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Sample records for angina unstable

  1. Unstable angina

    Science.gov (United States)

    ... pressure High LDL cholesterol Low HDL cholesterol Male gender Sedentary lifestyle (not getting enough exercise) Obesity Older ... Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your health ...

  2. STUDY OF VARIABLES IN UNSTABLE ANGINA

    OpenAIRE

    Vijay Kumar; Kashinath B; Sajjal; Shivraj B; Thirumala

    2014-01-01

    OBJECTIVES: Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary disease in Indians. Acute phase reactants C-reactive protein in Indian subjects with unstable angina were evaluated and compare them with suitable control to test the hypothesis that a relationship exists between acute phase reactants and unstable angina. METHODOLOGY: 50 cases unstable angina and 50...

  3. STUDY OF VARIABLES IN UNSTABLE ANGINA

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    Vijay Kumar

    2014-08-01

    Full Text Available OBJECTIVES: Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary disease in Indians. Acute phase reactants C-reactive protein in Indian subjects with unstable angina were evaluated and compare them with suitable control to test the hypothesis that a relationship exists between acute phase reactants and unstable angina. METHODOLOGY: 50 cases unstable angina and 50 suitable cases enrolled for the study. Unstable angina had significantly increased level of CRP compare to control group (p=0.01098.RESULTS: Statistically significant difference was found between case and control group in TLC (p=0.0037 and ESR (p=0.0368, TLC and ESR being more in case group as compare to control group. C- reactive protein was significantly correlated with TLC and ESR in case group and TLC and ESR in control group. C reactive protein, TLC and ESR in case group while no correlation was observed with any variable in control group. CONCLUSION: The present study concludes that a relationship exists between acute phase reactant studied and unstable angina

  4. Clinical Practice Guidelines for Unstable Angina Treatment.

    OpenAIRE

    Juan José Navarro López; Claudio Manuel González Rodríguez

    2009-01-01

    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.

  5. Arteriographic morphology and intracoronary thrombus in patients with unstable angina, non-Q wave myocardial infarction and stable angina pectoris.

    Science.gov (United States)

    Hussain, K M; Gould, L; Bharathan, T; Angirekula, M; Choubey, S; Karpov, Y

    1995-03-01

    Coronary artery lesions were compared in 71 patients with unstable angina, 15 patients with non-Q wave myocardial infarction (MI), and 40 patients with stable angina. In the unstable angina group, 29 patients had new-onset angina, 31 had crescendo angina, and 11 had rest angina. In a subgroup of patients with unstable angina, three-vessel disease was less frequently (P < 0.05) seen in patients with new-onset angina (10.3%) than in the patients with crescendo angina (51.6%) or rest angina (54.5%). An angina-producing artery could be identified in 59 patients with unstable angina, in 11 with non-Q wave MI, and in 30 with stable angina. Type II eccentric stenosis (asymmetric narrowing with narrow neck and overhanging irregular edges) was present in 31 patients (52.5%; P < 0.01) with unstable angina, in 7 (63.6%; P < 0.01) with non-Q wave MI, and in only 2 (6.7%) with stable angina. Abrupt occlusion of a vessel was observed in 7 patients (11.9%) with unstable angina and in 2 (18.2%) with non-Q wave MI. None of the patients with stable angina had this type of occlusion. In the group of unstable angina and non-Q wave MI, angiographic evidence of intracoronary thrombi was present in 16 (27.1%) and 3 patients (27.3%), respectively, but in stable angina in only 1 patient (3.3%; P < 0.05). Intracoronary thrombi were most frequently found in rest angina (88%; P < 0.001) and crescendo angina (33.3%; P < 0.01) compared with new-onset angina (3.7%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7879958

  6. Functional Role of Dendritic Cells in Patients with Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    LI Dazhu; Sharma Ranjit; ZENG Qiutang

    2005-01-01

    To investigate the function of dendritic cells (DC) in patients with unstable angina, 10 mL of blood was drawn from 30 subjects. 15 patients diagnosed as having unstable angina and 15 healthy subjects were included in an observation and a control groups respectively. The mononuclear cells were separated from the peripheral blood and cultured in RPMI1640 supplemented with recombinant human granulocyte/macrophage-colony stimulating factor (rh GM-CSF) and recombinant human interleukin-4 (rh IL-4) to induce dendritic cells. The shape and ultrastructure of DC was examined with electronic microscope. The phenotype of DC was analyzed with FACS and the alloantigen presenting capacity of DC was evaluated by mixed lymphocyte reaction (MLR). The expression rate of CD86 of DC in patients with unstable angina was (40.7±3.6) %, which was obviously higher than that of normal DC (29.6±2.5 %) (P<0.001). The capacity of the DCs in unstable angina patients to induce allogenic T cells (OD 2.73±1.10), was significantly higher than that of the normal DC (OD:0.9±0.21) (P<0.005). It is suggested that the function of DC in patients with unstable angina is increased, which may play an important role in the initiation of immune reaction in the plaque.

  7. Significance of Tc-99m pyrophosphate accumulation in unstable angina

    International Nuclear Information System (INIS)

    Tc-99m pyrophosphate (PYP) and Tl-201 simultaneous dual energy single photon emission computed tomography (SPECT) were performed in 33 patients with clinically unstable angina. According to the presence or absence of PYP accumulation in the myocardium, the patients were classified as PYP (+) group (n=22) and PYP (-) group (n=11). Clinical features, types of unstable angina, ECG changes, and serial creatine kinase (CK) data were compared in the two groups. The 'new angina at rest' type of unstable angina was more significantly common in the PYP (+) group (16/22) than the PYP (-) group (2/11). The remaining 6 patients in the PYP (+) group and 2 patients in the PYP (-) group had 'angina of effort with changing pattern'. There was a significant difference in the occurrence of ST elevation and ST depression between the group: 59% in the PYP (+) group vs. 18% in the PYP (-) group for ST elevation and 23% in the PYP (+) group vs. 64% in the PYP (-) group for ST depression. The PYP (+) group showed significant improvement in ejection fraction in the stable state (57±12%) as compared with the unstable state (62±11%), although there was no difference between the stable and unstable state in the PYP (-) group. Although wall motion abnormality index (WMI) was poorer in the PYP (+) group than the PYP (-) group, it improved to the same degree as the PYP (-) group one month later. These data suggest that the area showing PYP (+) may reflect stunned myocardium and that Tc-99m PYP accumulation may correlate with clinical features of unstable angina. (N.K.)

  8. Circulating fibrocytes as predictors of adverse events in unstable angina.

    Science.gov (United States)

    Keeley, Ellen C; Schutt, Robert C; Marinescu, Mark A; Burdick, Marie D; Strieter, Robert M; Mehrad, Borna

    2016-06-01

    Half of the patients who present with unstable angina (UA) develop recurrent symptoms over the subsequent year. Identification of patients destined to develop such adverse events would be clinically valuable, but current tools do not allow for this discrimination. Fibrocytes are bone marrow-derived progenitor cells that co-express markers of leukocytes and fibroblasts and are released into the circulation in the context of tissue injury. We hypothesized that, in patients with UA, the number of circulating fibrocytes predicts subsequent adverse events. We enrolled 55 subjects with UA, 18 with chronic stable angina, and 22 controls and correlated their concentration of circulating fibrocytes to clinical events (recurrent angina, myocardial infarction, revascularization, or death) over the subsequent year. Subjects with UA had a >2-fold higher median concentration of both total and activated fibrocytes compared with subjects with chronic stable angina and controls. In UA subjects, the concentration of total fibrocytes identified those who developed recurrent angina requiring revascularization (time-dependent area under the curve 0.85) and was superior to risk stratification using thrombolysis in myocardial infarction risk score and N-terminal pro B-type natriuretic peptide levels (area under the curve, 0.53 and 0.56, respectively, P fibrocyte level was associated with recurrent angina (hazard ratio, 1.016 per 10,000 cells/mL increase; 95% confidence interval, 1.007-1.024; P fibrocytes are elevated in patients with UA and successfully risk stratify them for adverse clinical outcomes. Fibrocytes may represent a novel biomarker of outcome in this population. PMID:27012475

  9. 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.

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

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    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.

  11. Comparative study of left ventricular function in patients with unstable angina, non-Q wave myocardial infarction and stable angina pectoris: assessment with atrial pacing and digital ventriculography.

    Science.gov (United States)

    Hussain, K M; Gould, L; Pomerantsev, E V; Angirekula, M; Bharathan, T

    1995-10-01

    To compare left ventricular global and segmental function at rest and during right atrial pacing in patients with unstable angina, non-Q wave myocardial infarction, and stable angina (class III angina), low-dose digital subtraction ventriculography was performed at rest and after abrupt cessation of pacing in 42 patients with unstable angina, 8 patients with non-Q wave myocardial infarction and 15 patients with stable angina during selective coronary arteriography. Left ventricular ejection fraction was significantly lower at rest in patients with unstable angina (P < 0.01) and non-Q wave myocardial infarction (P < 0.05) and during pacing (P < 0.01). These two groups of patients had significantly higher values of left ventricular end-diastolic and end-systolic volumes at rest and during pacing as compared with stable angina group. In comparing various clinical patterns of unstable angina, ejection fraction was significantly (P < 0.05) lower during pacing in patients with crescendo angina than in new-onset angina. However, ejection fraction was significantly (P < 0.01) lower in crescendo angina only at rest as compared with rest angina. The length of zone of severe hypokinesia was greater in unstable angina (P < 0.01) as well as in non-Q wave myocardial infarction (P < 0.05) both at rest and during pacing as compared with stable angina. Contractility of region of hypokinesia during pacing was higher (P < 0.01) in stable angina than in unstable angina and non-Q wave myocardial infarction. In analyzing segmental function in various subgroups of unstable angina, the authors found that the length of total hypokinesia was significantly higher (P < 0.05) during pacing in crescendo angina than in new-onset angina. Contractility of region of hypokinesia was lowest at rest and during pacing in patients with crescendo angina. This study demonstrates that patients with unstable angina as well as non-Q wave myocardial infarction were characterized by more pronounced global and

  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 < 0.05) as compared with the patients with new-onset angina (11%). Complex coronary morphology was statistically more likely to be found in crescendo angina. The angiographic evidence of intracoronary thrombi was found in 33% (P < 0.05) patients with 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 < 0.05) lower in 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) PMID:7785791

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

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    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.

  14. Relationship between the serologic status of helicobacter pylori with the presence of unstable angina

    International Nuclear Information System (INIS)

    To determine whether unstable angina is co-related to seropositivity to chronic Helicobacter pylori (HP) infection. It is a case control, descriptive study conducted at CCU in Razi Hospital in Ahwaz a city southwest Iran, from 2004 to 2005. We measured serum HP- lgG levels of participants in CCU in a hospital. Blood samples were drawn during study period from 96 patients (mean age 56 years) with Unstable Angina (UA) according to American Heart Association criteria and from 96 participants free of cardiovascular disease (mean age 58 years) and stored at 20 degree C. Serology results were studied in relation to UA. Using chi squared test, odds ratios (OR) and 95% confidence intervals (CI) were calculated, adjusting for age, gender, and established risk factors. Seventy nine (82.3%) of patients with unstable angina and 55(61.1%) in the control group presented a positive anti HP-lgG. Odds ratio was 3 with 95% CI: 1.9 to 4.3. There was significant relation between HP-lgG positivity and unstable angina (P0.05). Our study revealed relationship between seropositivity of HP-lgG and unstable angina. (author)

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

    OpenAIRE

    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 a...

  16. 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.

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

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    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.

  18. Predictor value of some clinical-biological parameters for the onset of depressive disorder in elderly patients with unstable angina

    OpenAIRE

    Cristina Moşuţan; George Săraci; Caius R. Duncea

    2012-01-01

    Abstract. Objective: To evaluate the potential predictor value of some parameters for the onset of depression after an episode of unstableangina in elderly. Material and Methods: We included 103 elderly patients who suffered an acute unstable angina episode. Clinical, laband imagistic data was recorded in the first week after admittance. Six month after unstable angina episode, patients were evaluated for thepresence of depression. Results: Univariate analysis showed statistically significant...

  19. Unstable angina

    Science.gov (United States)

    ... a close relative such as a sibling or parent had heart disease before age 55 in a man or before age 65 in a woman) High blood pressure High LDL cholesterol Low HDL cholesterol Male gender Sedentary lifestyle (not getting enough exercise) Obesity Older ...

  20. Unstable Angina

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    ... Privacy Policy What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

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

    OpenAIRE

    Xiaochen Yang; Xingjiang Xiong; Heran Wang; Guoyan Yang; Jie Wang

    2013-01-01

    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 ...

  2. Serial thallium-201 imaging at rest in patients with unstable and stable angina pectoris: relationship of myocardial perfusion at rest to presenting clinical syndrome

    International Nuclear Information System (INIS)

    In order to determine whether there are differences in myocardial perfusion at rest among patients with various unstable and stable angina syndromes, serial thallium-201 imaging was performed at rest in 19 patients presenting with rapidly worsening exertional angina (unstable angina, group A), 12 patients with rest angina alone without exertional symptoms (unstable angina, group B), and 34 patients with chronic stable angina. No patient had an episode of angina within 4 hours of study. Nineteen of 19 (100%) patients in group A demonstrated transient defects compared to only 3 of 12 (25%) patients in group B (p less than 0.0001) and 4 of 34 (12%) stable angina patients (p less than 0.0001). The majority of zones demonstrating transient defects in group A were associated with hypokinesis of the corresponding left ventriculogram segment without associated ECG evidence of previous infarction. There were no significant differences in the frequency of persistent thallium defects, severity of angiographic coronary artery disease, or frequency of regional wall motion abnormalities of myocardial segments supplied by stenotic coronary arteries among the three groups of patients. Transient defects have been shown to reflect reduction in regional coronary blood flow to viable myocardium. Therefore, we conclude that regional resting hypoperfusion of viable myocardium is far more common in patients with exertional unstable angina symptoms than in patients with rest angina alone or chronic stable angina

  3. Reduction of recurrent ischemia with abciximab during continuous ECG-ischemia monitoring in patients with unstable angina refractory to standard treatment (CAPTURE)

    NARCIS (Netherlands)

    S. Meij (Simon); R. Melkert (Rein); T. Lenderink (Timo); M.L. Simoons (Maarten); A.P.J. Klootwijk (Peter)

    1998-01-01

    textabstractBACKGROUND: In the CAPTURE (c7E3 Fab Anti Platelet Therapy in Unstable REfractory angina) trial, 1265 patients with refractory unstable angina were treated with abciximab or placebo, in addition to standard treatment from 16 to 24 hours preceding coronary intervention t

  4. Endothelial Dysfunction and Blood Viscosity Inpatients with Unstable Angina in Different Periods of a Solar Activity

    Science.gov (United States)

    Parshina, S. S.; Tokaeva, L. K.; Dolgova, E. M.; Afanas'yeva, T. N.; Strelnikova, O. A.

    The origin of hemorheologic and endothelial defects in patients with unstable angina (comparing with healthy persons) is determined by a solar activity period: the blood viscosity increases in a period of high solar activity in the vessels of small, medium and macro diameters, a local decompensate dysfunction of small vessels endothelium had been fixed (microcirculation area). In the period of a low solar activity there is an increase of a blood viscosity in vessels of all diameters, generalized subcompensated endothelial dysfunction is developed (on the background of the III phase blood clotting activating). In the period of a high solar activity a higher blood viscosity had been fixed, comparing with the period of a low solar activity.

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

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    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. Alterations in left ventricular function during therapy of unstable angina pectoris: relationship to clinical outcome

    International Nuclear Information System (INIS)

    We studied 30 consecutive patients with unstable angina during pain-free intervals with gated blood pool scintigraphy. The initial study was performed within 18 hours of admission to the coronary care unit. A second study was performed near the time of hospital discharge, after stabilization with medical therapy. Three months thereafter patients were categorized according to their worst anginal status following hospital discharge. Fifteen patients were New York Heart Association functional class I or II (group A); 15 patients were in functional class III or IV (group B). Left ventricular ejection fraction was similar at the time of initial study (55.9 +/- 2.18% and 56.0 +/- 3.55% for groups A and B respectively). At the time of hospital discharge the ejection fraction had risen to 60.3 +/- 1.85% (p less than 0.01) in group A and in group B it had fallen to 48.1 +/- 3.4% (p less than 0.005). End-systolic volume index in group B rose from 37 ml/m2 +/- 6.1 to 43 +/- 6.2 ml/m2 (p less than 0.005) at the time of the follow-up study. There were no significant intergroup patients during the two scintigraphic examinations. Eleven group B patients subsequently underwent coronary artery bypass surgery. A significant increase in ejection fraction and a significant decrease in end-systolic volume index were noted when these patients were restudied an average of 3.2 months after surgery. This study suggests that changes in left ventricular function during the course of unstable angina pectoris are common and may be detected by serial gated blood pool scintigraphy

  7. Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris

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    Aliyev Emil

    2004-04-01

    Full Text Available Abstract Aim The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1 in patients with unstable angina pectoris (AP. Methods Thirty-five patients with unstable AP (Group I, ten patients with stable AP (Group II and ten subjects who had angiographycally normal coronary arteries (Group III were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15 received tirofiban and Group IB (n = 20 did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h in all patients and at 72 h in Group I. Results The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. Conclusion The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point.

  8. Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris

    Science.gov (United States)

    Ercan, Ertugrul; Bozdemir, Huseyin; Tengiz, Istemihan; Sekuri, Cevad; Aliyev, Emil; Akilli, Azem; Akin, Mustafa

    2004-01-01

    Aim The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1) in patients with unstable angina pectoris (AP). Methods Thirty-five patients with unstable AP (Group I), ten patients with stable AP (Group II) and ten subjects who had angiographycally normal coronary arteries (Group III) were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15) received tirofiban and Group IB (n = 20) did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h) in all patients and at 72 h in Group I. Results The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. Conclusion The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point. PMID:15059285

  9. Comparison of percutaneous coronary intervention versus conservative treatment in unstable angina pectoris

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacies of percutaneous coronary intervention (PCI) and drug treatment in patients with unstable angina (UAP). Methods: 248 patients with UAP were divided into two groups: conservative group of 123 patients who received antiplatelet, anticoagulant and antianginal therapies only and invasive group of 125 patients who underwent additional PCI 4.4 days after admission. The occurrence of death, AMI, recurrent angina, readmission were assessed during the first hospitalization year. Results: There was no difference in the incidence of composite endpoint of death or AMI between the two groups during the hospitalization (0.8 % vs 1.6 %, P > 0.05 ), but hospitalization duration was shorter in the invasive group than in the conservative group (10.3 ± 5.6 days vs 14.6 ± 10.7 days, P < 0.01 ). In duration of one year, the incidence of AMI (2.4% vs 8.9%, P<0.03), death (1.6% vs 6.5%, P<0.05), composite endpoint of death or AMI (4.0 % vs 13.0 % P < 0.02), recurrent angina pectoris (26.4 % vs 48.7, P <0.001), CABG (1.6% vs 10.5%, P<0.01) and readmission (24.8% vs 45.5%, P<0.01) were also lower in the invasive group than in the conservative group. Survival rate free of composite death or AMI for 1 year was higher in the invasive group than in the conservative group(96.0 % vs 86.9 %, P < 0.02). There was a definite benefit of the invasive treatment in reducing the risk of composite endpoint of death or AMI in patients with chest pain at rest, troponin T positive and three vessel diseases. Old age, three vessel diseases, LAD disease, lower LVEF, ST-segment depression, diabetes and hypertension were the independent factors associated with composite of death or AMI. Conclusions: In patients with UAP, PCI associated with routine antiplatelet, anticoagulant and antiischemic treatment significantly decreases the incidence of adverse cardiac events and improves the survival rate in one year. Such beneficial effects can be more obvious for high-risk patients

  10. Pacing-induced ST segment deviation in patients with unstable angina: clinical, angiographic, and hemodynamic correlation.

