratio after administration of the drugs, indicating a reduction in LV lactate production. The data are consistent with the hypothesis that nicardipine and nisoldipine improve perfusion and aerobic metabolism in chronically ischemic areas, resulting in an augmented oxygen consumption and in a reduced lactate production.

  16. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Pugliese, Francesca; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Mollet, Nico R.A.; deFeyter, Pim J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Runza, Giuseppe [University of Palermo, Department of Radiology, Palermo (Italy); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy); Mieghem, Carlos van; Meijboom, Willem B.; Baks, Timo [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Malagutti, Patrizia [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); University of Ferrara, Department of Cardiology, Ferrara (Italy); Cademartiri, Filippo [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy)

    2006-03-15

    Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as {>=} 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. (orig.)

  17. Identifying Metabolite and Protein Biomarkers in Unstable Angina In-patients by Feature Selection Based Data Mining Method

    Institute of Scientific and Technical Information of China (English)

    SHI Cheng-he; YANG Yi; WANG Wei; ZHAO Hui-hui; HOU Na; CHEN Jian-xin; SHI Qi; XU Xue-gong; WANG Juan; ZHENG Cheng-long; ZHAO Ling-yan

    2011-01-01

    Unstable angina(UA) is the most dangerous type of Coronary Heart Disease(CHD) to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metaboiomics is a better avenue to understand the inner mechanism of it. Feature selection based data mining method is better suited to identify biomarkers of UA. In this study, we carried out clinical epidemiology to collect plasmas of UA in-patients and controls. Proteomics and metabolomics data were obtained via two-dimensional difference gel electrophoresis and gas chromatography techniques. We presented a novel computational strategy to select biomarkers as few as possible for UA in the two groups of data. Firstly, decision tree was used to select biomarkers for UA and 3-fold cross validation was used to evaluate computational performances for the three methods. Alternatively, we combined independent t test and classification based data mining method as well as backward elimination technique to select, as few as possible, protein and metabolite biomarkers with best classification performances. By the method, we selected 6 proteins and 5 metabolites for UA. The novel method presented here provides a better insight into the pathology of a disease.

  18. FEATURES OF CYTOKINE PRODUCTION IN PATIENTS WITH UNSTABLE ANGINA: DEPENDENCE ON ETHNICITY IN THE REPUBLIC OF SAKHA (YAKUTIA

    Directory of Open Access Journals (Sweden)

    A. S. Golderova

    2012-01-01

    Full Text Available Abstract. We investigated levels of spontaneous and mitogen-induced cytokine production (IL-1β, IL-4, IL-6, IL-10 and IFNγ by peripheral blood cells of 24 men with unstable angina (UA, including indigenous population (n = 12, Yakuts, and a group of Russian migrants to the Republic of Sakha (n = 12. Activation of inflammatory response was revealed in the total group of patients with UA, manifesting by increase of spontaneous and induced production of the pro-inflammatory IL-1β, IL-6 cytokines, and mitogen-induced production of IFNγ. As compared with healthy individuals, spontaneous and induced production of anti-inflammatory IL-4 was decreased in UA patients, whereas the mitogen-induced production of IL-10 proved to be enhanced. Therefore, it is highly possible that a pro-atherogenic Th1-immune response is developing during UA, along with suppression of Th2-driving response. The differences revealed for different ethnic groups suggest that severity and prevalence of atherosclerotic disease, which is more common in the non-native patients, is associated with increased production of pro-inflammatory IL-1β and IL-6 cytokines.

  19. Prognosis in the thrombolysis in myocardial ischemia III registry according to the Braunwald unstable angina pectoris classification.

    Science.gov (United States)

    Scirica, Benjamin M; Cannon, Christopher P; McCabe, Carolyn H; Murphy, Sabina A; Anderson, H Vernon; Rogers, William J; Stone, Peter H; Braunwald, Eugene

    2002-10-15

    The unstable angina pectoris (UAP) classification proposed by Braunwald in 1989, although often used, has never been validated in a large, prospective multicenter study in which all subgroups of patients were included. Patients with UAP or non-ST-elevation myocardial infarction (NSTEMI) were enrolled in the Thrombolysis In Myocardial Ischemia III Registry and classified according to the Braunwald classification for UAP. Clinical end points were compared at 6 weeks and 1 year. Of 3,318 patients, those with primary UAP had lower rates of recurrent myocardial infarction (MI) or death when compared with patients with secondary UAP and post-MI UAP at 6 weeks (4.1% vs 6.4% vs 13.4%, respectively; p Braunwald classification of UAP predicts prognosis with secondary UAP, post-MI UAP, and patients with pain at rest who have a higher risk for death or recurrent cardiac events. Given their high risk for adverse events, patients with secondary UAP should be treated aggressively.

  20. Usefulness of fractional flow reserve measurements to defer revascularization in patients with stable or unstable angina pectoris, non-ST-elevation and ST-elevation acute myocardial infarction, or atypical chest pain.

    Science.gov (United States)

    Potvin, Jean-Michel; Rodés-Cabau, Josep; Bertrand, Olivier F; Gleeton, Onil; Nguyen, Can Nanh; Barbeau, Gerald; Proulx, Guy; De Larochellière, Robert; Déry, Jean-Pierre; Batalla, Nuria; Dana, Ali; Facta, Alvaro; Roy, Louis

    2006-08-01

    This study determined the safety of deferring coronary revascularization based on a fractional flow reserve (FFR) value > or = 0.75 in a series of consecutive unselected coronary patients with moderate coronary lesions, including patients with unstable angina, myocardial infarction (MI), and/or positive noninvasive test findings. The study included 201 consecutive coronary patients (mean age 62 +/- 10 years; 65% men) with 231 lesions evaluated by FFR measurement for which revascularization was deferred based on a FFR value > or = 0.75. Lesions associated with a positive noninvasive test result were those located in an artery supplying a myocardial territory in which myocardial ischemia was demonstrated by a noninvasive test. Cardiac events (cardiac death, MI, revascularization) and Canadian Cardiovascular Society angina class were evaluated at follow-up. Indications for coronary angiography included unstable angina or MI (62%), stable angina (30%), or atypical chest pain (8%). Forty-four patients (22%) had > or = 1 coronary lesion associated with a positive noninvasive test result in which FFR was evaluated. Mean FFR value was 0.87 +/- 0.06 and mean lesion percent diameter stenosis was 41 +/- 8%. At 11 +/- 6 months of follow-up, cardiac events occurred in 20 patients (10%), and no significant differences were observed between patients with unstable angina or MI and those with stable angina (9% vs 13%, p = 0.44) or between patients with and without lesions associated with positive noninvasive test results (9% vs 10%, p = 1.00). At the end of follow-up, 88% of patients were asymptomatic in angina class 0 or I, with no differences across various groups. In conclusion, these results suggest that patients with moderate coronary lesions can be safely managed without revascularization on the basis of FFR measurements, irrespective of clinical presentation and/or presence of positive noninvasive test results.