    Science.gov (United States)

    Hussain, K M; Gould, L; Pomerantsev, E V; Angirekula, M; Bharathan, T

    1995-07-01

    To assess the clinical, coronary arteriographic, and hemodynamic differences between the unstable angina patients manifesting ST segment depression and those showing ST segment elevation as well as those demonstrating chest pain only without ST segment deviation during pacing, low-dose digital subtraction ventriculography was performed in 33 patients before and after abrupt cessation of atrial pacing during selective coronary arteriography. Transient ST segment depression during pacing was observed in 17 patients (52%), whereas 6 patients (18%) showed ST segment elevation; however, 10 patients (30%) did not manifest any ST segment deviation in spite of typical chest pain. Hypertension and a history of myocardial infarction were observed in a significantly higher (P < 0.05) proportion of patients with ST segment depression than in those with ST elevation. Patients who manifested ST segment depression during pacing had a higher incidence of triple-vessel disease (65 vs 17%; P < .05) as compared with the patients with ST segment elevation. Indirect evidence of intracoronary thrombi (complicated lesion, abrupt occlusion, and intraluminal filling defect) was noticed in a higher frequency (P < 0.05) in the group of patients with ST elevation during pacing. In patients with ST segment depression, no significant changes of global left ventricular (LV) functional parameters were observed. However, the length of the LV severe hypokinetic region was increased significantly (6.2 +/- 3.1 vs 23.5 +/- 6.2%; P < 0.005) during pacing in this group of patients. The shortening of the affected segments of the left ventricle was decreased significantly (52.3 +/- 3.6 vs 38.3 +/- 4.9%; P < 0.05) in these patients during pacing. In the group of patients with ST segment elevation during pacing, decrease in ejection fraction was associated with significant (P < 0.01) increase in midwall equatorial diastolic stress as compared with the patients with pacing-induced ST segment depression as

  11. 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.

  12. Xuesaitong soft capsule (chinese patent medicine) for the treatment of unstable angina pectoris: a meta-analysis and systematic review.

    Science.gov (United States)

    Yang, Xiaochen; Xiong, Xingjiang; Wang, Heran; Yang, Guoyan; Wang, Jie

    2013-01-01

    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. PMID:24489594

  13. 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. PMID:24078826

  14. Factors Associated with the Types of Heparin used in the Treatment of Unstable Angina at a Brazilian Hospital

    OpenAIRE

    Maria Auxiliadora Parreiras Martins; Sérgia Maria Starling de Magalhães; Cibele Comini César; Adriano Max Moreira Reis; Mauro Henrique Nogueira Guimarães de Abreu

    2010-01-01

    Unfractionated heparin (UFH) and low-molecularweight heparins (LMWHs) are widely used in curative and preventive treatments of thromboembolic disorders. The aim of the study was to investigate factors associated with the choice of these types of heparin to treat patients with unstable angina under real conditions of hospital use. A cross-sectional study was performed in a private general hospital in Belo Horizonte, Brazil, from January 1st to December 31th, 2001. Data...

  15. Can C reactive protein or troponins T and I predict outcome in patients with intractable unstable angina?

    OpenAIRE

    Curzen, N; Patel, D; Kemp, M; Hooper, J.; Knight, C.; Clarke, D.; Wright, C; Fox, K.

    1998-01-01

    Objective—To determine whether a single blood test for the measurement of C reactive protein, or troponin I or T concentrations could be used to stratify patients with intractable unstable angina awaiting transfer for coronary angiography by correlating these values with coronary anatomy and transient myocardial ischaemia.
Design—Prospective study.
Setting—Tertiary cardiac unit.
Patients—All patients admitted to their local hospital with ischaemic chest pain, uncontrolled by medical treatment...

  16. Use of Health Care System-Supplied Aspirin by Veterans With Postoperative Heart Attack or Unstable Angina.

    Science.gov (United States)

    Rivera, Cathleen M; Copeland, Laurel A; McNeal, Catherine J; Mortensen, Eric M; Pugh, Mary J; MacCarthy, Daniel J

    2015-10-01

    Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases. VA pharmacy records were used to determine whether a prescription for aspirin was filled after the postoperative MI or unstable angina. Multivariable logistic regression models estimated odd ratios of filling aspirin prescriptions for the predictors of interest. Of the 321,131 men and women veterans who underwent major surgery, 7,700 experienced a postoperative MI or unstable angina. Among those 7,700, 47% filled an aspirin prescription. Only 59% of veterans with no co-pay filled an aspirin prescription. Aspirin fills were more common in younger veterans, Blacks, Hispanics, males, hypertensive veterans, mentally ill patients, those with no co-pay and those prescribed antiplatelets/anticoagulants in addition to aspirin postoperatively. These findings suggest that the impact of dispensing aspirin as a prescription may not be significant in increasing the appropriate use of aspirin for secondary prevention. PMID:26351774

  17. 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.

  18. Correlation between Timi Risk Score and Clinical Outcome in Patients with Unstable Angina Pectoris

    Directory of Open Access Journals (Sweden)

    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.

  19. Unstable angina and non-ST-segment myocardial infarction: an evidence-based approach to management.

    Science.gov (United States)

    Kou, Victoria; Nassisi, Denise

    2006-01-01

    Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) represent two common, closely related acute coronary syndromes with potentially high morbidity and mortality. Integration of information from the history, physical exam, electrocardiogram, and cardiac biomarkers is used to formulate both the diagnosis of UA/NSTEMI and the overall assessment of patient prognosis and risk. Early diagnosis and risk stratification of patients with UA/NSTEMI enable the physician to initiate timely, appropriate treatment. (There is strong clinical evidence supporting the tailoring of specific therapies to the risk profile of the patient.) In recent years, powerful new medical and invasive therapies have been developed. Pharmaceutical agents for UA/NSTEMI may be broadly grouped into one of three categories: anti-ischemic, anti-platelet, and anti-thrombotic agents. Standard therapy for UA/NSTEMI has commonly included oxygen, aspirin, nitrates, morphine, beta-blockers and heparin. Potent new anti-platelet agents, including inhibitors of platelet adenosine diphosphate and glycoprotein IIb/IIIa receptors, play important, expanding roles in the management of these syndromes. Low-molecular-weight heparins have been shown to be an effective alternative to unfractionated heparin in their treatment. Major advances in invasive techniques and devices over the last decade include revascularization with percutaneous coronary intervention and drug-eluting intracoronary stents. Strong interest exists in studying the potential benefits and risks associated with an early invasive therapeutic strategy rather than an aggressive medical regimen for patients with UA/NSTEMI. As new treatments are rapidly added to our growing arsenal of management options, clinicians are constantly challenged with incorporating complex new information and guidelines into their practices in a timely fashion. To assist clinicians with this challenge, this article will review the evidence to support

  20. Evaluation of the add-on effect of chinese patent medicine for patients with stable or unstable angina: a systematic review and meta-analysis.

    Science.gov (United States)

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

    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), 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. PMID:24416066

  1. Myocardial rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid scintigraphy compared with dipyridamole stress thallium-201 scintigraphy in unstable angina

    International Nuclear Information System (INIS)

    Twelve patients with stable angina and 12 patients with unstable angina underwent rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid (BMIPP), dipyridamole stress thallium scintigraphy and delayed thallium scintigraphy. In stable angina, sensitivity for detecting ischemic segments was higher in dipyridamole thallium (74%) than rest BMIPP (48%) images (p<0.05), but there was no significant difference between the 2 images in unstable angina. In unstable angina, the incidence of segments with higher defect scores on BMIPP images than on delayed thallium images and the opposite pattern was 27 and 5 (p<0.01). In stable angina, there was no difference. The mean defect score on BMIPP (6.3±5.6) was higher than that on delayed thallium scintigraphy (2.9±2.7) and it was almost the same as on the initial dipyridamole stress test (6.5±5.2). In conclusion, BMIPP scintigraphy is safer and may be as useful in detecting myocardial ischemia in patients with unstable angina as thallium scintigraphy. (author)

  2. Analgesia epidural torácica para el tratamiento de la angina inestable Thoracal epidural analgesia for the management of unstable angina

    Directory of Open Access Journals (Sweden)

    M. Castro

    2005-07-01

    Full Text Available La miocardiopatía isquémica en pacientes con angina inestable refractaria al tratamiento médico constituye un escenario clínico complicado. Una anatomía desfavorable o un riesgo quirúrgico excesivamente alto pueden desaconsejar la realización de una angioplastia o de una cirugía de derivación coronaria. En este artículo se pretende revisar la utilización de la analgesia/anestesia epidural torácica para el tratamiento y estabilización de este tipo de pacientes, a través de una breve descripción de la fisiopatología de la isquemia cardiaca, estudios experimentales en animales y humanos, uso en cirugía cardiaca y efectos secundarios.Ischemic cardiomyopathy in patients with unstable angina refractory to medical therapy is a difficult medical condition. Unfavorable anatomy or excessive surgical risk can advise against the performance of angioplasty or coronary bypass surgery. This study has reviewed the use of thoracal epidural analgesia/anesthesia for the management and stabilization of this type of patients, with a brief description of the physiopathology of cardiac ischemia, experimental studies in animals and human beings, use of cardiac surgery and side effects.

  3. Factors Associated with the Types of Heparin used in the Treatment of Unstable Angina at a Brazilian Hospital

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Parreiras Martins

    2010-06-01

    Full Text Available

    Unfractionated heparin (UFH and low-molecularweight heparins (LMWHs are widely used in curative and preventive treatments of thromboembolic disorders. The aim of the study was to investigate factors associated with the choice of these types of heparin to treat patients with unstable angina under real conditions of hospital use. A cross-sectional study was performed in a private general hospital in Belo Horizonte, Brazil, from January 1st to December 31th, 2001. Data were collected from the hospital electronic database. Inpatients with angina who received enoxaparin or UFH were included in the survey. Data for 555 patients were recorded, including 401 treated with enoxaparin and 154 with UFH. Univariate analysis showed that male and elderly people predominated in both groups, with no statistical difference in the proportions (p>0.05. Multivariate analysis showed 4 factors associated with the use of enoxaparin: cardiac revascularization surgery (OR=0.434, arrhythmias (OR=9.343, risk factors for coronary artery disease (OR=1.333 and private health insurance (OR=0.297. Thus, clinical and organizational factors were associated with the type of heparin used by patients with unstable angina at this hospital. Further drug utilization studies are necessary to expand and improve the data available on the use of heparins in the hospital setting. Keywords: Hospital pharmacy/assessment. Angina pectoris/treatment. Heparin/prescription. Enoxaparin/prescription. RESUMO Fatores associados com os tipos de heparina usados no tratamento da angina instável em um hospital brasileiro A heparina não-fracionada (HNF e heparinas de baixo peso molecular (HBPM são amplamente utilizadas em tratamentos curativos e preventivos de tromboembolismo. O objetivo do estudo foi investigar os fatores associados com a escolha desses tipos de heparinas para tratar pacientes com angina instável sob as condições reais de uso hospitalar. Trata-se de um estudo

  4. 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.

  5. Influence of nifedipine on left ventricular perfusion and function in patients with unstable angina: Evaluation with radionuclide techniques

    International Nuclear Information System (INIS)

    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. (orig.)

  6. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    OpenAIRE

    Weverton Ferreira Leite; José Antonio Franchini Ramires; Luiz Felipe Pinho Moreira; Célia Maria Cassaro Strunz; José Armando Mangione

    2015-01-01

    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 an...

  7. FEATURES OF CYTOKINE PRODUCTION IN PATIENTS WITH UNSTABLE ANGINA: DEPENDENCE ON ETHNICITY IN THE REPUBLIC OF SAKHA (YAKUTIA)

    OpenAIRE

    A. S. Golderova; I. N. Nikolaeva; V. E. Tarasova; V. A. Kozlov

    2014-01-01

    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 cytoki...

  8. Evaluation of Role of C-Reactive Protein Level on Cardiovascular Events During 14 Days after Admission of Patients with Unstable Angina in the Ekbatan Hospital, Hamadan, 2002

    Directory of Open Access Journals (Sweden)

    B. Naghsh Tabrizi

    2007-01-01

    Full Text Available Introduction & Objective: Unstable angina is in the center of spectrum from chronic stable angina to acute myocardial infarction. Due to high prevalence of unstable angina, it is important to find a factor that predicts prognosis and management modality. We decided to measure CRP level for the items that mentioned above.Materials & Methods: This study was a cross-sectional study that 138 patients who were admitted with unstable angina in the CCU and cardiac ward of Ekbatan Hospital in Hamedan were considered for measuring CRP level. Age, sex, period of disease, and left ventricular ejection fraction percentile were worked out. After quantitative CRP measuring and 14 days follow up, the questionnaire was completed.Results: CRP levels were 116.3 and 124.3 ng/ml in the patients with and without cardiovascular events (whole events respectively during 14 days follow up. Recurrent unstable angina, myocardial infarction and mortality rate were higher in the patients with elevated level of CRP but need to perform coronary angiography was lower.Conclusion: CRP level had no correlation with occurrence of cardiovascular events (whole events during 14 days follow up.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    International Nuclear Information System (INIS)

    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

  14. 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.

  15. Increased expression and plasma levels of myeloperoxidase are closely related to the presence of angiographically-detected complex lesion morphology in unstable angina

    NARCIS (Netherlands)

    T. Naruko; A. Furukawa; K. Yunoki; R. Komatsu; M. Nakagawa; Y. Matsumura; N. Shirai; K. Sugioka; M. Takagi; T. Hozumi; A. Itoh; K. Haze; M. Yoshiyama; A.E. Becker; M. Ueda

    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

  16. Role of multi-slice CT coronary angiography in evaluating the different patterns of coronary artery disease in patients with unstable angina

    Directory of Open Access Journals (Sweden)

    Gamal Eldine M. Niazi

    2015-09-01

    Conclusion: Non-invasive multi-slice CT coronary angiography is a reliable technique of high ability to detect coronary artery disease and estimate the degree of obstruction, number of affected arteries and the pattern of their affection and can be used in workup in patients with unstable angina.

  17. Estratificando o risco na angina instável com a ecocardiografia sob estresse com dobutamina Stratifying the risk in unstable angina with dobutamine stress echocardiography

    Directory of Open Access Journals (Sweden)

    Brivaldo Markman Filho

    2006-09-01

    Full Text Available OBJETIVO: Avaliar a importância da ecocardiografia sob estresse pela dobutamina (EED na estratificação de risco de pacientes com angina instável (AI de baixo a moderado risco, quanto à capacidade de predizer os eventos clínicos combinados (morte de causa cardiovascular, infarto agudo do miocárdio (IAM, AI recorrente, necessidade de revascularização miocárdica no seguimento de 6 meses. MÉTODOS: Estudo prospectivo, multicêntrico. Os pacientes incluídos estavam internados, assintomáticos havia 24 horas e a medicação em uso não era suspensa para a realização do exame. O EED era realizado preferencialmente até 72 horas da chegada ao hospital. RESULTADOS: Foram avaliados 95 pacientes consecutivos. O EED foi positivo para isquemia em 40 pacientes (42,1% e em 55 (57,9%, foi negativo. Eventos ocorreram em 28 pacientes, 26 dos quais tinham o EED positivo para isquemia miocárdica. Os outros 67 pacientes não tiveram eventos; desses, 53 tinham o EED negativo. A sensibilidade, especificidade, acurácia, valor preditivo positivo e negativo do teste frente aos desfechos foram: 92,9%, 79,1%, 83,2%, 65% e 96,4%, respectivamente. Sobrevida livre de eventos após 6 meses para os pacientes com EED negativo foi de 96%, comparada com 35% nos que tiveram o EED positivo (pOBJECTIVE: To evaluate the role of dobutamine stress echocardiography (DSE in the risk stratification of low to moderate risk unstable angina (UA patients, to predict the combined clinical outcome of cardiovascular death, myocardial infarction (MI, recurrent UA and the need of revascularization procedures in a 6 month period. METHODS: Multicenter prospective study. Patients should be admitted to the hospital and asymptomatic in the last 24 hours. The exam was performed up to 72 hours from the hospital admission and no medication was stopped prior to the test. RESULTS: Ninety-five consecutive patients were evaluated by DSE. Forty patients (42,1% had a positive ischemic test and

  18. Changes of dendritic cells and fractalkine in type 2 diabetic patients with unstable angina pectoris: a preliminary report

    Directory of Open Access Journals (Sweden)

    Qian Juying

    2011-06-01

    Full Text Available Abstract Background It has been shown that dendritic cells (DCs and fractalkine play a role in accelerating progression of the inflamed atherosclerotic lesions and plaque rupture. We evaluated the numbers and functional changes of DCs and its subsets in human type 2 diabetes with or without unstable angina pectoris (UAP. Methods The study population consisted of 39 diabetic patients (DM:18 without CAD; DM + UAP: 21 with UAP, 18 non-diabetic UAP patients (UAP, and 15 healthy control (Normal. Peripheral blood DCs and its subsets were measured by three color flow cytometry. Serum levels of fractalkine, IL-12, and IFN-α were also measured. The functional status of the monocyte-derived DCs was analyzed by flow cytometry and allogeneic mixed T lymphocytes reaction. Results The percent and absolute numbers of DCs and mDC within the total leukocyte population was similar for Normal and DM, while significantly lower in DM + UAP. pDC numbers were not significantly altered. Serum fractalkine in DM + UAP was highest among the four groups (p = 0.04 vs. UAP, p = 0.0003 vs. DM, p p = 0.01 level. Compared with DM and UAP, the costimulatory molecules CD86 and proliferation of T cells stimulated by DCs were significantly increased in DM + UAP group. Conclusions Our study suggested that increases in the fractalkine level and the number and functional changes of blood DCs might contribute to diabetic coronary atherosclerosis and plaque destabilization.

  19. 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

    2014-07-01

    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.

  20. 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.

  1. 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

  2. An effective tool to detect lesions causing unstable angina with multivessel disease. Iodine-123-betamethyl-p-iodophenyl-pentadecanoic acid single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fukuzawa, Shigeru; Inagaki, Masayuki; Morooka, Shigeru; Inoue, Toshihisa; Sugioka, Juji; Ozawa, Shun [Funabashi Municipal Medical Center, Chiba (Japan)

    1996-10-01

    Radiolabeled fatty acids such as iodine-123-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) have unique metabolic properties suggesting potential use as myocardial perfusion tracers. The uptakes of BMIPP and thallium 201 were compared using single photon emission computed tomography (SPECT) in 24 patients displaying unstable angina with multivessel disease at a mean of 3.4 days after admission. Coronary angiography was performed within a week. Uptake was considered normal if the activity was greater than 80% of the normal area, mildly reduced if 50% to 79%, and severely reduced if less than 50%. The regional activities in four quadrants in short-axis slices were measured from basal, mid and apical sets. We attempted to identify the causative lesion on dual SPECT imaging. We planned the following management of each patient based on the results of the dual SPECT study. BMIPP activity imaging found 4 segments (1.4%) with severe decrease, 70 (24.3%) with mild decrease, and 214 (74.3%) with normal uptake. In contrast, Tl activity imaging showed normal uptake in 68 of 74 abnormal BMIPP activity segments. Furthermore, all segments with abnormal BMIPP uptake were matched with locations of coronary artery stenosis by coronary angiography. Accordingly, coronary revascularization (percutaneous transluminal coronary angioplasty, coronary artery bypass grafting) was performed based on BMIPP SPECT. Reductions in BMIPP activity were common in patients with unstable angina with multivessel disease. BMIPP SPECT is an excellent tool for detecting the causative lesion in unstable angina. The subsequent intervention could be performed with less risk based on the strategy of dilating the only causative lesion which was detected by the BMIPP SPECT in patients with multivessel disease displaying unstable angina. (author)

  3. Efficacy of nifedipine and metoprolol in the early treatment of unstable angina in the coronary care unit: Findings from the Holland Interuniversity Nifedipine/metoprolol Trial (HINT)

    OpenAIRE

    Lubsen, J; Tijssen, J.G.P.; HINT Research Group

    1987-01-01

    A multicenter, double-blind, placebo-controlled, randomized trial of nifedipine, metoprolol and their combination was conducted in 338 patients with unstable angina (hospital admission diagnosis) who had not previously received treatment with a β blocker. In addition, nifedipine was compared with placebo in 177 patients who were receiving β blockers upon hospital admission. The main outcome event was the recurrence of ischemia or progression to myocardial infarction within 48 hours. Trial med...

  4. 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; 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

    2015-01-01

    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...... 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...

  5. Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

    International Nuclear Information System (INIS)

    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

  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. 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.

  8. Pharmaceutical care for patients with unstable angina%不稳定性心绞痛患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    牟燕; 王清; 张勇; 李宏建

    2011-01-01

    Unstable angina (UA) is a common coronary heart disease with the clinical symptom situated between stable angina and acute myocardial infarction. For the complexity of its drug treatment, the clinical pharmaceutical care for patients with UA is very important. In this article, to further optimize the therapeutic project and ensure the safety of drug use, the contents of pharmaceutical care were discussed from the following four aspects respectively: undergoing anti-ischemia therapy, antiplatelet and anticoagulant therapy, lipid adjusting and plaque stabilizing therapy, and simultaneous therapy for some other disease.%不稳定性心绞痛(unstable angina,UA)是介于稳定性心绞痛与急性心肌梗死之间的一组临床综合征,其治疗药物十分复杂,临床药学监护尤为重要.本文结合实例,对抗心肌缺血治疗、抗血小板与抗凝治疗、调脂稳定斑块治疗、合并其他疾病用药时等情况下的药学监护内容进行逐一讨论,以期为该疾病的临床药学工作提供思路,优化临床治疗方案设计,保障患者的用药安全.

  9. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris. Acute results and incidence of restenosis during 6-month follow-up.

    Science.gov (United States)

    Karsch, K R; Haase, K K; Voelker, W; Baumbach, A; Mauser, M; Seipel, L

    1990-06-01

    A clinical study was conducted to evaluate the efficacy and safety of percutaneous coronary excimer laser angioplasty in 60 patients with coronary artery disease. Forty-nine patients had stable exertional angina, and 11 patients had unstable angina despite medical therapy. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter each arranged concentrically around a central lumen suitable for a 0.014-in. flexible guide wire was coupled to an excimer laser. A commercial excimer laser emitting energy at a wavelength of 308 nm with a pulse duration of 60 nsec was used. The laser was operated at 20 Hz. Mean energy transmission was 30 +/- 5 mJ/mm2. In five of the 60 patients, laser angioplasty was not attempted. In 23 patients with laser ablation alone, percent stenosis decreased from 76 +/- 14% before to 27 +/- 17% after ablation and was 34 +/- 15% at the early follow-up angiogram. In 32 patients, additional balloon angioplasty was performed because of vessel closure after laser ablation in 11 and an insufficient qualitative result in 21 patients. Of the 11 patients with unstable angina, one patient died due to vessel closure 3 hours after intervention, and two patients developed a myocardial infarction. In 22 of 47 patients with late follow-up angiography, restenosis within the 6-month follow-up period occurred. Rate of restenosis was higher in patients treated with laser ablation and balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (six of 19). These results suggest that coronary excimer laser angioplasty for ablation of obstructive lesions is feasible and safe in patients with stable angina. However, development of new catheter systems is necessary for an improved success rate. PMID:2344680

  10. 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

  11. Trends in time to invasive examination and treatment from 2001 to 2009 in patients admitted first time with non-ST elevation myocardial infarction or unstable angina in Denmark

    DEFF Research Database (Denmark)

    Mårtensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2014-01-01

    examination and treatment probability (CAG, PCI and CABG at 3, 7, 10, 30 and 60 days) for the years 2001-2009, taking the competing risk of death into account using Aalen-Johansen estimators and a Fine-Gray model. SETTING: Nationwide Danish cohort. RESULTS: The proportion of patients receiving a CAG and PCI...... hospitalisations with NSTEMI and unstable angina were identified in the National Patient Registry (n=65 909). Time from admission to initiation of coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) was calculated. We described the development in invasive...... increased substantially over time while the proportion receiving a CABG decreased for both NSTEMI and unstable angina. For both NSTEMI and unstable angina, a significant increase in invasive examination and treatment probability at 3 days for CAG and PCI were seen especially from 2007 through to 2009. For...

  12. Research Progress of Unstable Angina Syndromes Objectification——Metabonomics Article%不稳定型心绞痛中医证候客观化研究进展——代谢组学篇

    Institute of Scientific and Technical Information of China (English)

    周亚滨; 于晓红

    2011-01-01

    代谢组学的不断发展为不稳定型心绞痛的研究带来了新的思路和技术手段,对近年来从代谢组学角度研究不稳定心绞痛中医证候的文献进行了总结.%Metabolomics development for unstable angina study brings new ideas and technology, this paper in recent years from the Angle of metabonomics studies unstable angina syndromes of literature was summarized.

  13. The dynamics of platelet α-granule membrane protein and serum thromboxane B2 in patients with acute myocardial infarction and unstable angina

    International Nuclear Information System (INIS)

    To evaluate the dynamics of platelet activation in patients with acute myocardial infarction (AMI) and unstable angina (UA), the levels of platelet α-granule membrane protein (GMP-140)and serum thromboxane B2 (TXB2) were studied by RIA in 20 AMI and 30 UA patients and 20 controls. The results are: 1) The levels of GMP-140 and TXB2 were significantly higher in AMI patients within 12 h after the onset than those in controls (P0.05). TXB2 still remained at higher level in AMI patients on the 7th day after onset (P2 were markedly higher in UA patients when angina episode than those in controls (P0.05), but the peak level of GMP-140 and TXB2 and its persistent duration of elevation in UA were much lower than those in AMI. The platelet is highly activated in the patients with AMI and UA. In AMI there are more thrombplastic factors in coronary artery than in UA

  14. 异舒吉治疗不稳定型心绞痛的临床疗效观察%Observation on Clinical Efficacy of Isoket Treating Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    彭国顺; 林晓红

    2003-01-01

    Objective To compare the efficacy of intravenous Isoket with Nitroglycerine in patients with unstable angina pectoris.Methods 70 patients were enrolled and split into treatment group(Isoket group)and control group (Nitroglycerine group) randomly and double-blindedly.There were 36 cases in treatment group who were treated with intravenous Isoket 20~30mg per day for 10 consecutive days;whereas 34 cases in control group who were treated with intravenous Nitroglycerine 10~20mg per day for 10 days.Results 18 cases were significantly effective and 14 patients were effective with total effective rate 88.9% in treatment group compared with 8 cases,11 cases and 55.7% in control group respectively.The treatment group is significantly better than the control group.Conclusion It is effective and safe to treat the patients with unstable angina pectoris with intravenous Isoket.

  15. Impaired myocardial fatty acid metabolism detected by {sup 123}I-BMIPP in patients with unstable angina pectoris. Comparison with perfusion imaging by {sup 99m}Tc-sestamibi

    Energy Technology Data Exchange (ETDEWEB)

    Takeishi, Yasuchika; Sukekawa, Hiroyasu; Saito, Haruo; Nishimura, Shozo; Shibu, Takayuki; Sasaki, Yasuhiko; Tomoike, Hitonobu [Yamagata Univ. (Japan). School of Medicine

    1995-08-01

    The present study was undertaken to determine the potential diagnostic value of {sup 123}I-BMIPP scintigraphy for the detection of altered myocardial fatty acid metabolism in patients with unstable angina. Both myocardial metabolic imaging with {sup 123}I-BMIPP and perfusion imaging with {sup 99m}Tc-sestamibi were performed at rest in 28 patients with unstable angina in the pain-free state. The regional uptakes of {sup 123}I-BMIPP or {sup 99m}Tc-sestamibi were scored semiquantitatively (0=normal, 4=no activity) and compared with the coronary arteriographic findings. Decreased uptakes of {sup 123}I-BMIPP were observed in 18 patients, and 11 patients had abnormal {sup 99m}Tc-sestamibi images. Defect scores of {sup 123}I-BMIPP were larger than those of {sup 99m}Tc-sestamibi (7.8{+-}2.1 vs. 5.2{+-}1.9, p<0.01). The sensitivity for the detection of patients with unstable angina was higher in {sup 123}I-BMIPP than in {sup 99m}Tc-sestamibi (77% vs. 45%, p<0.01). The site of the decreased {sup 123}I-BMIPP uptake corresponded to the most stenotic coronary artery lesion in all patients. Fatty acid metabolic imaging with {sup 123}I-BMIPP was more sensitive for detecting myocardial ischemia than perfusion imaging with {sup 99m}Tc-sestamibi. {sup 123}I-BMIPP may be a clue to define the culprit lesion in unstable angina and be helpful to decide the best treatment and guide coronary angioplasty. (author).

  16. Characteristics, treatment and outcome of patients with non-ST-elevation acute coronary syndromes and multivessel coronary artery disease: observations from PURSUIT (Platelet Glycoprotein IIb/IIIa in unstable angina: receptor suppression using integreling therapy)

    OpenAIRE

    Breeman, Arno; Mercado, Nestor; Lenzen, Mattie; Harrington, Robert Alex; Califf, Robert; Topol, Eric; Simoons, Maarten; Brand, Marcel, van den; Boersma, Eric

    2002-01-01

    textabstractBACKGROUND: The 6-month clinical outcome of patients with multivessel disease enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) is described. Patients with complete angiography data were included; multivessel disease was stratified according to the treatment strategy applied early during hospitalization, i.e. medical treatment, percutaneous coronary intervention (PCI) (balloon), PCI (stent), or coronary artery by...

  17. 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

    nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by...... the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark....

  18. Effects of Ginkgo Leaf Extract on Function of Dendritic Cells and Th1/Th2 Cytokines in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    LI Da-zhu; SHARMA Ranjit; ZENG Qiu-tang

    2005-01-01

    Objective: To investigate the effects of Ginkgo leaf extract (GLE) on function of dendritic cells (DC) and Th1/Th2 cytokines in patients with unstable angina pectoris(UAP). Methods: Fifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor (GMCSF) and interleukin-4 (IL-4) to induce mature DC. The expression of co-stimulating factor CD86 (B7-2) on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction (MLR). The blood levels of cytokines, interferon-γ (IFN-γ), and IL-4, were analyzed by ELISA, and blood C-reactive protein (CRP) level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DC were also tested in vitro. Results: After treatment, CD86 expression on DC, the stimulating capacity of DC as well as levels of IFN-γ and CRP were lowered in both groups ( P<0.05 or P<0.01), but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DC. Conclusion: The inhibition of GLE on DC and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

  19. 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; Vincent C H Chung; 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...

  20. Detection of non-ST-elevation myocardial infarction and unstable angina in the acute setting: meta-analysis of diagnostic performance of multi-detector computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Sarno Giovanna

    2007-12-01

    Full Text Available Abstract Background Multi-detector computed tomography angiography (MDCTA has been increasingly used in the evaluation of the coronary arteries. The purpose of this study was to review the literature on the diagnostic performance of MDCTA in the acute setting, for the detection of non-ST-elevation myocardial infarction (NSTEMI and unstable angina pectoris (UAP. Methods A Pubmed and manual search of the literature published between January 2000 and June 2007 was performed. Studies were included that compared MDCTA with clinical outcome and/or CA in patients with acute chest pain, presenting at the emergency department. More specifically, studies that only included patients with initially negative cardiac enzymes suspected of having NSTEMI or UAP were included. Summary estimates of diagnostic odds ratio (DOR, sensitivity and specificity, negative (NLR and positive likelihood ratio (PLR were calculated on a patient basis. Random-effects models and summary receiver operating curve (SROC analysis were used to assess the diagnostic performance of MDCTA with 4 detectors or more. The proportion of non assessable scans (NAP on MDCTA was also evaluated. In addition, the influence of study characteristics of each study on diagnostic performance and NAP was investigated with multivariable logistic regression. Results Nine studies totalling 566 patients, were included in the meta-analysis: one randomised trial and eight prospective cohort studies. Five studies on 64-detector MDCTA and 4 studies on MDCTA with less than 64 detectors were included (32 detectors n = 1, 16 detectors n = 2, 16 and 4 detectors n = 1. Pooled DOR was 131.81 (95%CI, 50.90–341.31. The pooled sensitivity and specificity were 0.95 (95%CI, 0.90–0.98 and 0.90 (95%CI, 0.87–0.93. The pooled NLR and PLR were 0.12 (95%CI, 0.06–0.21 and 8,60 (95%CI, 5.03–14,69. The results of the logistic regressions showed that none of the investigated variables had influence on the diagnostic

  1. Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gorgels Anton PM

    2011-03-01

    Full Text Available Abstract Background Few studies investigated the association between smoking, alcohol consumption, or physical activity and the risk of unstable angina pectoris (UAP, while the strength of these associations may differ compared to other coronary diseases such as acute myocardial infarction (AMI. Therefore, we investigated whether the associations of these lifestyle factors with UAP differed from those with AMI. Additionally, we investigated whether these effects differed between subjects with and without a family history of myocardial infarction (MI. Methods The CAREMA study consists of 21,148 persons, aged 20-59 years at baseline and randomly sampled from the Maastricht region in 1987-1997. At baseline, all participants completed a self-administered questionnaire. After follow-up of maximally 16.9 years, 420 AMI and 274 UAP incident cases were registered. Incidence rate ratios (RRs were estimated using Cox proportional hazards models. Results For both diseases, smoking increased the risk while alcohol consumption was associated with a protective effect. Associations with both risk factors were stronger for AMI than UAP, although this difference was only statistically significant for smoking. In men, an inverse association was found with physical activity during leisure time which seemed to be stronger for the risk of UAP than of AMI. On the contrary, physical activity during leisure time was associated with an increased risk of both AMI and UAP in women which seemed to be weaker for UAP than for AMI. Except for occupational physical activity in women, no significant interactions on a multiplicative scale were found between the lifestyle factors and family history of MI. Nevertheless, the highest risks were found in subjects with both a positive family history and the most unfavorable level of the lifestyle factors. Conclusions The strength of the associations with the lifestyle factors did not differ between AMI and UAP, except for smoking

  2. Effect of short-term high-dose atorvastatin on systemic inflammatory response and myocardial ischemic injury in patients with unstable angina pectoris undergoing percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Sun Fei; Yin Zhao; Shi Quanxing; Zhao Bei; Wang Shouli

    2014-01-01

    Background Percutaneous coronary intervention (PCI) could develop periprocedural myocardial infarction and inflammatory response and statins can modify inflammatory responses property.The aim of this study was to evaluate whether short-term high-dose atorvastatin therapy can reduce inflammatory response and myocardial ischemic injury elicited by PCI.Methods From March 2012 to May 2014,one hundred and sixty-five statin-naive patients with unstable angina referred for PCI at Department of Cardiology of the 306th Hospital,were enrolled and randomized to 7-day pretreatment with atorvastatin 80 mg/d as high dose group (HD group,n=56) or 20 mg/d as normal dose group (ND group,n=57) or an additional single high loading dose (80 mg) followed 6-day atorvastatin 20 mg/d as loading dose group (LD group,n=52).Plasma C-reactive protein (CRP) and interleukin-6 (IL-6) levels were determined before intervention and at 5 minutes,24 hours,48 hours,72 hours,and 7 days after intervention.Creatine kinase-myocardial isoenzyme (CK-MB) and cardiac troponin I (cTnl) were measured at baseline and then 24 hours following PCI.Results Plasma CRP and IL-6 levels increased from baseline after PCI in all groups.CRP reached a maximum at 48 hours and IL-6 level reached a maximum at 24 hours after PCI.Plasma CRP levels at 24 hours after PCI were significantly lower in the HD group ((9.14±3.02) mg/L) than in the LD group ((11.06±3.06) mg/L) and ND group ((12.36±3.08) mg/L,P <0.01); this effect persisted for 72 hours.IL-6 levels at 24 hours and 48 hours showed a statistically significant decrease in the HD group ((16.19±5.39) ng/L and (14.26±4.12) ng/L,respectively)) than in the LD group ((19.26±6.34) ng/L and (16.03±4.08) ng/L,respectively,both P <0.05) and ND group ((22.24±6.98) ng/L and (17.24±4.84) ng/L,respectively).IL-6 levels at 72 hours and 7 days showed no statistically significant difference among the study groups.Although PCI caused a significant increase in CK-MB and cTnl at

  3. Clinical Experience of Beta Blocker Therapy in Unstable Angina%β受体阻滞剂治疗不稳定型心绞痛的临床体会

    Institute of Scientific and Technical Information of China (English)

    许志茹

    2015-01-01

    目的:针对β受体阻滞剂治疗不稳定型心绞痛的临床体会进行分析。方法选择我院在2013年6月~2014年6月期间,收治的80例不稳定型心绞痛患者,分为对照组和观察组。对照组常规心绞痛治疗,观察组常规治疗+β受体阻滞剂治疗。观察两组患者的临床治疗效果、不良反应、心绞痛发作情况。结果观察组与对照组患者的临床治疗总有效率分别为95.00%、65.00%,P<0.05,具有统计学意义。观察组与对照组患者的不良反应发生率分别为2.50%、15.00%,P<0.05,具有统计学意义。观察组与对照组患者的心绞痛发作次数和持续时间均有显著差异,P<0.05,具有统计学意义。结论在不稳定型心绞痛治疗中,β受体阻滞剂发挥重要作用,可以改善患者临床症状,降低不良反应,提高患者生活质量。%Objective To analysis Beta blockers in the treatment of unstable angina clinical experience. Methods Selected 80 patients with unstable angina treated in June 2013~June 2014, divided into control group and observation group. The control group conventional treatment angina pectoris, observation group conventional treatment+beta blockers. Observed the clinical therapeutic effect of two groups of patients, adverse reactions, angina pectoris attack Situation. Results Observation group and control group in patients with the clinical total effective rate respectively were 95.00%, 65.00%, P<0.05, there was statistical significance. Observation group and control group patients the incidence of adverse reactions were 2.50%, 15.00%, P<0.05, there was statistical significance. Observation group and control group in patients with angina frequency and duration were signiifcantly different, P<0.05, there was statistical signiifcance. Conclusion In the treatment of unstable angina, β-blockers play an important role, can improve the clinical symptoms and reduce adverse reactions and improve the