  1. Los videojuegos como objetos desarrolladores de aprendizaje

    OpenAIRE

    Rojas Rusinque, Claudia Victoria; Gómez Sánchez, Ligda; Guarnizo Pinto, María Isabel

    2014-01-01

    El principal objetivo de este proyecto, es valorar el uso y apropiación de los videojuegos como objetos desarrolladores de aprendizaje; así como, analizar el uso de los videojuegos como medio de alfabetización; reconocer las diferentes características de los videojuegos, diseñar una ruta de videojuegos que amplíe la visión del maestro en la utilización de herramientas pedagógicas

  2. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-06-01

    Full Text Available Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube. Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  3. La lengua inglesa como neolengua

    Directory of Open Access Journals (Sweden)

    Fernando BELTRÁN LLAVADOR

    2009-11-01

    Full Text Available RESUMEN: El artículo examina algunos usos y abusos de la lengua inglesa en la actualidad en el contexto de la globalización. Se define la neolengua, se ofrecen similitudes de la misma en el lenguaje publicitario en España, se trazan sus orígenes y se apuntan algunos antecedentes en la historia de la literatura inglesa, al tiempo que se ilustran ejemplos de variantes contemporáneas de la misma bajo la denominación de «nukespeak», especialmente abundantes en el discurso de los conflictos bélicos. La lengua inglesa está indisociablemente unida a complejos factores de orden económico, tecnológico y cultural que afectan a su misma morfología. Por otra parte, la presencia ubicua de la lengua inglesa, como idioma global, opera sobre las estructuras de sentimiento, pensamiento y acción de los ciudadanos en todo el mundo. Para los profesionales de la enseñanza del idioma inglés, ello comporta la obligación de discernir y resistir sus efectos potencialmente perversos al tiempo que siguen promoviendo sus valiosos beneficios culturales.ABSTRACT: Contemporary uses and abuses of the English language are examined in the context of complex issues and globalization trends. The term «newspeak» is defined, similitudes of it are found today in the language of advertising in Spain, its origins are traced back and antecedents are located in the history of English literature, while the presence of new modalities of the Orwellian reductionist language, such as «nukespeak», is illustrated within the language of warfare. The English language is inextricably bound up with economical, technological and cultural factors which affect its very morphology just as much as the pervasive influence of English as a global language affects the structures of feeling, thought and action of citizens all over the world, which poses an obligation on the part of EFL teachers to discern and resist its ill effects while they promote its still highly valuable cultural

  4. General Situation of Research on the Chinese and Western Medicine in Stable Angina Pectoris of Coronary Heart Disease%冠心病稳定型心绞痛的中西医研究概况

    Institute of Scientific and Technical Information of China (English)

    徐博洋; 王萍

    2015-01-01

    In recent years, angina pectoris of coronary heart diseaseis one of the high death rate disease, chest tightness, chest pain to the main clinical manifestations. From the research of Western medicine research survey, pathogenic factors, treatment of Western medicine and TCM etiology and pathogenesis, treatment of angina pectoris of coronary heart, treatment of angina pectoris of coronary heart diseaaeprogress summary, in order to reduce theincidence of angina pectoris of coronary heart disease, and treatment of angina pectoris of coronary heart disease, in order to improve the quality of life of patients and provide a theoretical basis.%冠心病心绞痛是近些年来高致死率疾病之一,是以胸闷、胸痛为主要的临床表现。现从西医研究概况、致病因素、西医治疗和中医的病因病机、治疗等方面综述冠心病心绞痛的研究进展,为降低冠心病心绞痛发生率和治疗冠心病心绞痛,为提高患者的生活质量提供理论依据。

  5. Review "Derecho y salud como realidades interactivas"

    OpenAIRE

    Vivas, Marcelo Dayrell

    2015-01-01

    Review "DERECHO Y SALUD COMO REALIDADES INTERACTIVAS" (Jorge Tomillo Urbina e Joaquín Cayón de Las Cuevas (Coord.), Aranzadi, Espanha, 2015) Resenha sobre a publicação "DERECHO Y SALUD COMO REALIDADES INTERACTIVAS", de Jorge Tomillo Urbina e Joaquín Cayón de Las Cuevas (Coord.) (Aranzadi, Espanha, 2015)

  6. Relationship Between Serum Creatine Kinase Isoenzyme MM Subbands and the Gradation of Coronary Stenosis in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Wu Ziqiang; Zhu shanju; Meng Suron; Sun Yueh

    2000-01-01

    Objective To observe the relationship between serum creatine kinase isoenzyme MM sub-bands (CKMM3/MM1 ratio) and the gradation of coronary stenosis and provide a simple, reliable, and economical method for identifying high-risk unstable angina pectoris (UAP). Mehtods Blood samples were drawn at different time after onset of chest pain in 21 patients with UAP and only once in 20 each volunteers for control. CKMM3/MM1 ratio was detected by nonserial buffer agarose gel electrophoresis. CKMB and CK were observed by velocity method. An emergent coronary arteriography was performed as soon as patients were admitted into hospital. Results Patients with UAP were divided into two subgroups:patients with elevated serum enzyme [P( + )] and patients with normal serum enzyme [P( - ) ] according to CKMM3/MM1 ratio < 0.5. Patients with UAP(+)had higher serum CKMM3/MM1 ratios from 0.5 to 12hrs and serum CKMB from 2 to 12 hrs than those with UAP( - ) and control ( P < 0.05) . Serum enzyme concentrations of patients with UAP whose coronary lumen had 90% or more than 90% stenosis were significantly higher than those whose coronary lumen had less than 90% stenosis (P<0.01) . AnyCKMM3/MM1 ratio was less than 1.0 and CK within the normal range in patients with UAP( + ) group. Conclusions CKMM3/MM1 ratios in patients with UAP can reflect severity of myocardial ischemia. Serum CKMM3/MM1 ratio provides a simple, reliable, and economical method for identifying high-risk UAP.

  7. The association of depression and angina pectoris across 47 countries: findings from the 2002 World Health Survey.

    Science.gov (United States)

    Loerbroks, Adrian; Bosch, Jos Antonio; Mommersteeg, Paula Maria Christina; Herr, Raphael Manfred; Angerer, Peter; Li, Jian

    2014-07-01

    Comorbid depression predicts poor health outcomes in patients with angina pectoris (AP). However, epidemiological data on the depression-AP comorbidity is limited and largely restricted to studies from Western countries, making generalizability to other regions uncertain. We aimed to provide additional epidemiological data for non-Western as well as Western countries. The present study used population-based data gathered in 47 countries from four continents (Africa, Asia, South America, and Europe) included in the cross-sectional 2002 WHO World Health Survey. Self-reported indicators of depression included: (a) its diagnosis, (b) its treatment, and (c) seven symptom items to determine presence of a major depressive episode. Similarly, information on AP comprised (a) a self-reported diagnosis, (b) self-reported AP treatment, (c) and a definition according to the WHO Rose questionnaire. In primary analyses, we operationalized depression or AP as positive if any of the respective indicators was present. Associations were estimated by multivariate logistic regression. In the entire sample (n = 213,264), the odds of AP were more than doubled among those with depression [odds ratio (OR) = 2.60, 95% confidence interval = 2.36, 2.87] versus those without depression. These positive associations were replicated across all continents and were observed in both men and women. Likewise, meaningful associations (ORs ≥ 1.5) were observed in virtually all individual countries (46/47). Application of different operationalizations of depression and AP confirmed the above findings, both in the entire sample and in continent-specific analyses. Our study extends the current evidence accrued in Western populations to non-Western populations. The co-occurrence of AP and depression appears to represent a universal phenomenon.