  4. CHANGES OF CELLULAR ADHESION MOLECULES AND COMPLEMENT COMPONENT IN SERUM OF PATIENTS WITH UNSTABLE ANGINA%不稳定型心绞痛病人sCAMS与sC5b-9的变化

    Institute of Scientific and Technical Information of China (English)

    王立杰; 王红巧

    2011-01-01

    目的 探讨不稳定型心绞痛(UA)病人可溶性细胞黏附分子(sCAMS)与可溶性补体激活产物(sC5b-9)水平的变化及其意义.方法 采用ELISA方法 检测36例健康人和110例UA病人血清sCAMS、sC5b-9浓度的变化.结果 UA病人血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞间黏附分子-1(sVCAM-1)、sC5b-9浓度明显高于对照组,差异有极显著性(t=4.485~37.314,P<0.001);心绞痛发作时sICAM-1、sVCAM-1、sC5b-9的浓度增高较缓解后更明显(t=5.764~30.638,P<0.001);不同类型的心绞痛病人发作时和缓解后sICAM-1、sVCAM-1、sC5b-9浓度差异也有显著性(F=12.074~709.477,q=3.340~52.308,P<0.05~0.001);自发性心绞痛病人sCAMS、sC5b-9浓度增高较其他类型更明显.心绞痛发作时和缓解后,血清sC5b-9与sICAM-1、sVCAM-1浓度呈正相关(r=0.530~0.703,P<0.001).结论 UA的发生发展与CAMS和sC5b-9浓度变化有密切关系.%Objective To discuss the significance of changes of the levels of soluble cellular adhesion molecules (sCAMS) and complement activation component (sC5b-9) in patients with unstable angina (UA). Methods Using enzyme-linked immu-nosorbent assay (ELISA) , changes of serum levels of sCAMS and sC5b-9 were detected in 110 UA patients and 36 healthy people. Results Levels of soluble intercellular adhesion moleeule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1 (sVCAM-1) and sC5b-9 in UA patients were significantly higher than that in healthy controls (t=4. 485 - 37. 314,P<0. 001) ; At angina pecto-ris attacks, the elevation of levels of sICAM-1, sVCAM-1 and sC5b-9 were more significant than after remission (2 = 5. 764 - 30. 638,P<0. 001). The differences of the above parameters in different type of patients at angina pectoris attacks and at remission were also significant (F=12. 074-709. 477;q=3. 340 - 52. 308;P<0. 05 - 0. 001), especially in those with spontaneous angina pectoris. The level of sC5b-9 was positively

  5. Practical value of cardiac magnetic resonance imaging in unstable angina diagnosis%心脏核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    唐新宇; 欧阳容

    2012-01-01

    Objective To investigate the value of magnetic resonance imaging of heart in diagnosis of unstable angina pectoris.Methods A total of 24 patients with unstable angina pectoris including 15 male and 9 female confirmed by coronary angiography (CAG) were enrolled.All 24 patients were scanned by cardiac magnetic resonance imaging ( CMR),and then the analyses of the first pass images and the delayed contrast enhancement images were carried out for comparison.The findings of cardiac structure,cardiac function,myocardial ischemia,myocardial necrosis,myocardial edema were taken for answering to the images made by echocardiography (UCG) and coronary angiography (CAG) linked with conventional examinations for the diagnosis of coronary disease.Results Compared with the UCG,CMR provided more detailed information about the right ventricle,and the information about left ventricular structure and function given by UCG was very good consistent with that offered by CMR,and CMR could detect myocardial ischemia,myocardial edema and the myocardial necrosis,which were of good consistency with findings often observed by conventional inspection methods.Conclusions Cardiac magnetic resonance imaging (CMR) is of high value in diagnosis and evaluation of unstable angina pectoris and is far superior over other conventional methods for examinations of unstable angina pectoris.%目的 研究心脏核磁共振在不稳定型心绞痛诊治中的价值.方法 选择确诊不稳定性心绞痛患者24例,其中男性15例,女性9例,均行冠脉造影.对24例患者进行心脏核磁共振(CMR)扫描,对图像进行首过灌注和延迟扫描分析(LEG),记录其在心脏结构、功能、心肌缺血、坏死、水肿等方面的信息,并使之与超声心动图(UCG)、冠脉造影(CAG)等传统检查结果对比.结果 CMR与UCG相比,可以提供更多右心室方面的信息.在左心室结构及功能方面,两者有很好的一致性;CMR能发现并检测心肌缺血、水肿及坏死,

  6. Stable angina

    Science.gov (United States)

    ... include: Coronary angiography Blood cholesterol profile ECG Exercise tolerance test (stress test or treadmill test) Nuclear medicine ( ... PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Angina Browse the Encyclopedia ...

  7. What Causes Angina?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. What Causes Angina? Underlying Causes Angina usually is a symptom of coronary heart ... and cause angina or a heart attack . Immediate Causes Many factors can trigger angina pain, depending on ...

  8. 小剂量降纤酶溶栓治疗不稳定型心绞痛的临床观察%Observation of the thrombolytic therapeutic effect of low-does defibrase on patients with unstable angina pectoric

    Institute of Scientific and Technical Information of China (English)

    周建; 王洪铎

    2001-01-01

    Objective: To observe the thrombolytic therapeutic effect of low-dose of defibraseon patients with unstable angina pectoric(UAP). Methods: In the article,36 patients with UAPwere randomly divided into two groups. The therapeutic group (A) and the control group (B), the A group (19case) was treated with low -dose defibrase,the control group (17case) was treated with the regular cure of anti-myocardiaiskemia. Results: The total effective rate of A group was superior to that of the control group (p<0.025) The rate of acute myocardial infarction (AMI) was obviously lower than the group B.(P<0.025) during 72hours,the same as the resulte after one year.Conclusions: The thrombolytic therapeutic effect of low-dose of defibrase on patients with unstable angina pectoric(UAP) is effective、 safety、and can improve the prognocis of the patients.%目的:观察小剂量降纤酶溶栓疗法对不稳定型心绞痛(UAP)的临床疗效。方法:随机将36例UAP分为A、B两组。A组(19例)常规抗心肌缺血治疗加小剂量降纤酶溶栓疗法;B组(17例)常规抗心肌缺血治疗。结果:A组72h内临床疗效显效率66.67%明显高丁B组2.5%(P<0.025);A组72h内急性心肌梗塞(AMl)发生率5.56%明显低于B组37.50%(P<0.025);随访一年间A组心脏猝死及AMI例数也明显低于B组。结论:该疗法高效、安全、能改善UAP患者近期预后。

  9. The Effects of Xuefu Zhuyu and Shengmai on the Evolution of Syndromes and Inflammatory Markers in Patients with Unstable Angina Pectoris after Percutaneous Coronary Intervention: A Randomised Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    Full Text Available We evaluated the effects of the Xuefu Zhuyu capsule (XFZY and the Shengmai capsule (SM on the evolution of syndromes and inflammatory markers in patients with unstable angina pectoris (UAP after percutaneous coronary intervention (PCI. Ninety patients with UAP after PCI were randomly and equally assigned to three groups: the XFZY group, the SM group, and the placebo group, with 30 patients in each group. Six syndrome factors (including Qi deficiency, yin deficiency, yang deficiency, blood stasis, phlegm, and Qi stagnation and 4 inflammatory markers (high-sensitivity C-reactive protein (Hs-CRP, endothelins-1 (ET-1, matrix metalloproteinases-9 (MMP-9, and homocysteine (Hcy were observed at week 0 and at the 1st, 4th and 12th weeks. In conclusion, the evolution of syndromes present in patients with UAP after PCI followed these trends (1 The deficiency syndromes gradually increased during a 12-week period, but the excess syndromes first gradually decreased and then mildly increased after PCI. (2 XFZY and SM can prevent excess syndromes from increasing in the later stages and prevent deficiency syndromes from increasing in all stages. (3 XFZY and SMcan reduce the levels of the inflammatory markers, especially in the later stages after PCI.

  10. [THE EFFECTIVENESS OF THE CORRECTION OF ENDOTHELIAL DYSFUNCTION AND REMODELING OF THE BRACHIAL ARTERY WITH CONCENTRIC AND ECCENTRIC LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH UNSTABLE ANGINA WITH COMORBID HYPERTENSION].

    Science.gov (United States)

    Denesiuk, E V

    2015-01-01

    The study involved patients with unstable angina (UA), comorbid hypertension (AH), myocardial infarction in 55.5% of cases. Systolic blood pressure was (163.2 ± 1.5) mm Hg. Art., diastolic blood pressure--(101.10 ± 0.67) mm Hg. Art., pulse pressure--(61.1 ± 17.0) mm Hg. Art. Examined patients underwent clinical studies, ECG in 12 conventional leads, echocardiography in M and B modes, Doppler ultrasonography of the brachial artery. To correct the detected change using standard combined therapy: perindopril 5-10 mg/day, bisoprolol--5-10 mg/day, atorvastatin--20 mg/day, acetylsalicylic acid--75-100 mg/day. Monitoring the treatment was carried out at 3; 6 and 12 months. Standard one-year comprehensive treatment of patients with UA with comorbid AH resulted in significant improvement of effective endothelial dysfunction in concentric and eccentric left ventricular hypertrophy in 3; 6 and 12 months, however, regression of hypertrophy brachial artery advancing much less mainly in concentric left ventricular hypertrophy. PMID:27089719

  11. Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. Report of The Holland Interuniversity Nifedipine/Metoprolol Trial (HINT) Research Group.

    OpenAIRE

    1986-01-01

    A multicentre, double blind, placebo controlled, randomised trial of nifedipine, metoprolol, and nifedipine and metoprolol combined was conducted in a group of 338 patients with unstable angina not pretreated with a beta blocker and of nifedipine in 177 patients pretreated with a beta blocker. The main outcome event was recurrent ischaemia or myocardial infarction within 48 hours. Trial medication effects were expressed as ratios of event rates relative to placebo. In patients not pretreated ...

  12. 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

    Directory of Open Access Journals (Sweden)

    Marçal de Oliveira Huoya

    2009-04-01

    -diabéticos con AI, lo que indica que ese cuadro clínico puede equilibrar la actividad inflamatoria entre los dos grupos y aumentar la concentración de marcadores inflamatorios de fase aguda, independientemente del estado metabólico.BACKGROUND: Studies comparing inflammatory activity between diabetic and non-diabetic individuals with acute coronary syndrome are scarce, and none including only patients with unstable angina (UA has been published to date. OBJECTIVE: We compared serum C-reactive protein (CRP, and interleukin-6(IL-6 between diabetic and non-diabetic patients with unstable angina (UA to determine if difference in inflammatory activity is responsible for a worse prognosis in diabetic patients. We also evaluated the correlation between inflammatory markers and the metabolic profile in diabetic patients and the correlation between inflammatory response and in-hospital outcomes: death, acute myocardial infarction, congestive heart failure, and length of stay in hospital. METHODS: A prospective cohort study of 90 consecutive patients admitted to a chest pain unit with UA and divided into two groups, diabetic and non-diabetic. Serum CRP, IL-6, metabolic profile and leukocyte count were measured at hospital arrival. RESULTS: Forty-two patients (47% were diabetic (age 62±9 vs. 48 (53% non-diabetic (age 63±12. No differences between median C-reactive protein (1.78 vs. 2.23mg/l,p=0.74 and interleukin-6 (0 vs. 0pg/ml,p=0.31 were found between the two groups. There was a positive correlation between CRP and total cholesterol (rs = 0.21,p = 0.05, CRP and LDL-cholesterol (rs=0.22,p=0.04 and between CRP and leukocyte count (rs = 0.32, p = 0.02 in both groups. No associations were found between inflammatory markers and in-hospital outcomes. CONCLUSION: We found no difference in inflammatory activity between diabetic and non-diabetic patients with UA, suggesting that this clinical condition may result in balanced inflammatory activity between the two groups and increase acute

  13. Research on the cardiac MRI in the diagnosis and treatment of unstable angina%核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李鹏; 亓燕

    2014-01-01

    Objective:To investigate the cardiac magnetic resonance technique in the diagnosis and treatment of unstable angina application value. Methods:The hospital diagnosed patients with unstable angina as research subjects, were given coronary angiography in patients (CAG) examination, ECG, echocardiography and cardiac MRI examination, recording the results and statistical analysis. Results:Cardiac MRI for>90%stenos is detected heart rate, and coronary angiography (CAG) showed no significant difference (x2=3.257, P>0.05), for0.05);cardiac MRI for cardiac function and cardiac structure determination is better than conventional echocardiography. Conclusion: Cardiac MRI technology to more accurately reflect changes in cardiac structure and function of the stenos is and effort ischemia detection rate with conventional inspection methods have better consistency.%目的:探讨核磁共振技术在不稳定心绞痛诊治中的应用价值。方法:选取经莱芜市人民医院确诊的不稳定心绞痛患者40例,分别给予冠状动脉造影(CAG)、心电图、超声心电图及心脏核磁共振检查,并对结果进行统计学分析。结果:核磁共振在心脏狭窄>90%的检出率高,与CAG间差异无统计学意义(x2=3.257,P>0.05),对<90%的狭窄检出率低,与CAG检查结果间差异有统计学意义(x2=17.267,x2=25.714;P<0.05);核磁共振对心脏狭窄程度高的患者的心肌缺血检出率高,与心电图检出率差异明显,有统计学意义(x2=4.65,P<0.05),但总检出率间差异不明显,无统计学意义(x2=0.251,P>0.05);核磁共振对于心功能及心脏结构的测定效果优于传统的超声心动图。结论:核磁共振技术能更准确的反应心脏结构和功能改变,对狭窄和心机缺血的检出率与传统检查方法有较好一致性。

  14. Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans

    International Nuclear Information System (INIS)

    To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001)

  15. Debate: Unstable angina - When should we intervene?

    Directory of Open Access Journals (Sweden)

    Kereiakes Dean J

    2000-07-01

    Full Text Available Abstract The prognosis of patients who present with non-ST segment elevation acute coronary syndromes (ACS is guarded. These patients can be risk-stratified on the basis of symptom complex, electrocardiographic ST segment depression, obvious hemodynamic compromise and particularly on the basis of serum troponin level. An elevated troponin level determines risk and also predicts the degree of benefit from treatment with either low molecular weight heparin or platelet glycoprotein (GP IIb/IIIa blockade. Higher risk patients should undergo early coronary angiography and myocardial revascularization as indicated and feasible. Although studies performed before the advent of coronary stenting and adjunctive platelet GP IIb/IIIa blockade suggested increased hazard for patients undergoing early intervention, recent experience cited herein supports an in-hospital and long-term clinical benefit for the aggressive approach. Here, I propose an algorithm for risk stratification and triage of appropriate patients for adjunctive pharmacotherapy and early revascularization.

  16. PROTECTIVE EFFECTS OF NICORANDIL ON PATIENTS WITH UNSTABLE ANGINA PECTORIS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION%尼可地尔对行PCI不稳定型心绞痛病人心肌保护作用

    Institute of Scientific and Technical Information of China (English)

    张彦; 孙道媛; 田建会

    2012-01-01

    Objective To observe the myocardial protective effect of oral Nicorandil on patients with unstable angina pec-toris (UAP) undergoing percutaneous coronary intervention (PCI) therapy. Methods Sixty patients with UAP needed PCI were equally randomized to Nicorandil group and control group. The patients in control group were given a conventional iherapy, those in Nicorandil group were added Nicorandil, 5 mg, three times a day, 48 hours prior to PCI, in addition to routine therapy. The medication was continued for eight weeks after PCI. Serum concentrations of creatine kinase-MB (CK-MB) and cardiac tropo-nin I (cTnl) were measured in both of the groups before and 6, 12, and 24 h after PCI. The electrocardiogram (ECG) and left ventricular ejection fraction (LVEF) were observed eight weeks after the procedure. Results The serum levels of CK-MB and cTnl were significantly lower in the Nicorandil group than that in the control group 24 h after PCI 1,1=2. 040,2. 241 ;P<0. OS). Post-PCI serum CK-MB and cTnl elevated were noted in five patients (16. 7%) in Nicorandil group and 13(43. 3%) in the control group, the difference being significant between the two groups (P=0. 047). Follow-up ECG and echocardiography conducted eight weeks after PCI revealed that the ECG and LEVF improved better in Nicorandil group than the control (u = 2.475,t = 2.061 ;P< C. 05). Conclusion Oral administration of Nicorandil has a definite myocardial protection in patients with UAP undergoing PCI.%目的 探讨口服尼可地尔对行经皮冠状动脉介入治疗(PCI)不稳定型心绞痛病人的心肌保护作用.方法 以在我科住院需行PCI的不稳定型心绞痛病人60例作为研究对象,随机分为2组,各30例.对照组入院后给予不稳定型心绞痛常规治疗;尼可地尔组在常规治疗的基础上,术前48 h给予尼可地尔每次5 mg,每天3次,术后继续以相同剂量口服尼可地尔8周.比较两组PCI治疗前及治疗后6、12、24 h血清肌酸激酶同

  17. 黄芪注射液治疗不稳定型心绞痛的系统评价%Systematic Review on HuangQi Injection in Treating Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    王晓怀; 潘文; 康开彪; 柳树英; 袁仁智

    2013-01-01

    目的:评价黄芪注射液治疗不稳定型心绞痛的疗效与安全性。方法:计算机检索MEDLINE、EMbase、Cochrane图书馆、CNKI、VIP和万方数据库,按照纳入与排除标准由两位研究者独立筛选和提取资料,采用Cochrane协作网随机对照试验的质量评价标准评价纳入文献质量,使用RevMan 5.2软件进行Meta分析。结果:共纳入6篇文献,714例患者。Meta分析结果显示:黄芪注射液组的临床疗效[RR=1.21,95%CI(1.12,1.30)]和心电图改善情况[RR=1.30,95%CI(1.15,1.46)]均优于对照组,2组相比差异有统计学意义。纳入的6篇文献中,4篇文献报道未见明显不良反应,2篇未提及安全性或不良反应。结论:黄芪注射液治疗不稳定型心绞痛,较其他常规西药和中药,可以提高其治疗效果。但由于本系统评价纳入研究质量低且样本量小,药物安全性不明确,尚需高质量随机对照试验进一步验证。%Objective:To evaluate therapeutic effects and the safety of HuangQi injection in treating unstable angina pectoris (UAP). Method:MEDLINE, EMbase, Cochrane library, CNKI, VIP and Wangfang database were searched;data was screened and abstracted by two investigators according to the standard of inclusion and exclusion, the quality of included literature was assessed by quality assessment of randomized controlled trial from Cochrane net and Meta analysis was performed by RevMan 5.2 software. Result:Six pieces of writing were included and 714 patients were involved. The results of Meta analysis showed: HuangQi injection group was superior to the control group in clinical effects [RR=1.21,95%CI (1.12,1.30)] and the improvements of ECG [RR=1.30,95%CI (1.15,1.46)], the difference had statistical meaning. Among six pieces of writing, there was no obvious adverse reac-tion in four articles, there was no safety and adverse reaction mentioned in two articles. Conclusion:HuangQi injec-tion in