  8. Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

    Energy Technology Data Exchange (ETDEWEB)

    Schlett, Christopher L. [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg (Germany); Nance, John W. Jr. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); O’Brien, Terrence X. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC (United States); Ebersberger, Ullrich [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Centre Munich-Bogenhausen, Munich (Germany); Headden, Gary F. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bamberg, Fabian [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Radiology, University of Munich, Grosshadern Campus, and Munich Heart Alliance, Munich (Germany); Department of Radiology, University of Tuebingen (Germany)

    2014-07-15

    Highlights: • Patients developing UAP had overall more atherosclerosis as patients without any events. • Patients developing MACE had only more mixed plaque as those developing UAP. • Different atherosclerotic plaque components by CTA carry different prognostic value. - Abstract: Objective: CT angiography (CTA) has prognostic value in patients. But it is unknown whether differences in atherosclerosis by CTA predict the development of unstable angina pectoris (UAP) vs. major adverse cardiac events (MACE). Methods: We followed patients undergoing CTA as part of their acute chest pain work-up. Primary outcome was the development of UAP or MACE (cardiac death, myocardial infarction, revascularization) during a minimum follow-up of 12-months. CTAs were assessed for extent and composition of coronary plaque and stenosis. Ordinal regression with a 3-level outcome (no events, UAP, MACE) was applied. Results: Among 315 patients, 22 developed UAP and 31 MACE. While UAP patients had higher atherosclerosis burden with respect to all assessed features compared to patients with no events (p ≤ 0.02), only mixed plaque extent was significantly different between UAP and MACE patients (p = 0.02). The odds ratio was 4.55 for being in a higher disease-level comparing patients with low extent to those with no mixed plaque, and 3.02 comparing patients with high to those with low. These findings remained after adjustments for potential confounders. Conclusion: The extent of mixed coronary plaque is different between patients who develop UAP vs. MACE, supporting the hypothesis that it is a more culprit morphology.

  9. Identical TCR beta-chain rearrangements in streptococcal angina and skin lesions of patients with psoriasis vulgaris.

    Science.gov (United States)

    Diluvio, Laura; Vollmer, Sigrid; Besgen, Petra; Ellwart, Joachim W; Chimenti, Sergio; Prinz, Joerg C

    2006-06-01

    Tonsillar infection with Streptococcus pyogenes may induce several nonsuppurative autoimmune sequelae. The precise pathogenetic mechanisms behind this clinically well-established association are still unresolved. Using TCR analysis, we sought to identify a link between streptococcal tonsillitis and the T cell-mediated autoimmune response in psoriasis. Three patients with streptococcal-induced psoriasis underwent tonsillectomy. Using size spectratyping and sequencing of TCR beta-chain variable region gene (TCRBV) rearrangements, we compared the TCR usage of psoriatic skin lesions, blood, tonsils, and tonsillar T cells fractionated according to the expression of the skin address in "cutaneous lymphocyte-associated Ag" (CLA). TCRBV-size spectratype analysis of the blood lymphocytes, tonsils, and the CLA-negative tonsillar T cells revealed largely unselected T cell populations. Instead, TCRBV gene families of the psoriatic lesions and skin-homing CLA-positive tonsillar T cells displayed highly restricted spectratypes. Sequencing of TCRBV cDNA identified various clonal TCRBV rearrangements within the psoriatic lesions that indicated Ag-driven T cell expansion. Several of these clonotypes were also detected within the tonsils and, in one of the patients, within the small subset of CLA-positive tonsillar T cells, suggesting that T cells from the same T cell clones were simultaneously present within skin and tonsillar tissue. Because after tonsillectomy psoriasis cleared in all three patients our observations indicate that T cells may connect psoriatic inflammation to streptococcal angina. They suggest that the chronic streptococcal immune stimulus within the tonsils could act as a source for pathogenic T cells in poststreptococcal disorders, and they may help to explain why eliminating this source with tonsillectomy may improve streptococcal-induced sequelae.

  10. Comparison of the efficacy and tolerability of ivabradine and ranolazine in patients of chronic stable angina pectoris

    Directory of Open Access Journals (Sweden)

    Aditi Chaturvedi

    2013-01-01

    Full Text Available Introduction: To compare the efficacy and tolerability of Ivabradine (IVA and Ranolazine (RAN in chronic angina patients. Materials and Methods: This was a follow-on, open-label trial conducted in a tertiary care hospital of Uttarakhand. Thirty patients each taking IVA 5 mg twice daily or RAN 500 mg twice daily were distributed to the respective groups. Patients were asked to fill a pretested questionnaire on frequency of anginal attacks and adverse reactions before and 2, 4 and 8 weeks after taking the respective medicines. Their blood pressure, heart rate and routine hematological and biochemical estimations were performed at baseline and after intervention. Results were statistically analyzed using different statistical tests, with P < 0.05 considered as significant. Results: There was no significant difference in the frequency of anginal attacks per week between the groups. The adverse drug reactions (ADRs reported in the IVA group were dizziness (30%, headache (16.6%, backache (16.6%, vertigo (13.3%, blurred vision (13.3%, muscle cramps (10%, arthralgia (10%, cough and dyspnea (6.6%, hypersensitivity rash (6.6%, fever (3.3% and nausea (3.3%. The ADRs in the RAN group were nausea (26.6%, dizziness (23.3%, vomiting (3.3%, constipation (3.3% and vertigo (3.3%. The blood pressure, heart rate and routine hematological and biochemical evaluations did not show any significant difference in the pre-post values. IVA significantly decreased the resting heart rate after eight weeks of intervention. Conclusions: Both antianginal agents appeared equiactive. However, RAN had a better safety and tolerability profile than IVA. Serum sickness-like reaction was an adverse event noticed with IVA, which needs causality establishment.

  11. Prognostic value of coronary artery calcium score in patients with stable an-gina pectoris after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Fang-Fang WANG; Jiang-Li HAN; Rong HE; Xiang-Zhu ZENG; Fu-Chun ZHANG; Li-Jun GUO; Wei GAO

    2014-01-01

    Objectives To evaluate the prognostic value of the coronary artery calcium (CAC) score in patients with stable angina pectoris (SAP) who underwent percutaneous coronary intervention (PCI). Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography (MSCT) were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events (MACE) were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score>300 (n=145) had significantly higher PCI complexity (13.1%vs. 5.8%, P=0.017) and rate of procedure-related complications (17.2%vs. 7.4%, P=0.005) than patients with a CAC score≤300 (n=189). After a median follow-up of 22.5 months (4-72 months), patients with a CAC score≤300 differ greatly than those patients with CAC score>300 in cumulative non-events survival rates (88.9 vs. 79.0%, Log rank 4.577, P=0.032). After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio (HR):4.3, 95%confidence inter-val (95%CI):2.4-8.2, P=0.038] in patients with a CAC score>300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.

  12. 脑钠肽检测预测心绞痛复发的临床价值%Clinical value of BNP testing to predict recurrence of angina

    Institute of Scientific and Technical Information of China (English)

    刘建修; 杨粟毅; 邹园枚

    2015-01-01

    目的:探讨脑钠肽(BNP)检测预测心绞痛复发的临床价值。方法选取我科2011年1月至2013年1月收治的82例稳定性心绞痛患者,所有患者均随访至2014年8月,以心绞痛再发为随访终点,按照是否再发分为未再发组72例和再发组10例。比较两组患者治疗前后的BNP水平、成功治疗后的基本特点,采用受试者工作特征(ROC)曲线计算BNP成功治疗后预测心绞痛的截断值,同时预测心绞痛再发的敏感性和特异性。结果未再发组成功治疗后的BNP水平显著低于治疗前与再发组治疗后,再发组成功治疗后的BNP水平显著高于治疗前(P<0.01)。未再发组的收缩压(SBP)、舒张压(DBP)、总甘油三酯(TG)和总胆固醇(TC)水平水平明显低于再发组(P<0.05)。BNP在成功治疗后缓解期的截断值为58.20 pg/ml,其ROC曲线的敏感性为71.09%,特异性为96.97%。结论稳定性心绞痛患者在其治疗前后测定其BNP水平,对于预测心绞痛再发有一定临床价值。%Objective To analyze the clinical value of brain natriuretic peptide (BNP) detection in predicting recurrence of angina. Methods Eighty-two patients of unstable angina in our department from January 2011 to Janu-ary 2013 were enrolled in the study. The patients were followed up to August 2014, with angina recurrence as the end of follow-up. According to the recurrence status, the patients were divided into non-recurrence group (n=72) and recur-rence group (n=10). BNP levels before and after treatment and the basic characteristics of successful treatment were compared in two groups of patients. Receiver operating characteristic (ROC) curve was used to calculate BNP cutoff value to predict angina pectoris after successful treatment and predict the sensitivity and specificity. Results BNP levels in non-recurrence group after treatment were significantly lower than those before treatment, and the levels was also significantly lower than those in

  13. Significance of retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Fumitaka; Hashimoto, Toshio; Uemura, Shiro; Kawamoto, Atsuhiko; Dohi, Kazuhiro [Nara Medical Univ., Kashihara (Japan); Matsushima, Akihiko

    2001-07-01

    This study investigated retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy in patients with vasospastic angina. Twenty-three patients with vasospastic angina showed abnormal uptake of BMIPP before medical treatment and had coronary vasospasm induced by acetylcholine. The patients were divided into two groups according to uptake of BMIPP after medical treatment: retardation of abnormal uptake of BMIPP (Group R, n=4) and normal uptake of BMIPP (Group N, n=19). Frequency of chest pain, medical treatment and autonomic nervous activity were compared between the two groups. Furthermore, the frequency of chest pain and uptake of BMIPP in group R were obtained after intensive medical treatment. Autonomic nervous activity was evaluated by heart rate variability on Holter electrocardiography. Heart rate variability contained high-frequency elements (HF; 0.15-0.4 Hz) and low-frequency elements (LF; 0.04-0.15 Hz). LF/HF was estimated for sympathetic nervous activity and HF was estimated for parasympathetic nervous activity. Daytime and nighttime autonomic nervous activity were compared between the two groups. The frequency of chest pain was higher in Group R than in Group N (p<0.05). Medical treatment was not different between the two groups. Circadian variation of sympathetic and parasympathetic nervous activity were absent in Group R. During the nighttime, Group R showed higher sympathetic nervous activity (p<0.05) and lower parasympathetic nervous activity (p<0.01) than Group N. The frequency of chest pain was significantly lower after intensive medical treatment (p<0.05), and uptake of BMIPP returned to normal in Group R. We suspected that the disorder in autonomic nervous activity was more severe in Group R, and thus induced coronary vasospasm. Retardation of abnormal uptake of BMIPP in patients with vasospastic angina indicates poor control of coronary vasospasm. Uptake of BMIPP is useful in the evaluation of

  14. Effect of Xinfuning V combined with western medicine therapy on serum blood viscosity, lipid metabolism and plaque stability in patients with coronary heart disease and angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Guo-Feng Ma; Xiang-Yang Wu; Ya-Ning Wang; Jun-De Li

    2016-01-01

    Objective:To analyze the effect of Xinfuning V combined with western medicine therapy on serum blood viscosity, lipid metabolism and plaque stability in patients with coronary heart disease and angina pectoris.Methods: A total of 200 patients with coronary heart disease and angina pectoris were randomly divided into observation group and control group (n=100), control group received routine western medicine therapy, observation group received routine western medicine treatment + adjuvant Xinfuning V treatment, and then the differences in with serum blood viscosity, lipid metabolism, plaque stability parameters, etc were compared between the two groups after treatment.Results: The whole blood viscosity under different shear rate (1/s, 5/s, 30/s and 200/s), plasma viscosity and fibrinogen content in peripheral blood of observation group after 4 weeks of treatment were significantly lower than those of control group; lipid metabolism indexes TC, TG, LDL-C and ApoB content in serum were lower than those of control group while HDL-C content was higher than that of control group; inflammatory factors Lp-PLA2, sICAM-1, NF-κB, hs-CRP and TNF-α content in serum were lower than those of control group; plaque stability parameters AT, TTP, mTT, PI, BI and EI levels were significantly lower than those of control group.Conclusions:Xinfuning V combined with western medicine therapy can optimize the circulating internal environment in patients with coronary heart disease and angina pectoris, and also has a remarkable effect on stabilizing plaque properties.

  15. Effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after PCI

    Institute of Scientific and Technical Information of China (English)

    Jing Peng; Li Chen

    2016-01-01

    Objective:To study the effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after percutaneous coronary intervention (PCI).Methods:A total of 130 angina pectoris patients who received PCI treatment in our hospital from May 2012 to October 2015 were selected for study, patients' medical records were retrospectively analyzed, they were divided into the experimental group and the control group based on the different medication schemes after PCI, experimental group received routine treatment combined with salvianolate and meglumine adenosine cyclphosphate treatment after operation, and control group received conventional medical treatment after operation. The changes of perioperative blood viscosity, inflammatory factor and NT-proBNP content were compared between two groups.Results:After PCI, the blood viscosity indexes as well as inflammatory factor and NT-proBNP levels of experimental group were significantly lower than those before PCI (P0.05), inflammatory factor and NT-proBNP levels were significantly lower than those before PCI (P<0.05); 7 days after PCI, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity and aggregation index as well as TNF-α, sICAM-1, sVCAM-1, LP-PLA2, NT-proBNP, D-dimer and PTEN levels of experimental group were significantly lower than those of control group (P<0.05).Conclusions: Salvianolate combined with meglumine adenosine cyclphosphate can reduce the blood viscosity of patients with angina pectoris after PCI, and can also reduce inflammation and improve heart pump function.

  16. Changes of Lipid Profile and C-Reactive Protein after Withdrawal of Xuezhikang, an Extract of Cholestin, in Patients With Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hu Chenglin; Xiang Jizhou; Li Yanbo; Zou Yongguang; Liu Jun; Tang Qizhu; Huang Congxin

    2006-01-01

    Objectives In addition to its lipid-lowering properties, statin decreases the level of C-reactive protein (CRP) resulting in reduction of cardiovascular events. However, information about discontinuation of statin therapy in stable cardiac patients is limited. This was a prospective cohort study to explore whether withdrawal of statin treatment could result in rebound of inflammation in patients with stable angina pectoris in a short-term course.Methods and Results 75 patients with stable angina pectoris were randomly divided into three groups: ① Pretreatment with Xuezhikang (XZK, an extract of cholestin) for 6 weeks and then replaced by placebo; ②Treatment with XZK throughout the study; ③ Placebo. Lipid levels, highly sensitive CRP (hs-CRP) and serum cardiac troponin T (cTnT) were assessed before receiving the XZK therapy, 1 day before discontinuation of XZK, and on day 1, 2, 3,7 and 14 after discontinuation of XZK, respectively.At day 14 after discontinuation of XZK therapy,total cholesterol, LDL-C and triglyceride significantly increased, whereas HDL-C level significantly decreased. The median level of hs-CRP increased significantly from the second day after withdrawal of XZK therapy. There was a prominent rebound of hs-CRP concentration 3 days after discontinuation of XZK therapy. 7 to 14 days after discontinuation of XZK therapy, the hs-CRP concentration declined to a similar level as in the placebo group. Elevated cTnT level did not occur throughout the study course in either group. Conclusions Short-term discontinuation of statin therapy could induce a rapid rebound phenomenon of inflammatory response independently of changes of lipid parameters. However, it was not enough to induce myocardial injury in this cohort of patients with stable angina pectoris.