  18. 脑钠肽与不稳定型心绞痛患者左心功能相关性研究%Relationship between brain natriuretic peptide and left heart function in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    杨波; 夏勇

    2012-01-01

    Objective To observe the changing rule of plasma level of brain natriuretic peptide (BNP) and left ventricular end-diastolic pressure (LVEDP)in patients with unstable angina pectoris ( UAP) ,and explore the correlation between the changes of left heart function and BNP. Methods Fifty-seven cases who underwent coronary angiography( CAC) examination were included. Twelve cases with normal CAG examination results as control group, forty -five patients with UAP were divided into grade Ⅰ group(n = 16) ,grade Ⅱ group(n = 14) and grade Ⅲ group(n = 15) according to the class of Braunwald. The left atrial dianieter(LAD) ,left ventricular end-diastolic diameter( LVEDd), left ventricular posterior wall thickness( LVP-WT) ,intervenlricular septal thickness( IVST) ,left ventricular ejection fraction( LVEF)and E/A were detected in all cases by Doppler echocardiography. The value of LVEDP was detected by record left ventricular pressure curves in all cases. The plasma concentration of BNP was measured by radioimmunoassay. Results There were significant differences in the plasma levels of BNP and LVEDP in control group,grade Ⅰ, Ⅱ, Ⅲ groups(P 0.05). The plasma level of BNP was obviously correlated with LVEDP in all cases ( r = 0.756, P < 0.01). Conclusion The level of BNP could reflect the severity of cardiac ischemia in patients with UAP.it could reflect the severities of congestive heart failure to some extend.%目的 研究血浆脑钠肽(BNP)水平与左心室舒张末期压力(LVEDP)在不稳定型心绞痛(UAP)患者中的变化规律,探讨左心功能的变化与BNP变化的相关性.方法 选择57例冠状动脉造影(CAG)检查者为研究对象,CAG检查正常者12例作为对照组,45例UAP患者按Braunwald分级分为Ⅰ级组(16例)、Ⅱ级组(14例)和Ⅲ级组(15例).所有患者采用多普勒超声心动图检测左心房前后径(LAD)、左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分

  19. Nitroglycerin alone and its combination with other drugs for treatment of unstable angina pectoris:A meta-analysis%硝酸甘油单用与联用治疗不稳定性心绞痛疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    关秀萍; 黎明丽; 杨柳

    2011-01-01

    背景:在治疗不稳定性心绞痛时,联硝酸甘油合用药的疗效是否要优于单用,尚缺乏相关的循证医学证据.目的:评估硝酸甘油单用与联用治疗不稳定性心绞痛的疗效.方法:通过计算机和手工系统检索Cochrane 图书馆(2010 年第2 期)、Medline、Embase、Science Direct、SIGLE、GreyNet、中国生物医学文献数据库(CBMdisc)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)和万方数据库,纳入硝酸甘油单用与联用比较用于治疗不稳定性心绞痛的临床随机对照试验,评价其方法学质量后采用RevMan 5.0 软件,对其疗效进行Meta 分析.结果与结论:纳入8 个单中心临床随机对照试验,共715 例患者,方法学质量均为B 级.Meta 分析结果显示:硝酸甘油联用的临床疗效和心电图疗效优于单独应用(RR =0.79,95%CI:1.56~3.08,P < 0.01;RR =0.72,95%CI:0.64~0.81,P <0.01).但上述结果可能存在各种偏倚,建议根据临床症状及循证医学证据选用恰当的联用药物而非滥用.%BACKGROUND: Nitroglycerin is widely used as first-line drug to treat unstable angina pectoris, but the development of tolerance is a major problem that may reduce its clinical efficacy. It has been suggested that the addition of other drugs to nitroglycerin can reverse the development of tolerance, potentiate the hemodynamic response to nitroglycerin and may improve therapy prognosis in unstable angina pectoris.OBJECTIVE: To evaluate whether nitroglycerin combined with drugs show better curative effects than nitroglycerin alone in treatment of unstable angina pectoris.METHODS: A computer-based online search of Cochrane Library, Medline(ovid), EMbase, Science direct, SIGLE, GreyNet,CBMdisc, VIP, CNKI and Wanfang Data for the clinical randomized controlled trials (RCTs) of nitroglycerin alone and its combination of drugs for treating unstable angina pectoris. Hand searching was also done to obtain any further information

  20. Pharmacotherapy of Vasospastic Angina.

    Science.gov (United States)

    Harris, Justin R; Hale, Genevieve M; Dasari, Tarun W; Schwier, Nicholas C

    2016-09-01

    Vasospastic angina is a diagnosis of exclusion that manifests with signs and symptoms, which overlap with obstructive coronary artery disease, most often ST-segment elevation myocardial infarction. The pharmacotherapy that is available to treat vasospastic angina can help ameliorate angina symptoms. However, the etiology of vasospastic angina is ill-defined, making targeted pharmacotherapy difficult. Most patients receive pharmacotherapy that includes calcium channel blockers and/or long-acting nitrates. This article reviews the efficacy and safety of the pharmacotherapy used to treat vasospastic angina. High-dose calcium channel blockers possess the most evidence, with respect to decreasing angina incidence, frequency, and duration. However, not all patients respond to calcium channel blockers. Nitrates and/or alpha1-adrenergic receptor antagonists can be used in patients who respond poorly to calcium channel blockers. Albeit, evidence for use of nitrates and alpha1-adrenergic receptor antagonists in vasospastic angina is not as robust as calcium channel blockers and can exacerbate adverse effects when added to calcium channel blocker therapy. Despite having a clear benefit in patients with obstructive coronary artery disease, the benefit of beta-adrenergic receptor antagonists, statins, and aspirin remains unclear. More data are needed to elucidate whether or not these agents are beneficial or harmful to patients being treated for vasospastic angina. Overall, the use of pharmacotherapy for the treatment of vasospastic angina should be guided by patient-specific factors, such as tolerability, adverse effects, drug-drug, and drug-disease interactions. PMID:27081186

  1. Comparison of Outcomes of Patients ≥80 Years of Age Having Percutaneous Coronary Intervention According to Presentation (Stable vs Unstable Angina Pectoris/Non-ST-Segment Elevation Myocardial Infarction vs ST-Segment Elevation Myocardial Infarction)

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per;

    2011-01-01

    prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3......,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and......Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and...

  2. Comparative Study on the Effects of Small Dose of Aspirin Combined with Ginkgo-damole Injection(银杏达莫注射液) and the Effects of Conventional Dose of Aspirin in Treating Senile Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    陈学林; 张劲农; 袁杰; 杨彬; 江凌; 刘承云

    2004-01-01

    Objective: To evaluate the therapeutic and adverse effect of small dose of aspirin (Asp) (UA). Methods: One hundred and twenty old in-patients of coronary heart disease with UA were randomly divided into two groups. The 60 patients in the treated group were treated with oral administration of enteric soluble 50 mg Asp once a day and GDI 20 ml per day by intravenous dripping, with 14 days as one therapeutic course, while the other 60 in the control group were treated with enteric soluble Asp 100 mg alone once a day orally. Besides, isosorbide-5-mononitrate 20 mg twice a day was applied to both groups, and the β-adrenoceptor blocker, blood lipids regulatory agents and nitroglycerin (10 mg by intravenous dripping) were given accordingly. The angina total improving rate, hemorrheologic indexes (whole blood viscosity, plasma viscosity, fibrinogen, platelet aggregation rate), comprehensive clinical terminal event and the total occurrence rate of adverse reaction in the two groups were observed. Results: After treatment, comparison between the two groups showed insignificant difference in aspects of angina total improving rate (75.00% vs 65.00 % ), hemorrheological indexes and comprehensive clinical terminal event rate (25.00 % vs 31. 67 % ),P>0.05, and the hemorrheological indexes were improved in both groups ( P<0.05), but the total occurrence rate of adverse reaction in the treated group was lower than that in the control group (6. 67% vs 25.00%), showing significant difference (P<0.05). Conclusion: In treatment of senile UA, small dose of Asp combined with GDI showed therapeutic effect similar to that of conventional dose of Asp, but it has lower adverse reaction.

  3. How Is Angina Treated?

    Science.gov (United States)

    ... may be advised to get annual flu shots. Medical Procedures If lifestyle changes and medicines don't control angina, you may need a medical procedure to treat the underlying heart disease. Both angioplasty ( ...

  4. 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

  5. 丹红注射液联合西药常规治疗不稳定型心绞痛疗效和安全性系统评价%Efficacy and Safety of Danhong Injection Plus Conventional Western Medicine for Unstable Angina: A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    崔然; 夏昆; 时萍; 聂小曼

    2012-01-01

    目的 系统评价丹红注射液联合西药常规治疗不稳定型心绞痛的有效性与安全性.方法 检索PubMed、Medline、中国期刊全文数据库、万方数据知识服务平台中丹红注射液联合西药常规治疗不稳定型心绞痛的临床随机对照试验文献,按照Cochrane协作网推荐的方法评价纳入研究文献的质量后,采用RevMan 4.2软件进行Meta分析.结果 经筛选纳入23篇文献,共2 675例,其中治疗组(丹红注射液联合西药常规治疗)1 382例,对照组(单纯西药治疗)1 293例.各研究基线情况具有可比性.Meta分析结果显示:丹红注射液加西药常规治疗在提高心电图疗效[RR=2.84,95% CI(2.28,3.55)]、心绞痛疗效[RR=4.13,95% CI(3.12,5.47)],升高高密度脂蛋白-胆固醇[high density lipoprotein-cholesterol,HDL-C)(WMD=0.29,95% CI(0.05,0.52)],降低低密度脂蛋白-胆固醇(low density lipoprotein-cholesterol,LDL-C)[WMD=-0.98,95% CI(-1.33,-0.63)]和高敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)[WMD=-1.42,95% CI(-2.18,-0.65)]方面均优于西药常规治疗组.结论 丹红注射液联合西药常规治疗在改善不稳定型心绞痛患者的心电图疗效,升高HDL-C,降低LDL-C和hs-CRP水平方面优于对照组.受纳入文献质量的限制,本研究结论尚需更多高质量大样本的临床随机双盲对照研究加以验证.%Objective To systematically evaluate the efficacy and safety of Danhong Injection, a patent traditional Chinese Medicine (TCM) mainly composed of Salvia miltiorrhiza and safflower for activating blood stasis, combined with conventional western medicine in the treatment of unstable angina. Methods The literatures, which involve with randomized controlled trials (RCTs ) of Danhong Injection combined with conventional western medicine in the treatment of unstable angina, were retrieved in the databases such as PubMed, Medline, Chinese Journal Full-text Database, and Wanfang Data Knowledge Service Platform. The

  6. Effects of Omega-3 polyunsaturated fatty acids on serum inflammatory factors in patients with unstable angina pectoris%Omega-3多不饱和脂肪酸对不稳定型心绞痛血清炎症因子的影响

    Institute of Scientific and Technical Information of China (English)

    臧书文; 王开成

    2015-01-01

    Objective:To evaluate the changes and effects of Omega-3 polyunsaturated fatty acids(PUFAs) on serum levels of inflammatory factors in patients with unstable angina(UAP). Methods:54 patients with UAP admitted between Mar 2013 and June 2014 were randomly divided into the Omega-3 PUFAs group(n=27) who received Omega-3 PUFAs, and the placebo group(n=27). The serum levels of inflammatory factors such as tumor necrosis factor(TNF-α), interleukin 6(IL-6), High sensitivity C reactive protein(Hs-CRP), IL-10 and transforming growth factorβ(TGF-β)were measured before and after treatment, and Major adverse cardiovascular event and side effects were observed. Results:after treatment, The serum expression levels of TNF-α, IL-6 and CRP in the Omega-3 PUFAs group were lower than the placebo group(P0.05);与对照组比较, Omega-3组用药8周后血清IL-6、TNF-α及CRP表达水平显著降低,IL-10、TGF-β表达显著上升;差异均有统计学意义(P0.05),两组不良反应发生比较差异无统计学意义。结论:不稳定型心绞痛患者口服Omega-3多不饱和脂肪酸能显著抑制炎症,纠正促炎和抑炎失衡,发挥其抗动脉粥样硬化作用。

  7. Nicorandil in patients with acute coronary syndrome and stable angina undergoing Percutaneous Coronary Intervention: literature review

    OpenAIRE

    Neda Partovi; Homa Falsoleiman

    2014-01-01

    Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary...

  8. Unstable volatility

    DEFF Research Database (Denmark)

    Casas, Isabel; Gijbels, Irène

    2012-01-01

    The objective of this paper is to introduce the break-preserving local linear (BPLL) estimator for the estimation of unstable volatility functions for independent and asymptotically independent processes. Breaks in the structure of the conditional mean and/or the volatility functions are common i...

  9. Management of refractory angina pectoris

    Directory of Open Access Journals (Sweden)

    Ristić Anđelka

    2004-01-01

    Full Text Available An increasing number of patients with coronary artery disease have ischemie symptoms that are unresponsive to both conventional medical therapy and revascularization techniques. The objective of this study was to define the population of patients with refractory angina pectoris and to present the therapeutic options currently available for this condition. Among many techniques, the enhanced external counterpulsation, transmyocardial laser revascularization and neurostimulation have been shown to reduce angina and to improve objective measures of myocardial ischemia in patients with refractory angina.

  10. Omega-3多不饱和脂肪酸对不稳定型心绞痛血清炎症因子的影响%Effects of Omega-3 polyunsaturated fatty acids on serum inflammatory factors in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    臧书文; 王开成

    2015-01-01

    目的:观察Omega-3多不饱和脂肪酸对不稳定型心绞痛患者血清炎症因子的影响及疗效。方法:选择未行冠脉成形术(percutaneous coronary intervention,PCI)治疗的不稳定型心绞痛(unstable angina,UA)患者54例,随机分为Omega-3多不饱和脂肪酸组及安慰剂治疗组各27例。分别于入院时及治疗8周后检测患者空腹血清中白介素6、肿瘤坏死因子α、高敏C反应蛋白、IL-10及转化生长因子β等炎症因子表达变化;记录不良反应及半年内心血管事件发生率。结果:治疗后Omega-3组血清IL-6、TNF-α及CRP表达水平均较治疗前显著下降(P0.05);与对照组比较, Omega-3组用药8周后血清IL-6、TNF-α及CRP表达水平显著降低,IL-10、TGF-β表达显著上升;差异均有统计学意义(P0.05),两组不良反应发生比较差异无统计学意义。结论:不稳定型心绞痛患者口服Omega-3多不饱和脂肪酸能显著抑制炎症,纠正促炎和抑炎失衡,发挥其抗动脉粥样硬化作用。%Objective:To evaluate the changes and effects of Omega-3 polyunsaturated fatty acids(PUFAs) on serum levels of inflammatory factors in patients with unstable angina(UAP). Methods:54 patients with UAP admitted between Mar 2013 and June 2014 were randomly divided into the Omega-3 PUFAs group(n=27) who received Omega-3 PUFAs, and the placebo group(n=27). The serum levels of inflammatory factors such as tumor necrosis factor(TNF-α), interleukin 6(IL-6), High sensitivity C reactive protein(Hs-CRP), IL-10 and transforming growth factorβ(TGF-β)were measured before and after treatment, and Major adverse cardiovascular event and side effects were observed. Results:after treatment, The serum expression levels of TNF-α, IL-6 and CRP in the Omega-3 PUFAs group were lower than the placebo group(P<0.05), and the serum expression levels of IL-10 and TGF-βwere higher than in the placebo group(P<0.05). The incidence rate of

  11. Effects of problem solving interventions on perceived health behavior in patients with unstable angina%解决问题技能干预对提高不稳定性心绞痛患者健康行为自我效能的影响

    Institute of Scientific and Technical Information of China (English)

    邵燕

    2014-01-01

    Objective:To determine the effects of problem solving intervention on perceived health behavior in patients with unstable angina. Methods: One hundred subjects underwent examination using the perceived health behavior scale, which was consisted of 28 items, including 4 subscales in 4 domains:the responsibility for health, psychological well being, nutrition, and exercise. The questionnaire was rated as 0 to 4 points, with the total score ranging from 0 to 112 points, with higher scores indicating a higher efficiency of implementation of perceived health behaviors. Problem solving skills were then offered as the intervention steps: determination of the problem, generation of alternative solutions, decision making, as well as implementation of plans and evaluate the results. The main contents included the misperceptions of patient ' s own disease, intervention on patients lacking knowledge, skills and confidence, the intervention of adverse behaviors as well as intervention against adverse psychological conditions. At month 3 after intervention, the self efficiency was reassessed using the perceived health behavior scale. Data were compared using the t tests. Results: The intervention with problem solving skills markedly improved the self efficiency and perceived health behaviors among all domains ( all P<0.01) . Conclusion:The intervention with problem solving skills effectively improves patient's perceived health behavior and self efficiency and promotes recovery in patients with unstable angina.%目的:观察解决问题技能干预对提高不稳定性心绞痛患者自觉健康行为自我效能的影响作用。方法:被试对象100例,采用自觉健康行为自我效能量表进行入组测评。该量表共28个条目,包含4个分量表(4个维度):即健康责任、心理安适、营养、运动。问卷采用予0~4级计分,总分为0~112分,得分愈高代表自觉执行健康行为的自我效能越高。然后给予问题解决技能

  12. How Can Angina Be Prevented?

    Science.gov (United States)

    ... changes and treating related conditions. Making Lifestyle Changes Healthy lifestyle choices can help prevent or delay angina and heart disease. To adopt a healthy lifestyle, you can: Quit smoking and avoid secondhand ...