  17. Effect of Xin'anning Nasal Drop ( 心安宁滴鼻剂 ) in Treating Coronary Heart Disease with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To observe the clinical efficacy of Xin'anning Nasal Drop (XAND, 心安宁滴鼻剂 )in treating coronary heart disease with unstable angina pectoris (CHD-UAP). Methods: Sixty patients with CHD-UAP were assigned, according to the randomizing number table, to two groups, the control group treated with conventional Western medicine, and the treated group treated with conventional Western medicine plus XAND. The clinical efficacy and the changes of S-T segment in resting EKG and total ischemia burden (TIB) in 24-h dynamic EKG were observed. Results: The clinical efficacy, including the effect of angina alleviation, its initiation, and the effect of TCM syndrome score reduction, were significantly superior in the treated group to those in the control group ( P<0.05 or P<0.01 ). The degree and extent of myocardial ischemia were significantly improved in both groups ( P<0.01 ), but the improvement in the treated group was better than that in the control group ( P<0.05). Moreover, it was worth mentioning that the immediate effect in the treated group was better than that in the control group, and the reduction of TIB, the improvement in heart rate and myocardial oxygen consumption (immediately after the first administration or by the end of the therapeutic course), and systolic blood pressure after treatment in the former were all superior to those in the latter, showing significant difference ( P<0.05 or P<0. 01 ). Conclusion: XAND has a quick effect in alleviating angina in patients with CHD-UAP, and it is worthy of further studies and spreading in clinical practice.

  18. Stable Angina Pectoris Treated with Integrated Therapy of Traditional Chinese and Western Medicine%中西药联用治疗稳定型心绞痛

    Institute of Scientific and Technical Information of China (English)

    李艳娜; 梁秀芬

    2008-01-01

    目的 观察血塞通与常规西药方案联用对稳定犁心绞痛患者的临床疗效.方法 将120例冠心病心绞痛患者随机分为治疗组和对照组各60例,两组均给予静脉输注硝酸酯类药物、心肌营养药物及口服降压药物:治疗组在此基础上,静脉滴注血塞通200 mg/a,10 d为1疗程.结果 1个疗程后,治疗组总有效率97.7%,对照组为80.3%,两组比较有显著性差异(P<0.05).结论 血塞通与常规西药方案联用治疗稳定型心绞痛,临床疗效满意.%Objective To observe the clinical efficacy of combined therapy of Xuesaitong and routine Western Medicine in treating stable angina pectoris. Methods 120 cases of stable angina pectoris were randomly divided into treatment group and control group, with 60 cases in each group. Intravenous Nitrates, cardiac muscle nutrieeufical and antihypertensive medicine were administrated to the both groups. Xuesaitong injection was intravenous dripped to patients in the treatment group with 200 mg/d for 10 days. Results The total effective rate was 97.7% in the treatment group and 80.3%in the control group. There was significant difference between the two groups (P<0.05). Conclusion Integrated therapy of xuesaitong injection and ratine Western Medicine has a great efficacy in treating patients with stable angina pectoris.

  19. Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?

    DEFF Research Database (Denmark)

    Martensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2016-01-01

    AIMS: Our aim was to investigate whether there is social inequality in access to invasive examination and treatment, and whether access explains social inequality in case fatality in a nationwide sample of patients admitted for the first time with unstable angina or non-ST-elevation myocardial...... infarction (NSTEMI) in Denmark. METHODS AND RESULTS: All patients admitted for the first time with NSTEMI (n=16,625) or unstable angina (n=8,800) from 2001 to 2009 in Denmark were included. We measured time from admission to coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary...... artery bypass graft (CABG). The outcomes were 30-day and one-year case fatality. We found social inequality in access to CAG and one-year case fatality for both NSTEMI and unstable angina patients, but the time waited for CAG did not explain the social inequality in case fatality. CONCLUSIONS: Despite...

  20. Study on Effect of Zhixinkang Capsule(脂欣康胶囊)in Treating Unstable Effort Angina and Hyperlipidemia and Lts Function in Vascular Endothelium Protection

    Institute of Scientific and Technical Information of China (English)

    ZHANGWen-gao; MENG-Xian-zhongtffu

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endotelium of Zhixin-kang Capsule(ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia.Methods:Sixty-five patients with unstable effort angina were randomly divided into ZXKC group(34 ca-ses)and control group(31 cases).Conventional western medical therapy was given to both groups,with ZXKC group receiving additional ZXKC treatment.Data of 20 healthy persons were taken as normal group.Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 ca-ses) and control group treated with Yixintong(17 cases).The changes of clinical symptoms and laborato-ry indexes in all the patients were observed before and after treatment.Results:In patients with unstable effort angina,the efficacy of treatment of ZXKC,the withdrawal rate of nitroglycerin,the relieving of symptoms,the improvement of the electrocardiogram,the counts of circulating endothelial cells,the con-tent of platelet P-selectin,the content of plasma endothelin(ET),the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde(MDA) were all better than those in the control group.In patients with hyperlipidemia,there was no significant difference in lipids reduction between ZXKC group and the control group.In both groups,the total cholesterol(TC),triglyceride(TG),low density lipo-protein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],ET, oxidized low density lipoprotein,MDA,arte-riosclerotic index(AI)all lowered obviously,while the SOD,HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly.In the ZXKC group,the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly.The total effective rate in symptom relieving,the markedly effective rate,the reduction of TC,ET and ET/CGRP,and the elevation of SOD in ZXKC group were all superior to those in the control group.Conclusion:ZXKC could effectively resist myocardial ische

  1. Unstable angina early after aortic valve replacement surgery in a female patient with normal coronary arteries preoperatively – a case report

    Directory of Open Access Journals (Sweden)

    Schwarz Christian

    2009-07-01

    Full Text Available Abstract Background Angina pectoris early after aortic valve replacement surgery in patients with previously normal coronary arteries may be life threatening and has to be assessed immediately. Case report 12 weeks after aortic valve replacement surgery, a 60-year-old female patient was referred for evaluation of recent onset of severe chest pain on mild exertion and at rest. Coronary angiography showed severe stenosis nvolving the left coronary ostium and the left main stem. The patient was urgently referred for bypass surgery and had an uneventful postoperative recovery. Conclusion A high degree of suspicion is needed for early recognition and aggressive management of this rare but serious complication.

  2. Study on Effect of Zhixinkang Capsule (脂欣康胶囊)in Treating Unstable Effort Angina and Hyperlipidemia and Its Function in Vascular Endothelium Protection

    Institute of Scientific and Technical Information of China (English)

    张文高; 颜亭祥; 高福军; 孟宪忠; 刘建平; 尹格平; 刘丽莉; 罗南萍; 史炳娥; 马学盛

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endothelium of Zhixinkang Capsule (ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia.Methods: Sixty-five patients with unstable effort angina were randomly divided into ZXKC group (34 cases)and control group (31 cases). Conventional western medical therapy was given to both groups, with ZXKC group receiving additional ZXKC treatment. Data of 20 healthy persons were taken as normal group. Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 cases) and control group treated with Yixintong (17 cases). The changes of clinical symptoms and laboratory indexes in all the patients were observed before and after treatment. Results: In patients with unstable effort angina, the efficacy of treatment of ZXKC, the withdrawal rate of nitroglycerin, the relieving of symptoms, the improvement of the electrocardiogram, the counts of circulating endothelial cells, the content of platelet P-selectin, the content of plasma endothelin (ET), the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde (MDA) were all better than those in the control group. In patients with hyperlipidemia, there was no significant difference in lipids reduction between ZXKC group and the control group. In both groups, the total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), lipoprotein(a) [Lp(a)], ET, oxidized low density lipoprotein, MDA, arteriosclerotic index (AI) all lowered obviously, while the SOD, HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly. In the ZXKC group, the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly. The total effective rate in symptom relieving, the markedly effective rate, the reduction of TC, ET and ET/CGRP, and the elevation of SOD in ZXKC group were all superior to those in the control group. Conclusion: ZXKC could

  3. Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Przemyslaw Kardas

    2007-05-01

    Full Text Available Przemyslaw KardasThe First Department of Family Medicine, Medical University of LodzBackground: A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.Methods: One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.Results: The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01, and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001. The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01. The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01, correct interdose intervals (77.4% v 53.1%, p < 0.0001, and therapeutic coverage (85.6% vs 73.7%, p < 0.001 were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.Conclusions: The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.Keywords: patient compliance, quality of life, stable angina pectoris, randomized controlled trial

  4. Transient myocardial ischemia during nifedipine therapy in stable angina pectoris, and its relation to coronary collateral flow and comparison with metoprolol

    DEFF Research Database (Denmark)

    Egstrup, K; Andersen, P E

    1993-01-01

    angina and coronary artery disease were randomized to a parallel double-blind study with nifedipine and metoprolol, and compared for effects on transient ischemic episodes during ambulatory electrocardiographic monitoring and exercise-induced ischemia. The effects were correlated to the presence...... at either the onset of transient ischemia out of the hospital or exercise-induced ischemia. This was in contrast with the effect in 21 patients treated with metoprolol (9 in group 1, and 12 in group 2) where significant reductions were observed in the frequency of both total (p

  5. Predictive value of the corrected TIMI frame count in patients with suspected angina pectoris but no obstructive coronary artery disease at angiography

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrøm, Steen Z; Peña, Adam

    2014-01-01

    AIMS: To evaluate whether the corrected thrombolysis in myocardial infarction frame count (CTFC), an index of resting coronary blood flow, is associated with the risk of major adverse cardiovascular events (MACE) in patients with suspected stable angina pectoris (SAP) but no obstructive coronary...... artery disease (CAD) at angiography. METHODS AND RESULTS: In this case-control study, CTFC at baseline in 127 patients (50 % women) who subsequently experienced a myocardial infarction, non-hemorrhagic stroke or cardiovascular death during 2001-2011 was compared with CTFC in 254 event-free matched...

  6. Kinetics of blood lipoprotein spectrum indices in patients with angina pectoris during and after low-intensity laser therapy as a paraclinical criterion for treatment efficiency

    Science.gov (United States)

    Babushkina, G. V.; Kartelishev, A. V.

    2001-04-01

    An investigation was made of applying (lambda) equals 0.63 micrometers laser radiation in treating 403 patients affected by angina pectoris. The patients were administered a course of combined laser therapy consisting of the intravenous laser irradiation of blood combined with laser acupuncture. Apart from that, the patients took the maintenance doses of antianginal preparations and therapeutic doses of vitamins A and E. The blood lipoprotein spectrum revealed that this combined laser therapy was capable of producing an antiatherogenic effect. It was also found that the most effective exposure time of laser radiation was in the range of 10 to 15 min.

  7. Rest delayed images on {sup 99m}Tc-MIBI myocardial SPECT as a noninvasive screen for the diagnosis of vasospastic angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Soichi; Yamaguchi, Hiroyuki; Takayama, Shin [Yamagata Prefectural Shinjo Hospital (Japan); Kurabe, Atsushi; Heito, Takayuki [Yamagata Prefectural Nihonkai Hospital, Sakata (Japan)

    2002-05-01

    Diagnostic usefulness of {sup 99m}Tc-hexakis-2-methoxy isobutyl isonitrile (MIBI) myocardial SPECT at rest was examined in 39 cases of coronary vasospastic angina pectoris who were diagnosed by a positive reaction to ergonovine provocation. SPECT was performed 45 minutes (early image) and 3 hours (delayed image) after the intravenous injection of approximately 600 MBq of MIBI. Decrease in accumulation was ranked by four defect scores (0: normal; 1: slight decrease; 2: moderate decrease; 3: severe decrease) and the total defect score was evaluated semiquantitatively. The washout rate between the normal area and the spasm area was also evaluated quantitatively using bull's eye. As a result, 15 cases (15/39; 38.4%) showed decreased accumulation in the early image and 27 cases (27/39; 69.2%) showed decreased accumulation in the delayed image. All of the cases which showed decreased accumulation in the early image had decreased accumulation in the delayed image as well. In 6 cases (6/34; 17.6%) showed ST wave changes during exercise ECG and 16 cases (16/34: 47%) showed decreased accumulation in the exercise myocardial SPECT. The washout rate of MIBI in the decreased accumulation area was significantly higher than that of the normal area. Of 32 ergonovine induced vasospastic area, 23 areas (72%) exhibited decreased accumulation in the delayed image for the same area. Decreased accumulation in the delayed image in MIBI was due to the enhanced washout, which, in turn, indicated declined retention of MIBI by mitochondrial membrane. In coronary vasospastic angina pectoris, spasm induced ischemia was thought to have an effect on the mitochondria. This study suggested that even with a normal exercise ECG and exercise myocardial SPECT, there's a strong possibility of coronary vasospastic angina pectoris if a decreased accumulation was found in the delayed image in the MIBI myocardial SPECT at rest. Hence, in diagnosing coronary vasospastic angina pectoris, the delayed

  8. Analysis of thrombelastography in type 2 diabetes patients complicated with angina pectoris of coronary heart disease and its correlation with disease severity

    Institute of Scientific and Technical Information of China (English)

    Hong-Hong Liu; Zhao-Chuan Liu; Hong-Tao Liu; Yu-Ji Zhang; Qing-Ling Fu; Jun-Ling Wang

    2016-01-01

    Objective:To analyze the thrombelastography parameters in type 2 diabetes patients complicated with angina pectoris of coronary heart disease and their correlation with disease severity.Methods:30 cases of healthy volunteers, 30 cases of patients with simple angina pectoris of coronary heart disease (CHD) and 30 cases of type 2 diabetes patients complicated with angina pectoris of coronary heart disease were selected for study. Thrombelastography parameters R value, K value, αangle and MA value as well as inflammation-associated molecules YKL-40 and NK-kB expression were detected.Results:R values and K values of simple CHD group and diabetes complicated with CHD group were lower than those of control group, and αangle and MA values were higher than those of control group; R values and K values of diabetes complicated with CHD group were lower than those of simple CHD group, and αangle and MA values were higher than those of simple CHD group; R values and K values of 2 branch lesions group and 3 branch lesions group were lower than those of 1 branch lesion group, and αangle and MA values as well as YKL-40 and NK-kB contents were higher than those of 1 branch lesion group; R values and K values of 3 branch lesions group were lower than those of 2 branch lesions group, and αangle and MA values as well as YKL-40 and NK-kB contents were higher than those of 2 branch lesions group; R value and K value were negatively correlated with YKL-40 and NK-kB contents, and αangle and MA value were positively correlated with YKL-40 and NK-kB contents.Conclusions: Thrombelastography parameters in type 2 diabetes patients complicated with angina pectoris of coronary heart disease are significantly abnormal, and R value, K value, αangle and MA value can reflect disease severity and inflammation degree.