  13. 介入治疗联合应用腺苷对不稳定型心绞痛患者冠状动脉血流和临床预后的影响%Effects of Adenosine on coronary artery patency and clinical outcomes in unstable angina patients underwent percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    马莉; 陈晓敏; 俞晓薇; 曹树军; 刘弢

    2011-01-01

    Objective To evaluate the effects of Adenosine on target artery patency and clinical outcomes in unstable angina (UA) patients underwent percutaneous coronary intervention (PCI). Methods From March 2009 to December 2009, 60 UA patients underwent PCI were randomized to receive intravenous Adenosine (within 10 minutes before PCI, n= 30) or saline ( within 10 minutes before PCI, n= 30). All subjects were pretreated with aspirin and clopidogrel. Thrombolysis In Myocardial Infarction (TIMI) flow grade and Corrected TIMI Frame Count (CTFC) of target artery before and after PCI were recorded. All the patients were followed up for 3 months and the incidence of major adverse cardiovascular event (MACE) after PCI were recorded. Results The TIMI flow grade 2-3 and CTFC were not statistically significant between the two groups before PCI (76. 2% vs. 72. 5% , 41.60 ± 13.76 vs. 42. 13 ± 14.30, P >0. 05). The TIMI flow grade 3 was similar between the two groups after PCI (97. 6% vs. 92. 9% , P >0. 05) , but Adenosine group was associated with a significantly better CTFC ( 23.03 ± 8.38 vs. 28.50 ± 10. 24, P < 0. 05 ). Conclusions Based on pretreatment with Aspirin and Clopidogrel, Adenosine is associated with improved target artery patency.%目的 评价经皮冠状动脉介入治疗(PCI)联合静脉应用腺苷对不稳定型心绞痛(UA)患者冠状动脉血流和近期临床预后的影响.方法 2009年3~12月,60例准备行PCI的UA患者按随机数字表法分配到腺苷组(PCI术前10 min应用腺苷,30例)和对照组(PCI术前10 min应用生理盐水,30例).观察两组在常规使用阿司匹林和氯吡格雷的基础上,PCI术前和术后即刻靶血管TIMI血流分级和校正的TIMI帧数(CTFC).随访PCI术后3个月内两组患者主要不良心血管事件(MACE)的发生率.记录使用腺苷治疗期间不良反应的发生情况.结果 两组PCI术前即刻靶血管TIMI血流2~3级发生率和CTFC差异无统计学意义(76.2%比72

  14. Unstable Horizons

    CERN Document Server

    Hubeny, V E; Hubeny, Veronika E.; Rangamani, Mukund

    2002-01-01

    We investigate some of the issues relating to the dynamical instability of general static spacetimes with horizons. Our paper will be partially pedagogical and partially exploratory in nature. After discussing the current understanding, we generalize the proposal of Gubser and Mitra, which identifies dynamical instability of black branes with local thermodynamic instability, to include all product spacetimes with the horizon uniformly smeared over an internal space. We support our conjecture by explicitly exhibiting a threshold unstable mode for Schwarzschild-AdS_5 x S^5 black hole. Using the AdS/CFT correspondence, this simultaneously yields a prediction for a phase transition in the dual gauge theory. We also discuss implications for spacetimes with cosmological horizons.

  15. Unstable horizons

    International Nuclear Information System (INIS)

    We investigate some of the issues relating to the dynamical instability of general static spacetimes with horizons. Our paper will be partially pedagogical and partially exploratory in nature. After discussing the current understanding, we generalize the proposal of Gubser and Mitra, which identifies dynamical instability of black branes with local thermodynamic instability, to include all product spacetimes with the horizon uniformly smeared over an internal space. We support our conjecture by explicitly exhibiting a threshold unstable mode for Schwarzschild-AdS5xS5 black hole. Using the AdS/CFT correspondence, this simultaneously yields a prediction for a phase transition in the dual gauge theory. We also discuss implications for spacetimes with cosmological horizons. (author)

  16. Medications for Angina (Beyond the Basics)

    Science.gov (United States)

    ... of medications used to treat stable angina: ● Nitrates ● Beta blockers ● Calcium channel blockers ● Ranolazine Nitrates or beta blockers are usually preferred for initial treatment of angina, ...

  17. 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 ... please enable JavaScript. Coronary artery disease - living with Heart Disease and Angina Coronary heart disease (CHD) is a ...

  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. 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. PMID:5761833

  20. 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

  1. Myocardial ischemia and angina pectoris

    International Nuclear Information System (INIS)

    Ambulatory monitoring of ST segment changes was performed in 60 patients presenting with angina, positive ECG stress tests and coronary artery disease, 85% of ischemic ECG events were asymptomatic, 37% occurred with no increase in heart rate and 15% of episodes either lasted 20 minutes or more or fluctuated in severity. A controlled pilot study in ten patients showed depression. Radionuclide studies in 50 patients with angina and coronary artery disease have shown that stress (i.e., atrial pacing) produced different patterns of disturbed regional myocardial perfusion related to the patient's exercise capacity and eventually leading to a decrease in regional myocardial perfusion during the ischemic episode. ST segment depression appeared only after the decrease in regional myocardial perfusion. These findings combined with past research suggest that patients with angina and coronary artery disease can suffer frequent asymptomatic disturbances of the regional myocardial perfusion. The frequency of these episodes and the time course for the recovery of the metabolic consequences mean that segments of ventricular myocardium may be constantly abnormal. The relative importance of changes in coronary tone and malfunction of platelets in the diseased coronary tree needs to be examined in clinical research. Pilot studies of antiplatelet agents have shown a significant beneficial effect on episodes of ischemia occurring at night and those occurring without any increase in heart rate. The techniques and observations in these patients with coronary artery disease all suggest that acute transient regional myocardial ischemia is caused by a variety of mechnisms. Further research using objective methods is required to discover the causes of ischemia and to rationalize treatment. (orig./MG)

  2. Recent advances in the management of chronic stable angina II. Anti-ischemic therapy, options for refractory angina, risk factor reduction, and revascularization

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-08-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas, USAAbstract: The objectives in treating angina are relief of pain and prevention of disease ­progression through risk reduction. Mechanisms, indications, clinical forms, doses, and side effects of the traditional antianginal agents – nitrates, ß-blockers, and calcium channel ­blockers – are reviewed. A number of patients have contraindications or remain unrelieved from anginal discomfort with these drugs. Among newer alternatives, ranolazine, recently approved in the United States, indirectly prevents the intracellular calcium overload involved in cardiac ischemia and is a welcome addition to available treatments. None, however, are disease-modifying agents. Two options for refractory angina, enhanced external counterpulsation and spinal cord stimulation (SCS, are presented in detail. They are both well-studied and are effective means of treating at least some patients with this perplexing form of angina. Traditional modifiable risk factors for coronary artery disease (CAD – smoking, hypertension, dyslipidemia, ­diabetes, and obesity – account for most of the population-attributable risk. Individual therapy of high-risk patients differs from population-wide efforts to prevent risk factors from appearing or reducing their severity, in order to lower the national burden of disease. Current American College of Cardiology/American Heart Association guidelines to lower risk in patients with chronic angina are reviewed. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE trial showed that in patients with stable angina, optimal medical therapy alone and percutaneous coronary intervention (PCI with medical therapy were equal in preventing myocardial infarction and death. The integration of COURAGE results into current practice is discussed. For patients who are unstable, with very high risk, with left main coronary artery lesions, in

  3. Angina

    Science.gov (United States)

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71. Lange RA, Hillis LD. ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 72. Marrow DA, Boden WE. ...

  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. Angina - what to ask your doctor

    Science.gov (United States)

    ... Below are some questions you may want to ask your health care provider to help you take ... What to ask your doctor about angina and heart disease; Coronary artery disease - what to ask your doctor

  6. Therapy for Stable Angina in Women

    OpenAIRE

    Sarbaziha, Raheleh; Sedlak, Tara; Shufelt, Chrisandra; Mehta, Puja K.; Merz, C. Noel Bairey

    2012-01-01

    Mortality rates for cardiovascular disease are higher in women than in men, but studies of women have been conducted less frequently. Current pharmacological and nonpharmacological treatment options for women with stable angina are reviewed.

  7. 不稳定性心绞痛患者心理社会因素与血小板聚集功能关系的研究%Relationship between Psychosocial Factors end Platelet Aggregation Function inPatients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    夏大胜; 刘书坤; 高陆; 曹燕然; 菅练

    2001-01-01

    目的:探讨不稳定性心绞痛(UAP)患者心理社会因素与血小板聚集功能的关系。方法:采用6个心理量表对46例UAP患者和46例健康人进行评定,并测定ADP诱导的血小板聚集率。结果:UAP组负性生活事件刺激量、消极应对、CH、焦虑和抑郁积分及血小板聚集率均高于对照组(均P<0.01),社会支持总分和积极应对分低于对照组(均P<0.01),UAP组A型行为、焦虑及抑郁分别占73.91%、82.6%和71.4%,高于对照组36.96%、34.8%和21.7%(均P<0.01)。UAP患者焦虑、抑郁程度与负性生活事件刺激量、消极应对分、CH分及血小板聚集率正相关(P<0.05或P<0.01),与社会支持总分负相关(均P<0.05),血小板聚集率与负性生活事件刺激量、CH分亦显著正相关(均P<0.01)。结论:UAP患者由于处于心理应激状态,表现焦虑、抑郁情绪障碍,血小板聚集功能增强,对疾病的发展和预后可能产生不利影响。%Objective:To explore the relationship between psychosocial factors and platelet aggregation function in patients withunstable angina pectoris(UAP). Methods:Forty-six UAP patients and 46 healthy subjects were evaluated with 6 psychologi-cal scales,and their adenosine diphosphate(ADP)-induced platelet aggregation function was determined. Results: The scoresof negative life event stimuli,negative coping,CH, anxiety, depression and the rate of platelet aggregation function in UAPgroup were significantly higher than controls, whereas the scores of total social support and positive coping were markedlylower than controls(all P<0.01). The prevalence of type A behavior, anxiety and depression in UAP group(73.91%,82.60% and 71.40% respectively)was higher than controls(36.96% ,34.80% and 21.70%respectively)(all P<0.01).The scores of anxiety or depression in UAP group had a positive correlation with the scores of negative life event stimuli,negative coping

  8. Short‐term and long‐term outcomes in 133 429 emergency patients admitted with angina or myocardial infarction in Scotland, 1990–2000: population‐based cohort study

    OpenAIRE

    Capewell, S; Murphy, N F; MacIntyre, K.; Frame, S; Stewart, S.; Chalmers, J.W.T.; Boyd, J.; Finlayson, A; Redpath, A.; McMurray, J J V

    2006-01-01

    Objective: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. Methods: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years...

  9. CLINICAL EFFECT OF TESTOSTERONE IN MEN WITH STABLE ANGINA

    OpenAIRE

    A. Ya. Kravchenko; V. M. Provotorov

    2016-01-01

    Aim. To study efficacy of testosterone undecanoate (TU) therapy in men with stable angina and androgen deficiency.Material and methods. The serum testosterone level was detected in 247 men (aged 51,6±1,8 y.o.) with stable effort angina. 60 patients with androgen deficiency additionally to basic angina therapy received TU (120-160 mg daily). 54 patients with androgen deficiency (control group) received only basic angina therapy. Dynamics of clinical and ECG manifestations of myocardial ischemi...

  10. Utility of ranolazine in chronic stable angina patients

    OpenAIRE

    Patel, Pawan D; Arora, Rohit R

    2008-01-01

    Pawan D Patel, Rohit R AroraDepartment of Cardiology, Chicago Medical School, North Chicago, IL, USAAbstract: Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding o...

  11. [Helicobacter pylori infection and state of antioxidant protection in patients with the unstable course of ischemic disease].

    Science.gov (United States)

    Kratnov, A E; Pavlov, O N

    2004-01-01

    92 patients with ischemic heart disease (IHD) have been examined. Unlike stable angina pectoris, unstable angina and acute myocardial infarction occur more often against the aggravation of chronic atrophic gastritis with a high degree of H. pylori colonization in the mucous coat of the antral part of the stomach. The development of repeated coronary phenomena within one year in patients with unstable angina and acute myocardial infarction was related to the high degree of H. pylori colonization in the mucous coat of the stomach. Irrespective of the presence of IHD in patients, increased H. pylori colonization in the mucous coat was accompanied by a drop in the antioxidant protection activity against the growth of the blood malonic dialdehyde content. PMID:15770853

  12. Control of Unstable Flows

    Institute of Scientific and Technical Information of China (English)

    刘曾荣; 茅坚民

    2003-01-01

    Without introducing a discrete model, unstable continuous flows in a neighbourhood of an unstable stationary point can be stabilized. The linear part of the vector field of disturbing the flow can be managed to become the state variable multiplied by a negative constant. The nonlinear part of the vector field keeps to be unchanged,therefore flows far away from the stationary point are almost unaffected by the disturbance. The control method is easy to be used, even for practical problems for which a priori analytical knowledge of system dynamics is unavailable.

  13. Unstable Particles near Threshold

    CERN Document Server

    Chway, Dongjin; Kim, Hyung Do

    2015-01-01

    We explore physics of unstable particles when mother particle mass is around the sum of its daughter particle masses. In this case, the conventional wave function renormalization factor is ill-defined. We propose a simple resolution of the threshold singularity problem which still allows the use of narrow width approximation by defining branching ratio in terms of spectral density. The resonance peak and shape is different for different decay channels and no single decay width can be assigned to the unstable particles. Non-exponential decay happens in all time scales.

  14. Painful/unstable shoulder

    International Nuclear Information System (INIS)

    This paper reports on the diagnostic performance of CT-arthrography of the painful/unstable shoulder that was evaluated in more than 300 patients. We have encountered a great variety of painful shoulder pathology, including impingement syndrome, cuff tear arthropathy, lesions of the long head of the biceps tendon, calcifying tendinitis, adhesive capsulitis, dead arm syndrome, and degenerative joint disease. Lesions related to instability include cases of capsular avulsions, disruption of the glenohumeral ligaments, labral pathology, glenoid fractures, Hill-Sachs lesions, and changes in glenoid angulation. CT-arthrography is an accurate exploration for both unstable and painful shoulders

  15. Angina - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Portuguese (português) ... poitrine - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Angina हिन्दी (Hindi) Bilingual PDF ...

  16. Utility of ranolazine in chronic stable angina patients

    Directory of Open Access Journals (Sweden)

    Pawan D Patel

    2008-08-01

    Full Text Available Pawan D Patel, Rohit R AroraDepartment of Cardiology, Chicago Medical School, North Chicago, IL, USAAbstract: Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding of myocardial ischemia have prompted evaluation of a number of new antianginal strategies. In this review we discuss the utility of ranolazine, a recently approved novel antianginal agent and its efficacy in the diabetic patient population. In addition to its antianginal action in diabetic patients with chronic angina, ranolazine may have favorable effects on glycated hemoglobin levels.Keywords: chronic stable angina, antianginal, ranolazine, diabetes mellitus, glycated hemoglobin

  17. The economic burden of angina on households in South Asia

    OpenAIRE

    Alam, Khurshid; Mahal, Ajay

    2014-01-01

    Background Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. Methods We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) he...

  18. Usefulness of hyperventilation myocardial SPECT for diagnosing vasospastic angina pectoris

    International Nuclear Information System (INIS)

    We evaluated the usefulness of hyperventilation myocardial scintigraphy (HV-SPECT) for diagnosing vasospastic angina pectoris. The subjects consisted of 11 patients with rest angina and 13 with rest and exertional angina in whom coronary spasm was demonstrated by coronary angiography, and 6 with exertional angina in whom a significant stenotic lesion was observed by coronary angiography. Hyperventilation was performed at a rate of 40/min for 5 minutes in all the patients. Ischemia was considered to be present when defect and redistribution were observed by SPECT. HV-SPECT revealed positive findings in 8 patients with rest angina (73%) and 9 with exertional and rest angina (69%) but only in 1 with exertional angina (17%). Ischemic ST changes on monitor ECG were observed in 13 of the 30 patients (43%); ST was enhanced in 4 patients and depressed in 9 patients. In the patients with rest angina, HV-SPECT induced ischemic findings more frequently than exercise SPECT (73% vs 55%). HV-SPECT seems to be useful as a non-invasive method for diagnosing angina pectoris resulting from coronary spasm. (author)

  19. Safety and efficacy of angioplasty with intracoronary stenting in patients with unstable coronary syndromes. Comparison with stable coronary syndromes

    Directory of Open Access Journals (Sweden)

    Luís C. L. Correia

    2000-06-01

    Full Text Available OBJECTIVE: To assess safety and efficacy of coronary angioplasty with stent implantation in unstable coronary syndromes. METHODS: Retrospective analysis of in-hospital and late evolution of 74 patients with unstable coronary syndromes (unstable angina or infarction without elevation of the ST segment undergoing coronary angioplasty with stent placement. These 74 patients were compared with 31 patients with stable coronary syndromes (stable angina or stable silent ischemia undergoing the same procedure. RESULTS: No death and no need for revascularization of the culprit artery occurred in the in-hospital phase. The incidences of acute non-Q-wave myocardial infarction were 1.4% and 3.2% (p=0.6 in the unstable and stable coronary syndrome groups, respectively. In the late follow-up (11.2±7.5 months, the incidences of these events combined were 5.7% in the unstable coronary syndrome group and 6.9% (p=0.8 in the stable coronary syndrome group. In the multivariate analysis, the only variable with a tendency to significance as an event predictor was diabetes mellitus (p=0.07; OR=5.2; 95% CI=0.9-29.9. CONCLUSION: The in-hospital and late evolutions of patients with unstable coronary syndrome undergoing angioplasty with intracoronary stent implantation are similar to those of the stable coronary syndrome group, suggesting that this procedure is safe and efficacious when performed in unstable coronary syndrome patients.

  20. Unstable nonlocal interface dynamics.

    Science.gov (United States)

    Nicoli, Matteo; Cuerno, Rodolfo; Castro, Mario

    2009-06-26

    Nonlocal effects occur in many nonequilibrium interfaces, due to diverse physical mechanisms like diffusive, ballistic, or anomalous transport, with examples from flame fronts to thin films. While dimensional analysis describes stable nonlocal interfaces, we show the morphologically unstable condition to be nontrivial. This is the case for a family of stochastic equations of experimental relevance, paradigmatically including the Michelson-Sivashinsky system. For a whole parameter range, the asymptotic dynamics is scale invariant with dimension-independent exponents reflecting a hidden Galilean symmetry. The usual Kardar-Parisi-Zhang nonlinearity, albeit irrelevant in that parameter range, plays a key role in this behavior. PMID:19659099

  1. 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.

  2. 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.