  9. Efficacy of controlled-release isosorbide-5-mononitrate as adjunctive treatment to beta-blocking agents in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Aldershvile, J; Abildgaard, U

    1989-01-01

    to a beta blocker. In bicycle ergometer exercise tests performed 4 h after study drug intake, total exercise time and time until 1-mm ST-depression increased significantly during both regimens as compared with placebo (p less than 0.05). However, only the 60-mg once-daily regimen was significantly better...... than placebo with regard to time until angina pectoris. The results indicate that ISMN-CR 60 mg once daily is effective as adjunctive to beta-blocker treatment, and nitrate tolerance appeared to develop during the twice-daily regimen. In 10 of the patients, the effect of additional sublingual...

  10. Universal health care no guarantee of equity: Comparison of socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction and angina

    Directory of Open Access Journals (Sweden)

    Kelman Chris W

    2009-12-01

    Full Text Available Abstract Background In Australia there is a socioeconomic gradient in morbidity and mortality favouring socioeconomically advantaged people, much of which is accounted for by ischaemic heart disease. This study examines if Australia's universal health care system, with its mixed public/private funding and delivery model, may actually perpetuate this inequity. We do this by quantifying and comparing socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction (AMI and patients with angina. Methods Using linked hospital and mortality data, we followed patients admitted to Western Australian hospitals with a first admission for AMI (n = 5539 or angina (n = 7401 in 2001-2003. An outcome event was the receipt, within a year, of a coronary procedure—angiography, angioplasty and/or coronary artery bypass surgery (CABG. Socioeconomic status was assigned to each individual using an area-based measure, the SEIFA Index of Disadvantage. Multivariable proportional hazards regression was used to model the association between socioeconomic status and procedure rates, allowing for censoring and adjustment of multiple covariates. Mediating models examined the effect of private health insurance. Results In the AMI patient cohort, socioeconomic gradients were not evident except that disadvantaged women were more likely than advantaged women to undergo CABG. In contrast, in the angina patient group there were clear socioeconomic gradients for all procedures, favouring more advantaged patients. Compared with patients in the most disadvantaged quintile of socioeconomic status, patients in the least disadvantaged quintile were 11% (1-21% more likely to receive angiography, 52% (29-80% more likely to undergo angioplasty and 30% (3-55% more likely to undergo CABG. Private health insurance explained some of the socioeconomic variation in rates. Conclusions Australia's universal health care system does not guarantee

  11. Study of relationship between the levels of serum bilirubin ,uric acid and unstable angina pectoris%不稳定型心绞痛患者血清胆红素及尿酸水平的分析

    Institute of Scientific and Technical Information of China (English)

    梁启权; 曾胜宏

    2009-01-01

    目的 探讨冠心病不稳定型心绞痛与胆红素及尿酸的关系.方法 将入选202例冠心病不稳定型心绞痛患者,采集空腹静脉血测定总胆红素、直接胆红素、间接胆红素及尿酸,比较其心绞痛发作时、3个月、6个月及1年内未再发作时胆红素及尿酸的变化情况.结果 心绞痛发作时胆红素降低,尿酸偏高.结论 胆红素和尿酸水平可间接反映不稳定型心绞痛机体氧化、抗氧化情况,胆红素对评估病情有一定帮助.%Objective To investigate the relationship between the levels of serum bilirubin,uric acid(UA) and coronary heart disease unstable angina pectoris.Methods The leves of total bilirubin (TBIL),direct bilirubin (DBIL),indirect bilirubin(IBIL) and UA in venous blood by limosis were determind in 202 patients with unstable angina pectoris.We determine the different levels of TBIL,DBIL,IBIL and UA when they were suffering from angina pectoris.Then we respectively determine the levels of TBIL,DBIL,IBIL and UA in 3 months,6 months and 12 months after they had been suffered from angina pectoris.Results The levels of serum bilirubin were lower and UA were higher,when the patients were suffering from angina pectoris.Conclusion We can indirectly assess the oxidative and antioxidative activities by testing bilirubin and UA in unstable angina pectoris.

  12. Los ritmos como terapia para la impulsividad

    Directory of Open Access Journals (Sweden)

    Mónica Triviño

    2012-10-01

    Full Text Available Investigaciones recientes muestran que el uso de patrones rítmicos facilita la respuesta óptima en el tiempo, por lo que el entrenamiento mediante ritmos podría proponerse como terapia novedosa ante problemas como la impulsividad. Esto podría beneficiar a pacientes con daño prefrontal o personas con trastorno por déficit de atención e hiperactividad (TDAH, que suelen mostrar conductas impulsivas, así como dificultad para estimar el paso del tiempo.

  13. El videojuego como material educativo: La Odisea

    Directory of Open Access Journals (Sweden)

    Belén Mainer Blanco

    2012-04-01

    Full Text Available La investigación se basa en la función educativa que pueden cumplir los videojuegos, un campo que consideramos inexplorado por tres motivos principalmente: su reciente incorporación, su impopularidad educativa (el rechazo el videojuego como herramienta de aprendizaje y considerado, por el contrario, como una distracción, y la incompleta incorporación de las nuevas tecnologías de información y comunicación (TIC en el ámbito familiar y educativo. En una segunda parte, se ha realizado una aplicación práctica tomando como referencia la gran obra universal “La Odisea”, cuya intención es mostrar la utilidad del videojuego como complemento educativo.

  14. El Derecho como argumentación

    Directory of Open Access Journals (Sweden)

    Atienza, Manuel

    1999-11-01

    Full Text Available Not available

    Frente a las concepciones del Derecho como norma, como hecho o como valor (que caracterizan, respectivamente, al norrnativismo, al realismo jurídico y al iusnaturalismo, se propone aquí un cuarto enfoque que consiste en ver el Derecho como argumentación (y que cohra especial relevancia en las sociedades democráticas. Sin embargo, no hay una única forma de entender la argumentación jurídica. Aunque conectadas entre sí, en el trabajo se distinguen tres concepciones: la formal, la material y la pragmática o dialéctica; muchas cuestiones que se plantean en el ámbito de la teoría de la argumentación jurídica pueden resolverse -o aclararse- teniendo en cuenta esa triple perspectiva.

  15. COMO ENTENDER AS PRINCIPAIS TEORIAS DA LE

    OpenAIRE

    Nascimento, Francisco de Assis do; Carvalho, Jander Ramos; Costa, Priscila Márcia de Andrade; Bastos, Rafael Lira Gomes

    2013-01-01

    O presente artigo mostrará algumas das principais teorias de aquisiçãode LE. Desta forma mostraremos como fatores como afetividadee o meio, encontrados nessas teorias podem influenciar no processode aquisição de uma língua estrangeira. Observaremos também quecada teoria observa pontos diferentes do processo de aquisição de L2,uns tendem ao cognitivismo outras ao social, e outras aos aspectos lingüísticos.