  3. Imaging unstable plaque.

    Science.gov (United States)

    Sriranjan, Rouchelle S; Tarkin, Jason M; Evans, Nicholas R; Chowdhury, Mohammed M; Rudd, James H

    2016-09-01

    Recent advances in imaging technology have enabled us to utilise a range of diagnostic approaches to better characterise high-risk atherosclerotic plaque. The aim of this article is to review current and emerging techniques used to detect and quantify unstable plaque in the context of large and small arterial systems and will focus on both invasive and non-invasive imaging techniques. While the diagnosis of clinically relevant atherosclerosis still relies heavily on anatomical assessment of arterial luminal stenosis, evolving multimodal cross-sectional imaging techniques that encompass novel molecular probes can provide added information with regard to plaque composition and overall disease burden. Novel molecular probes currently being developed to track precursors of plaque rupture such as inflammation, micro-calcification, hypoxia and neoangiogenesis are likely to have translational applications beyond diagnostics and have the potential to play a part in quantifying early responses to therapeutic interventions and more accurate cardiovascular risk stratification. PMID:27273430

  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) PMID:1829846

  5. Mediastinite descendente necrosante pós-angina de Ludwig Necrotizing descending mediastinitis afetr Ludwig angina

    Directory of Open Access Journals (Sweden)

    MARICÉLIA BROMMELSTROET

    2001-09-01

    Full Text Available A angina de Ludwig é uma infecção do espaço submandibular originada, em geral, da infecção do 2º ou 3º molar inferior. Como conseqüência, pode causar mediastinite descendente necrosante, que representa uma forma grave e rara de infecção mediastinal, a qual exige diagnóstico precoce e tratamento cirúrgico para reduzir a alta mortalidade associada a esta doença. Dois casos de mediastinite descendente necrosante pós-angina de Ludwig foram tratados com excelentes resultados em nosso hospital. A drenagem mediastinal transcervical está justificada em pacientes com doença limitada ao mediastino superior. Porém, sepse com comprometimento extenso do mediastino requer drenagem através de toracotomia sem demora.Ludwig's angina is an infection of the submandibular space generally caused by an infection of the 2nd or 3rd lower molar. As a consequence, descending necrotizing mediastinitis, a rare and severe form of mediastinal infection, may occur. The descending necrotizing mediastinitis represents a rare form of mediastinal infection. It presents a high mortality and to decrease that rate it is necessary prompt diagnosis and surgical treatment. Two cases of descending necrotizing mediastinitis due to Ludwig's angina were treated with excellent results in our hospital. The transcervical mediastinal drainage is justified in patients with disease limited to the upper mediastinum. Even so, when there is extensive involvement of the whole mediastinum it is suitable the accomplishment of a wide thoracotomy.

  6. 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.

  7. Physical Activitiea Associted with Angina Pectoris Before Myocardial Infarction and the Onset of Myocardial Infarction

    OpenAIRE

    Matsuda, Masako

    1984-01-01

    One hundred and ninety-seven patients with a history of myocardeal infarction were interviewed to evaluate the incidence of angina pectoris and the physical activity precipitating angina before myocardial infarction, and the mode of physical activity at the onset of myocardial infarction. Ninety-ewo patients had no angina before infarction, whereas 105 did, In 105 patients, 58 had a chronic stable angina without a change of pattern of angina before infarction, while 22 noticed worsening of th...

  8. 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; Gillberg, L; Pehrsson, K; Hardy, I; Ståhle, A; Andersen, Claus; Mannheimer, C

    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....

  9. Unstable states in quantum theory

    Science.gov (United States)

    Kuksa, V. I.

    2014-05-01

    Various approaches to the problem of describing unstable particles are reviewed. Fundamental problems that arise in quantum field description of these particles and the ways of their solution are considered. Among them, there is an approach related to the notion of the smeared (continuous) mass, which originates from the finite lifetime of unstable particles. The quantum field model of unstable particles with smeared mass, which is built upon two basic axiomatic elements, is considered in detail. The basic processes with unstable particles (decay and scattering) are considered within the framework of the model and the formalism for describing physical characteristics of those processes is developed. The model is successfully applied to describing the processes of pair and triple boson production at the linear collider, top quark pair production, and certain hadronic decays. Based on this model, the factorization method is developed, which allows a description of complicated and multistep scattering and decay processes with unstable particles to be considerably simplified.

  10. 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.

  11. Observations on the warm up phenomenon in angina pectoris.

    OpenAIRE

    Joy, M; Cairns, A W; Sprigings, D

    1987-01-01

    Adaptation to exercise was investigated in 14 men aged 34-69 years (mean 51) with stable exertional angina caused by occlusive coronary artery disease. All underwent exercise electrocardiography to symptom limitation according to the Bruce protocol (first effort), and exercise to the onset of angina (warm up) followed by four minutes' rest, followed by exercise to symptom limitation (second effort). This protocol was repeated after sequential treatment for one month each with nifedipine 10 mg...

  12. NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

    OpenAIRE

    Gavrilov, Y V; V. A. Sulimov; V. I. Makolkin

    2015-01-01

    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 treat...

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

    OpenAIRE

    Vadnais, David S; Wenger, Nanette K.

    2010-01-01

    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 loadi...

  14. CLINICAL EFFECT OF TESTOSTERONE IN MEN WITH STABLE ANGINA

    Directory of Open Access Journals (Sweden)

    A. Ya. Kravchenko

    2016-01-01

    Full Text Available Aim. To study efficacy of testosterone undecanoate (TU therapy in men with stable angina and androgen deficiency.Material and methods. The serum testosterone level was detected in 247 men (aged 51,6±1,8 y.o. with stable effort angina. 60 patients with androgen deficiency additionally to basic angina therapy received TU (120-160 mg daily. 54 patients with androgen deficiency (control group received only basic angina therapy. Dynamics of clinical and ECG manifestations of myocardial ischemia and quality of life (QOL parameters was studied.Results. Androgen deficiency is revealed in 114 (46,2% of patients. Therapy with TU during 3 months resulted in reduction of angina attacks and extent of myocardial ischemia (according to Holter ECG monitoring and stress test as well as QOL improvement.Conclusion. Androgen deficiency is observed in 46,2% of men with stable angina. TU increases of antianginal therapy efficacy, improves QOL and is well tolerated. 

  15. Ranolazine Reduces Patient-Reported Angina Severity and Frequency and Improves Quality of Life in Selected Patients with Chronic Angina

    OpenAIRE

    Muhlestein, Joseph B.; Grehan, Sharon

    2013-01-01

    Background Chronic stable angina negatively affects quality of life (QoL). American College of Cardiology/American Heart Association guidelines highlight maintaining/restoring a level of activity, functional capacity, and QoL that is satisfactory to the patient as an objective of treatment, and further define the treatment goal for most patients as maximizing survival and achieving prompt and complete (or near-complete) elimination of angina with a return to normal activities. Objective To as...

  16. Physics of Unstable Nuclei

    Science.gov (United States)

    Khoa, Dao Tien; Egelhof, Peter; Gales, Sydney; Giai, Nguyen Van; Motobayashi, Tohru

    2008-04-01

    Studies at the RIKEN RI beam factory / T. Motobayashi -- Dilute nuclear states / M. Freer -- Studies of exotic systems using transfer reactions at GANIL / D. Beaumel et al. -- First results from the Magnex large-acceptance spectrometer / A. Cunsolo et al. -- The ICHOR project and spin-isospin physics with unstable beams / H. Sakai -- Structure and low-lying states of the [symbol]He exotic nucleus via direct reactions on proton / V. Lapoux et al. -- Shell gap below [symbol]Sn based on the excited states in [symbol]Cd and [symbol]In / M. Górska -- Heavy neutron-rich nuclei produced in the fragmentation of a [symbol]Pb beam / Zs. Podolyák et al. -- Breakup and incomplete fusion in reactions of weakly-bound nuclei / D.J. Hinde et al. -- Excited states of [symbol]B and [symbol]He and their cluster aspect / Y. Kanada-En'yo et al. -- Nuclear reactions with weakly-bound systems: the treatment of the continuum / C. H. Dasso, A. Vitturi -- Dynamic evolution of three-body decaying resonances / A. S. Jensen et al. -- Prerainbow oscillations in [symbol]He scattering from the Hoyle state of [symbol]C and alpha particle condensation / S. Ohkubo, Y. Hirabayashi -- Angular dispersion behavior in heavy ion elastic scattering / Q. Wang et al. -- Microscopic optical potential in relativistic approach / Z.Yu. Ma et al. -- Exotic nuclei studied in direct reactions at low momentum transfer - recent results and future perspectives at fair / P. Egelhof -- Isotopic temperatures and symmetry energy in spectator fragmentation / M. De Napoli et al. -- Multi-channel algebraic scattering theory and the structure of exotic compound nuclei / K. Amos et al. -- Results for the first feasibility study for the EXL project at the experimental storage ring at GSI / N. Kalantar-Nayestanaki et al. -- Coulomb excitation of ISOLDE neutron-rich beams along the Z = 28 chain / P. Van Duppen -- The gamma decay of the pygmy resonance far from stability and the GDR at finite temperature / G. Benzoni et al

  17. Two dimensional unstable scar statistics.

    Energy Technology Data Exchange (ETDEWEB)

    Warne, Larry Kevin; Jorgenson, Roy Eberhardt; Kotulski, Joseph Daniel; Lee, Kelvin S. H. (ITT Industries/AES Los Angeles, CA)

    2006-12-01

    This report examines the localization of time harmonic high frequency modal fields in two dimensional cavities along periodic paths between opposing sides of the cavity. The cases where these orbits lead to unstable localized modes are known as scars. This paper examines the enhancements for these unstable orbits when the opposing mirrors are both convex and concave. In the latter case the construction includes the treatment of interior foci.

  18. Proton scattering from unstable nuclei

    Indian Academy of Sciences (India)

    Y Blumenfeld; E Khan; F Maréchal; T Suomijärvi

    2001-08-01

    Recent improvements in the intensities and optical qualities of radioactive beams have made possible the study of elastic and inelastic proton scattering on unstable nuclei. The design and performances of an innovative silicon strip detector array devoted to such experiments are described. The quality of the data obtained are illustrated with recent results obtained at the GANIL facility for unstable oxygen, sulfur and argon isotopes. Methods to analyse the data using phenomenological and microscopic optical model potentials are discussed.

  19. Reduced peripheral vascular reactivity in refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne M; Edvinsson, Marie-Louise; Pettersson, Thomas;

    2011-01-01

    compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian......AIMS: To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. METHODS: Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were...

  20. Neurostimulation bei refraktärer Angina pectoris

    OpenAIRE

    Theres H; Baumann G; Eddicks S; Maier-Hauff K; Schenk M.; Spies C

    2005-01-01

    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 IIIIV), 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 b...

  1. Combination treatment with trimetazidine and diltiazem in stable angina pectoris

    OpenAIRE

    Manchanda, S; Krishnaswami, S

    1997-01-01

    Objective—To assess antianginal efficacy and possible adverse haemodynamic effects of combination treatment with trimetazidine and diltiazem in patients with stable angina.
Design—Double blind, randomised, placebo controlled trial of four weeks duration.
Setting—Outpatient department of two Indian hospitals.
Subjects—64 male patients with stable angina, uncontrolled on diltiazem alone.
Interventions—Diltiazem 180 mg and trimetazidine 60 mg, or diltiazem 180 mg and placebo daily.
Main outcome ...

  2. Unstable decay and state selection

    International Nuclear Information System (INIS)

    We consider the problem of state selection for a stochastic system, initially in an unstable stationary state, when multiple metastable states compete for occupation. Using path-integral techniques we derive remarkably simple and accurate formulae for state-selection probabilities. The method is sufficiently general that it is applicable to a wide variety of problems. (author)

  3. Hyperchaotic system with unstable oscillators

    DEFF Research Database (Denmark)

    Murali, K.; Tamasevicius, A.; Mykolaitis, G.;

    2000-01-01

    A simple electronic system exhibiting hyperchaotic behaviour is described. The system includes two nonlinearly coupled 2nd order unstable oscillators, each composed of an LC resonance loop and an amplifier. The system is investigated by means of numerical integration of appropriate differential...... equations, PSPICE simulations and hardware experiments. The Lyapunov exponents are presented to confirm hyperchaotic mode of the oscillations....

  4. Stabilization Strategies for Unstable Dynamics

    Science.gov (United States)

    Saha, Devjani J.; Morasso, Pietro

    2012-01-01

    Background When humans are faced with an unstable task, two different stabilization mechanisms are possible: a high-stiffness strategy, based on the inherent elastic properties of muscles/tools/manipulated objects, or a low-stiffness strategy, based on an explicit positional feedback mechanism. Specific constraints related to the dynamics of the task and/or the neuromuscular system often force people to adopt one of these two strategies. Methodology/Findings This experiment was designed such that subjects could achieve stability using either strategy, with a marked difference in terms of effort and control requirements between the two strategies. The task was to balance a virtual mass in an unstable environment via two elastic linkages that connected the mass to each hand. The dynamics of the mass under the influence of the unstable force field and the forces applied through the linkages were simulated using a bimanual, planar robot. The two linkages were non-linear, with a stiffness that increased with the amount of stretch. The mass could be stabilized by stretching the linkages to achieve a stiffness that was greater than the instability coefficient of the unstable field (high-stiffness), or by balancing the mass with sequences of small force impulses (low-stiffness). The results showed that 62% of the subjects quickly adopted the high-stiffness strategy, with stiffness ellipses that were aligned along the direction of instability. The remaining subjects applied the low-stiffness strategy, with no clear preference for the orientation of the stiffness ellipse. Conclusions The choice of a strategy was based on the bimanual coordination of the hands: high-stiffness subjects achieved stability quickly by separating the hands to stretch the linkages, while the low-stiffness subjects kept the hands close together and took longer to achieve stability but with lower effort. We suggest that the existence of multiple solutions leads to different types of skilled behavior

  5. 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

  6. 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.

  7. Capecitabine cardiac toxicity presenting as effort angina: a case report.

    Science.gov (United States)

    Lestuzzi, Chiara; Crivellari, Diana; Rigo, Fausto; Viel, Elda; Meneguzzo, Nereo

    2010-09-01

    We report a case of capecitabine-induced cardiotoxicity (effort angina) in a woman with metastatic breast carcinoma. Due to cancer progression, rechallenge of therapy with capecitabine was attempted, using several strategies in order to prevent cardiotoxicity. The most (even if not fully) effective strategy was reducing capecitabine dosage together with nitrates, calcium-channel blockers and trimetazidine therapy. PMID:20093950

  8. Transluminal angioplasty in the management of mesenteric angina

    International Nuclear Information System (INIS)

    The efficacy of transluminal angioplasty for the treatment of peripheral atherosclerotic disease has been well documented. The successful treatment of abdominal angina has been reported, although the follow-up is too short to accurately evaluate the long term results of this procedure. (orig.)

  9. Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine

    OpenAIRE

    Vadnais, David S; Wenger, Nanette K.

    2009-01-01

    Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective) thereby improving survival, and/or relieve ischemic symptoms (antianginal) thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents, lipid lowering therapy and angiotensin-converting enzyme (ACE) inhibitors. Conv...

  10. 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...

  11. 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

  12. Inherently Unstable Internal Gravity Waves

    CERN Document Server

    Liang, Y

    2016-01-01

    Here we show that there exist internal gravity waves that are inherently unstable, that is, they cannot exist in nature for a long time. The instability mechanism is a one-way (irreversible) harmonic-generation resonance that permanently transfers the energy of an internal wave to its higher harmonics. We show that, in fact, there are countably infinite number of such unstable waves. For the harmonic-generation resonance to take place, nonlinear terms in the free surface boundary condition play a pivotal role, and the instability does not obtain if a simplified boundary condition such as rigid lid or linear form is employed. Harmonic-generation resonance presented here also provides a mechanism for the transfer of the energy of the internal waves to the higher-frequency part of the spectrum where internal waves are more prone to breaking, hence losing energy to turbulence and heat and contributing to oceanic mixing.

  13. Evaluation of plaque texture by means of multislice computed tomography in patients with acute coronary syndrome and stable angina

    International Nuclear Information System (INIS)

    In the present study, multislice spiral computed tomography (MSCT), which allows non-invasive assessment of coronary artery plaque, was used to compare the CT density of plaque between patients with acute coronary syndrome (ACS) and those with stable angina (SA). MSCT was performed in 20 patients with ACS (17 with acute myocardial infarction, 3 with unstable angina) and 22 patients with SA. The presence of the plaque was defined on the basis of multi-planar reformation and axial images. At least 4 regions of interest were then placed within the plaque and the minimum CT density was measured and expressed as Hounsfield units (HU). The number of plaques did not differ between the 2 groups, but the minimum CT density was significantly lower in patients with ACS (25±15 HU) than in those with SA (71±16 HU, range 46-101 HU, p<0.001). Similarly, the minimum plaque density was significantly lower in the culprit coronary segment (26±16 HU) than in the non-culprit segment (48±17 HU) in 15 ACS patients with multiple plaques. MSCT can potentially differentiate vulnerable from stable plaque in patients with coronary artery disease, although long-term, prospective analysis is needed to establish the conclusion. (author)

  14. Unstable oscillators based hyperchaotic circuit

    DEFF Research Database (Denmark)

    Murali, K.; Tamasevicius, A.; G. Mykolaitis, A.;

    1999-01-01

    A simple 4th order hyperchaotic circuit with unstable oscillators is described. The circuit contains two negative impedance converters, two inductors, two capacitors, a linear resistor and a diode. The Lyapunov exponents are presented to confirm hyperchaotic nature of the oscillations in the...... circuit. The performance of the circuit is investigated by means of numerical integration of appropriate differential equations, PSPICE simulations, and hardware experiment....

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

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez Sotelo

    2004-01-01

    primary goal of this study is to determine HRV relationship with other prognostic markers in unstable angina patients. Materials and methods: We studied prospectively patients with diagnosis of unstable angina. We considered predictors of cardiovascular risk (unresponsive rest angina, hipotension, heart failure, dynamic ST changes, ejection fraction less than 40% and angiographic features (2 or more vessels, conforming two groups, high risk and low risk. In every patient was made a 5 minute electrocardiographic recording and we analysed HRV variables in time domain and frequency domain. All this variables were compared between both groups Results: We included 63 patients (44 males, 70% with mean age 63 + 10.4 years old (35-90; 46 were considered of high risk because dynamic ST changes and depressed ejection fraction and the remaining 17 were considered at low risk. In the first group, total spectral power was statistically different (p=0.04 compared with low-risk group. Low frequency band (LF was also different but without statistic significance (p=0.07 and other variables like SDNN, NN5 0 and low frequency showed only a trend to be less in the high-risk group. Conclusion: Clinical high-risk patients with unstable angina have low HRV variables. This feature could be predictive of poor survival in follow-up prospective studies.

  16. Prasugrel versus clopidogrel for patients with unstable angina or non-ST-segment elevation myocardial infarction with or without angiography

    DEFF Research Database (Denmark)

    Wiviott, Stephen D; White, Harvey D; Ohman, E Magnus;

    2013-01-01

    Treatment with prasugrel and aspirin improves outcomes compared with clopidogrel and aspirin for patients with acute coronary syndrome who have had angiography and percutaneous coronary intervention; however, no clear benefit has been shown for patients managed first with drugs only. We assessed ...... outcomes from the TRILOGY ACS trial based on whether or not patients had coronary angiography before treatment was chosen....

  17. Influence of Lipid Transport System Gene Polymorphism on the Dyslipidemia and Coronary Lesions in Patients with Unstable Angina

    OpenAIRE

    Aziz S. Eshpulatov; S.U. Hashimov; Alexander B. Shek; Ravshanbek D. Kurbanov

    2015-01-01

    The purpose of this study was to identify the features of lipid metabolism and coronary lesions in view of the combined carrier of the ε4 allele of APOE ε2/ε3/ε4 polymorphism and the S2 allele of APOC3SstI polymorphism in UA patients. Materials and Methods: The study included 141 Uzbek patients with UA class IIB (Braunwald E. et al., 1989) who had coronary atherosclerosis of varying degrees, according to coronary angiography. The control group consisted of 50 healthy, age-matched, randomly...