  16. "La noche boca arriba" como encrucijada literaria

    OpenAIRE

    Amícola, José

    1997-01-01

    El principio de deslizamiento de planos había aparecido ya como principio constructivo tangencial en un cuento de Borges como "Tlön, Uqbar, Orbis Tertius"; sería tarea de Cortázar catapultarlo a factor dominante. Objetivo de nuestro análisis es demostrar la función que este principio desempeña en el relato. (Párrafo extraído del texto a modo de resumen)

  17. El humor como herramienta para lograr aprendizajes

    Directory of Open Access Journals (Sweden)

    Hilda Torres de Sánchez

    2003-09-01

    Full Text Available Una tendencia mundial se ha originado: el uso del humor como herramienta para lograr aprendizajes y mejorar el ambiente donde la persona se encuentre. En el área educativa hay pruebas que demuestran su utilidad y que efectivamente origina cambios positivos, medidos en las evaluaciones, tanto en los estudiantes como en participantes de sesiones de facilitación. El objetivo del experimento realizado fue: Determinar el comportamiento a través de la calificaciones en la primera prueba, del efecto del uso del humor en el dictado de clases utilizando diferentes herramientas como: chistes, anécdotas, analogías en los contenidos. A través de un estudio experimental con un grupo de control realizado en dos aulas de clases con 35 alumnos cada uno, al grupo experimental se le aplicó diferentes recursos humorísticos como herramientas de aprendizaje. Se analizaron las calificaciones en la primera prueba a través de porcentajes de aprobados y aplazados, observándose que el grupo experimental arrojó los mayores porcentajes de aprobados. Tales resultados confirman que el humor como herramienta, si induce a un desempeño excelente en alumnos, lo que lleva a implementar acciones de adiestramiento para los facilitadores, así como el surgimiento de investigaciones más profundas sobre el uso del humor en la educación.

  18. Clinical Observation of Shexiang Baoxin Pill in the Treatment of Refractory Angina Pectoris%麝香保心丸辅助治疗顽固性心绞痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨生平; 黄华; 吴斌

    2013-01-01

    OBJECTIVE: To explore therapeutic efficacy of Shexiang baoxin pills in the treatment of refractory angina pectoris. METHODS: 86 cases of refractory angina pectoris during Oct. 2010 -Dec. 2011 were randomized into treatment group and control group. Control group received conventional treatment of anti-angina; treatment group was given Shexiang baoxin pills orally, 3 pills each time, tid. on the basis of control group. The angina pectoris attacks, angina pectoris stable state and treatment satisfaction were observed in 2 groups after 2 weeks according to Seattle angina questionnaire (SAQ); Limitation of body activity and improvement of the understanding of disease were also observed. RESULTS: Angina pectoris attack (79.3 ± 9.5), angina pectoris stable state (83 ±7.9), satisfaction degree (90.2 ±7.5), limitation of physical activity (71.2 ± 13.2) and understanding of disease (77.4 ± 8.2) in treatment group were obviously improved, compared to angina pectoris attack (88.3 ± 11.4) , angina pectoris stable state (63 ± 11.5), satisfaction degree (78.2 ± 9.4), limitation of physical activity (89.2 ± 7.8) and understanding of disease (71.2 ± 13.7) of control group. There was no significant serious ADR found in both groups. There was statistical difference in therapeutic efficacy of 2 groups (P<0.05). CONCLUSION: Patients with refractory angina pectoris treated with Shexiang baoxin pills obtain sound curative effect, and there are rare adverse drug reactions.%目的:观察麝香保心丸辅助治疗顽固性心绞痛的疗效和安全性.方法:将2010年10月-2011年12月住院治疗的顽固性心绞痛患者86例,随机均分为治疗组与对照组.对照组给予常规抗心绞痛治疗;治疗组在对照组治疗基础上口服麝香保心丸治疗,3粒/次,tid.2周后根据西雅图心绞痛量表观察两组患者的心绞痛发作情况、稳定状态及对患者治疗的满意程度,并观察患者躯体活动受限程度以及对疾病认识程度.结

  19. [Effectiveness of nifedipine on exercise tolerance in patients with angina pectoris. Comparison with a nitroderivative and a beta-blocking agent].

    Science.gov (United States)

    De Ponti, C; Mauri, F; Fiorista, F; Ciliberto, G R; Carù, B; Rovelli, F

    1977-01-01

    The effect of nifedipine on effort angina was investigated by means of exercise tests with bycicle ergometer and compared, in the same patients, with the effects of a nitroderivative and a betablocking agent. Five patients with stable effort angina entered the study, after an hemodynamic and contrasto-graphic control. According to the protocol of a latin square 5 X 5, all the patients received in a random sequence the following treatments: placebo, 1 c. orally; isosorbide dinitrate, 5 mg sublingually; propranolol, 40 mg orally; nifedipine, 10 mg sublingually; nifedipine, 10 mg orally. No significant change of any of the considered parameters was observed after the placebo. Isosorbide dinitrate and nifedipine produced significant increases of the duration of work before appearance of pain and EKG positivity, and of total work performed before anginal pain. Only the duration of work before EKG positivity was improved by propranolol. The comparisons between treatments showed no significant difference of the effects of the administered doses of isosorbide dinitrate and nifedipine. The improvements observed after propranolol were significantly lower than that observed after isosorbide dinitrate and oral nifedipine. On the basis of the observed changes of cardiac rate, maximal arterial pressure, ejection time index and triple product, the authors evaluate the possible mechanism of action of nifedipine.

  20. 不稳定型心绞痛院前急救临床观察%Clinical observation of unstable angina pre-hospital emergency intervention

    Institute of Scientific and Technical Information of China (English)

    郭华林

    2008-01-01

    目的 总结不稳定型心绞痛院前急救治疗的经验.方法 对院前胸痛患者,采集病史,体格检查,描记ECG并对其做出低中高危的评估,应用硝酸甘油、阿司匹林、使用β-受体阻滞剂、钙拮抗剂、转换酶抑制剂及肝素治疗,基础生命支持与监护.结果 留观期间:心绞痛症状缓解,有效98例(81.7%),加重21例(17.5%),收住院,其中因心绞痛发生顽固性心肌缺血4例,发展为严重心绞痛心律失常心房颤动6例,心源性休克4例,急性心力衰竭5例,非ST段抬高心肌梗死2例.院前猝死1例(0.8%).结论 不稳定型心绞痛患者院前急救措施的开展具有积极作用,早期识别、干预控制冠心病的危险因素,使心肌缺血症状改善,可减轻劳力性心绞痛的发作及改善患者的生活质量.%Objective To sum up unstable angina pre-hospital treatment interventions,clinical observation and assessment guide for emergency treatment.MethodsFor chest pain patients,collecting history,doing physical examination,checking ECG and making risk assessment,then,treating them with nitroglycerin,aspirin,beta-blocker,calcium antagonists,converting enzyme inhibitors,heparin therapy,and basic life support and monitor.Results During detention,there are 98 cases(81.7%)effective with angina symptoms subsided and discharged,21 cases (17.5%)aggravating and hospitalization,in which there are four cases get myocardial ischemia because of refractory angina,six cases of serious arrhythmia AF,four cases of cardiogenic shock,five cases of acute heart failure,and two cases of non.ST-segment elevation myocardial infarction.Also,there is one case(0.8%)of sudden death before prehospital treatment.Conclusion Pre-hospital treatment of unstable angina played a positive role in early identification,intervention and control of the risks of coronary artery disease,it also helps improving the symptoms of myocardial ischemia,reducing angina attack,and improving the life quality of the