  18. Infrared Sensitivity of Unstable Vacua

    CERN Document Server

    Krotov, Dmitry

    2010-01-01

    We discover that some unstable vacua have long memory. By that we mean that even in the theories containing only massive particles, there are correllators and expectation values which grow with time. We examine the cases of instabilities caused by the constant electric fields, expanding and contracting universes and, most importantly, the global de Sitter space. In the last case the interaction leads to a remarkable UV/IR mixing and to a large back reaction. This gives reasons to believe that the cosmological constant problem could be resolved by the infrared physics.

  19. Infrared sensitivity of unstable vacua

    International Nuclear Information System (INIS)

    We discover that some unstable vacua have long memory. By that we mean that even in the theories containing only massive particles, there are correllators and expectation values which grow with time. We examine the cases of instabilities caused by the constant electric fields, expanding and contracting universes and, most importantly, the global de Sitter space. In the last case the interaction leads to a remarkable UV/IR mixing and to a large back reaction. This gives reasons to believe that the cosmological constant problem could be resolved by the infrared physics.

  20. 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 83...... %) with no prior cardiovascular disease who had a first-time coronary angiography (CAG) in 2008-2009 due to suspected stable angina to participate in a questionnaire survey in 2011 with the Seattle Angina Questionnaire and the Hospital Anxiety and Depression Scale as key elements. Long-term persistent...... angina (i.e., symptoms at least once a month) was present in 64 % of patients with diffuse non-obstructive CAD (1-49 % stenosis), 49 % of patients with normal coronary arteries (0 % stenosis), and 41 % of patients with obstructive CAD (a parts per thousand yen50 % stenosis) (P = 0.01). Depression and...

  1. 'Variant' angina: Evidence for small vessel coronary artery spasm

    International Nuclear Information System (INIS)

    A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on 201TI-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antangonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm. (orig.)

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

    DEFF Research Database (Denmark)

    Larsen, C T; Sørum, C; Rasmussen, V; Fischer Hansen, J

    1993-01-01

    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......The purpose of this study was to examine the 24-hour antiischemic efficacy of once-a-day anipamil compared to placebo in the treatment of patients with stable angina. The study was designed as a double-blind, placebo-controlled crossover study with an initial 3 week single-blind placebo period. The...... once a day is an effective 24-hour antiischemic drug in the treatment of transient myocardial ischemia....

  3. Thoracic empyema resulting from direct extension of Ludwig's angina

    OpenAIRE

    Youssef, M

    2016-01-01

    A 17-year-old Egyptian male developed Ludwig's angina after a failed trial of treatment a left lower teeth abscess, which was complicated by LT sided empyema and pneumonia. Assessment/Results: The patient arrived at ER dep. .Intraoral examination showed moderate trismus, fetid odor. There was bilateral sublingual edema (left > right) and an ulceration in the left floor of the mouth that was spontaneously draining purulent fluid. No cardiac murmurs or rubs were evident.Initial diagnostic labor...

  4. Myocardial bridge: The cause of angina in a young man

    OpenAIRE

    Vijayvergiya, Rajesh; Mittal, Bhagwant Rai

    2013-01-01

    Myocardial bridging is basically the systolic narrowing of epicardial coronary arteries, secondary to their tunneled course in myocardium. Though it is a benign condition it can have the symptoms like acute coronary syndrome, arrhythmias and sudden cardiac death. We report a 32-year-old male, who presented with typical exertional angina, had positive exercise treadmill and thallium-201 test. Coronary angiography revealed myocardial bridge of distal left anterior descending coronary artery. He...

  5. Epidural spinal electrical stimulation in severe angina pectoris.

    OpenAIRE

    Mannheimer, C; Augustinsson, L E; Carlsson, C A; Manhem, K; Wilhelmsson, C

    1988-01-01

    The short term effects of epidural spinal electrical stimulation were studied in 10 patients with angina pectoris of New York Heart Association functional class III or IV. The antianginal pharmacological treatment given at entry to the study was regarded as optimal and was not changed during the study. The effects of epidural spinal electrical stimulation were measured by repeated bicycle ergometer tests. Treatment with epidural spinal electrical stimulation increased the patients' working ca...

  6. Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine

    Directory of Open Access Journals (Sweden)

    David S. Vadnais

    2009-01-01

    Full Text Available Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective thereby improving survival, and/or relieve ischemic symptoms (antianginal thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents, lipid lowering therapy and angiotensin-converting enzyme (ACE inhibitors. Conventional antianginal therapy for patients with chronic stable angina consists of beta-blockers, calcium channel blockers and nitrates, with surgical or percutaneous revascularization serving an adjunctive role. Despite the investigation of multiple novel therapies and medications over the past 25 years, arguably the most significant contribution to antianginal therapy during that time involved the recent introduction of ranolazine. Ranolazine acts via a distinctive pathway, inhibiting the late sodium current of the action potential in ischemic myocytes. Multiple studies have demonstrated that ranolazine significantly reduces anginal symptoms and improves exercise performance in patients with chronic stable angina but does not reduce mortality. Ranolazine does not affect either heart rate or blood pressure, a unique property among the current antianginal agents. Despite its QT prolongation, ranolazine has a proven safety profile and is not proarrhythmic. In fact, in a recent large randomized trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation and bradycardic events. Ranolazine may confer some additional benefits such as a reduction in HbA1c levels and improved left ventricular diastolic function. Ranolazine is now approved for use in chronic stable angina. Current guidelines recommend beta-blockers as the first line antianginal agent due to the proven mortality reduction. However, for

  7. 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 symptom...

  8. 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

  9. Stabilization strategies for unstable dynamics.

    Science.gov (United States)

    Morasso, Pietro; Casadio, Maura; De Santis, Dalia; Nomura, Taishin; Rea, Francesco; Zenzeri, Jacopo

    2014-12-01

    The stabilization of the human standing posture was originally attributed to the stiffness of the ankle muscles but direct measurements of the ankle stiffness ruled out this hypothesis, leaving open the possibility for a feedback stabilization strategy driven by proprioceptive signals. This solution, however, could be implemented with two different kinds of control mechanisms, namely continuous or intermittent feedback. The debate is now settled and the latter solution seems to be the most plausible one. Moreover, stabilization of unstable dynamics is not limited to bipedal standing. Indeed many manipulation tasks can be described in the same framework and thus a very general protocol for addressing this kind of problems is the use of haptic virtual reality where instability is generated by some kind of divergent or saddle-like force field. Several studies demonstrated that human subjects can choose to adopt a stiffness or feedback strategy as a combination of biomechanical and task constraints and can learn to switch from one strategy to the other if it is feasible or to use one or the other is infeasible. Understanding such mechanisms is relevant, for example, for the design of novel ergonomic man-machine interfaces in difficult, unstable tasks. PMID:25453479

  10. Practical experience with unstable compressors

    Science.gov (United States)

    Malanoski, S. B.

    1980-01-01

    Using analytical mathematical modeling techniques for the system components, an attempt is made to gauge the destabilizing effects in a number of compressor designs. In particular the overhung (or cantilevered) compressor designs and the straddle-mounted (or simply supported) compressor designs are examined. Recommendations are made, based on experiences with stable and unstable compressors, which can be used as guides in future designs. High and low pressure compressors which operate well above their fundamental rotor-bearing lateral natural frequencies can suffer from destructive subsynchronous vibration. Usually the elements in the system design which contribute to this vibration, other than the shafting and the bearings, are the seals (both gas labyrinth and oil breakdown bushings) and the aerodynamic components.

  11. Sensitivity and related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy to detect stable effort angina pectoris

    International Nuclear Information System (INIS)

    This study evaluated the sensitivity and the related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy to detect stable angina. The subjects were 198 patients with stable angina who underwent BMIPP before percutaneous coronary intervention or coronary bypass graft surgery. Patients with unstable angina, myocardial infarction, congestive heart failure, cardiomyopathy and vasospastic angina were excluded. After investigation of the sensitivity of BMIPP, the patients with single-vessel disease without collateral flow were classified into the normal 123I-BMIPP uptake group (normal group) or decreased 123I-BMIPP uptake group (decreased group), and various factors were compared between the two groups. Sensitivity was 61% overall, 58% in single-vessel disease, 69% in double-vessel disease, 53% in triple-vessel disease, 43% in only left main vessel disease, and 89% in left main and other vessel disease (NS). In single-vessel disease, the sensitivity was 40% in 75% coronary artery stenosis, 58% in 90% stenosis, 89% in 99% stenosis, and 69% in total occlusion (p=0.003). Comparing the decreased and normal groups, diabetes mellitus was more frequent in the normal group (14.6% vs 39.5%), minimal lumen diameter was smaller (0.75±0.37 vs 0.98±0.49 mm) and lesion length was longer in the decreased group (15.4±4.9 vs 11.6±5.5 mm). Logistic multivariate analysis showed that the independent factors were diabetes mellitus [odds ratio 0.20, 95% confidence interval (CI) 0.04-0.87, p=0.03], minimal lumen diameter (odds ratio 0.10, 95% CI 0.02-0.48, p=0.003) and lesion length (odds ratio 1.12, 95% CI 1.00-1.25, p=0.03). BMIPP is useful in stable angina patients because of the acceptable sensitivity. Diabetes mellitus, minimal lumen diameter and lesion length were independent factors associated with decreased BMIPP uptake. (author)

  12. Unstable supercritical discontinuous percolation transitions

    Science.gov (United States)

    Chen, Wei; Cheng, Xueqi; Zheng, Zhiming; Chung, Ning Ning; D'Souza, Raissa M.; Nagler, Jan

    2013-10-01

    The location and nature of the percolation transition in random networks is a subject of intense interest. Recently, a series of graph evolution processes have been introduced that lead to discontinuous percolation transitions where the addition of a single edge causes the size of the largest component to exhibit a significant macroscopic jump in the thermodynamic limit. These processes can have additional exotic behaviors, such as displaying a “Devil's staircase” of discrete jumps in the supercritical regime. Here we investigate whether the location of the largest jump coincides with the percolation threshold for a range of processes, such as Erdős-Rényipercolation, percolation via edge competition and via growth by overtaking. We find that the largest jump asymptotically occurs at the percolation transition for Erdős-Rényiand other processes exhibiting global continuity, including models exhibiting an “explosive” transition. However, for percolation processes exhibiting genuine discontinuities, the behavior is substantially richer. In percolation models where the order parameter exhibits a staircase, the largest discontinuity generically does not coincide with the percolation transition. For the generalized Bohman-Frieze-Wormald model, it depends on the model parameter. Distinct parameter regimes well in the supercritical regime feature unstable discontinuous transitions—a novel and unexpected phenomenon in percolation. We thus demonstrate that seemingly and genuinely discontinuous percolation transitions can involve a rich behavior in supercriticality, a regime that has been largely ignored in percolation.

  13. Myocardial bridge: The cause of angina in a young man

    International Nuclear Information System (INIS)

    Myocardial bridging is basically the systolic narrowing of epicardial coronary arteries, secondary to their tunneled course in myocardium. Though it is a benign condition it can have the symptoms like acute coronary syndrome, arrhythmias and sudden cardiac death. We report a 32-year-old male, who presented with typical exertional angina, had positive exercise treadmill and thallium-201 test. Coronary angiography revealed myocardial bridge of distal left anterior descending coronary artery. He was put on β-blockers and was doing well at 8 years of follow-up

  14. Comparison of patients undergoing enhanced external counterpulsation and spinal cord stimulation for refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne; Pettersson, Thomas; Erdling, André;

    2008-01-01

    with refractory angina. METHODS: 153 patients with refractory angina were treated with either EECP, SCS, or were retained on their pharmacological treatment (control). Glyceryl trinitrate usage and Canadian Cardiovascular Society classification were registered at baseline, 6 and 12 months after therapy. RESULTS...

  15. One year follow-up of patients with refractory angina pectoris treated with enhanced external counterpulsation

    DEFF Research Database (Denmark)

    Pettersson, Thomas; Bondesson, Susanne; Cojocaru, Diodor; Ohlsson, Ola; Wackenfors, Angelica; Edvinsson, Lars

    2006-01-01

    the long-term outcome of EECP treatment at a Scandinavian centre, in relieving angina in patients with chronic refractory angina pectoris. METHODS: 55 patients were treated with EECP. Canadian cardiovascular society (CCS) class, antianginal medication and adverse clinical events were collected prior...

  16. 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

  17. 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

    coherence tomography have been applied to study the coronary pathology in patients with vasospastic angina. Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis. They share the common pathophysiological phenomenon of...

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    interest was death or myocardial infarction (MI). The increasing intensity of guideline compliant medical therapy was quantified by means of a simple treatment score based on the use of guideline advocated therapies: antiplatelets, statins, and beta-blockers. A total of 3779 patients were included in the...... initial survey. Increasing intensity of guideline compliant therapy at initial assessment was associated with a reduction in death and MI during follow-up in patients with angina and confirmed coronary disease (HR 0.68; 95% CI 0.49-0.95 per unit increase in treatment score). All cardiovascular events were...... stable angina. Methods and results The Euro Heart Survey of Stable Angina is a multicentre prospective observational study conducted between 2002 and 2003. Patients with a clinical diagnosis of stable angina by a cardiologist were enrolled and follow-up was conducted at 1 year. The primary outcome of...

  19. Rheology of unstable mineral emulsions

    Directory of Open Access Journals (Sweden)

    Sokolović Dunja S.

    2013-01-01

    Full Text Available In this paper, the rheology of mineral oils and their unstable water emulsion were investigated. The oil samples were domestic crude oil UA, its fractions UA1, UA4 and blend semi-product UP1, while the concentration of oil in water emulsions was in the range from 1 up to 30%. The results were analyzed based on shear stress. The oil samples UA, UA1 and UP1 are Newtonian fluids, while UA4 is pseudoplastic fluid. The samples UA and UA4 show higher value of shear stress (83.75 Pa, 297 Pa, then other two samples UA1 and UP1 (18.41 Pa, 17.52 Pa. Rheology of investigated oils due to its complex chemical composition should be analyzed as a simultaneous effect of all their components. Therefore, structural composition of the oils was determined, namely content of paraffins, naphthenes, aromatics and asphaltenes. All samples contain paraffins, naphthenes and aromatics but only oils UA and UA4 contain asphaltenes as well. All investigated emulsions except 30% EUA4 are Newtonian fluids. The EUA4 30% emulsion shows pseudoplastic behaviour, and it is the only 30% emulsion among investigated ones that achieves lower shear stress then its oil. The characteristics of oil samples that could have an influence on their properties and their emulsion rheology, were determined. These characteristics are: neutralization number, interfacial tension, dielectric constant, and emulsivity. Oil samples UA and UA4 have significantly higher values of neutralization number, dielectric constants, and emulsivity. The sample UA has the lowest value of interface tension and the greatest emulsivity, indicating that this oil, among all investigated, has the highest preference for building emulsion. This could be the reason why 20% and 30% emulsions of the oil UA achieve the highest shear stress among all investigated emulsions.

  20. Electromagnetic Radiation Originating from Unstable Electron Oscillations

    DEFF Research Database (Denmark)

    Juul Rasmussen, Jens; Pécseli, Hans

    1975-01-01

    Electromagnetic oscillations in the range 300 – 700 MHz were observed from an unmagnetized argon discharge with an unstable electron velocity distribution function.......Electromagnetic oscillations in the range 300 – 700 MHz were observed from an unmagnetized argon discharge with an unstable electron velocity distribution function....

  1. 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.

  2. Assessing Quality of Life and Medical Care in Chronic Angina: An Internet Survey

    Science.gov (United States)

    2016-01-01

    Background Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to the Internet makes identification of community cohorts feasible and offers a complementary picture of angina. Objective To describe a population self-identified as experiencing chronic angina by use of an Internet survey. Methods Using email and an Internet portal, we invited individuals with a diagnosis of angina and recent symptoms to complete an Internet survey on treatment and quality of life (QOL). In total, 1147 surveys were received. The main analysis was further limited to those reporting a definite coronary heart disease (CHD) history (N=646, 56% of overall). Results Overall, about 15% reported daily angina and 40% weekly angina. Those with more frequent angina were younger, more often depressed, and reported a shorter time since diagnosis. They also had substantially worse treatment satisfaction, physical function, and overall QOL. Fewer than 40% were on ≥ 2 anti-anginals, even with daily angina. The subjects without a history of definite CHD had unexpectedly low use of antianginal and evidence-based medicines, suggesting either a lack of specificity in the use of self-reported angina to identify patients with CHD or lack of access to care. Conclusions Use of inexpensive electronic tools can identify community-based angina cohorts for clinical research. Limitation to subjects with a definite history of CHD lends diagnostic face validity to the approach; however, other symptomatic individuals are also identified. PMID:27125492

  3. 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.

  4. 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.

  5. Cost-utility of enoxaparin compared with unfractionated heparin in unstable coronary artery disease

    Directory of Open Access Journals (Sweden)

    Milne Ruairidh

    2001-10-01

    Full Text Available Abstract Background Low molecular weight heparins hold several advantages over unfractionated heparin including convenience of administration. Enoxaparin is one such heparin licensed in the UK for use in unstable coronary artery disease (unstable stable angina and non-Q wave myocardial infarction. In these patients, two large randomised controlled trials and their meta-analysis showed small benefits for enoxaparin over unfractionated heparin at 30–43 days and potentially at one year. We found no relevant published full economic evaluations, only cost studies, one of which was conducted in the UK. The other studies, from the US, Canada and France, are difficult to interpret since their resource use and costs may not reflect UK practice. Methods We aimed to compare the benefits and costs of short-term treatment (two to eight days with enoxaparin and unfractionated heparin in unstable coronary artery disease. We used published data sources to estimate the incremental cost per quality adjusted life year (QALY, adopting a NHS perspective and using 1998 prices. Results The base case was a 0.013 QALY gain and net cost saving of £317 per person treated with enoxaparin instead of unfractionated heparin. All but one sensitivity analysis showed net savings and QALY gains, the exception (the worst case being a cost per QALY of £3,305. Best cases were a £495 saving and 0.013 QALY gain, or a £317 saving and 0.014 QALY gain per person. Conclusions Enoxaparin appears cost saving compared with unfractionated heparin in patients with unstable coronary artery disease. However, cost implications depend on local revascularisation practice.

  6. Efficacy of a device to narrow the coronary sinus in refractory angina

    DEFF Research Database (Denmark)

    Verheye, Stefan; Jolicœur, E Marc; Behan, Miles W; Pettersson, Thomas; Sainsbury, Paul; Hill, Jonathan; Vrolix, Mathias; Agostoni, Pierfrancesco; Engstrom, Thomas; Labinaz, Marino; de Silva, Ranil; Schwartz, Marc; Meyten, Nathalie; Uren, Neal G; Doucet, Serge; Tanguay, Jean-François; Lindsay, Steven; Henry, Timothy D; White, Christopher J; Edelman, Elazer R; Banai, Shmuel

    2015-01-01

    the coronary sinus, thus redistributing blood into ischemic myocardium. METHODS: We randomly assigned 104 patients with Canadian Cardiovascular Society (CCS) class III or IV angina (on a scale from I to IV, with higher classes indicating greater limitations on physical activity owing to angina) and...... treatment group (37 of 52 patients), as compared with 42% of those in the control group (22 of 52) (P=0.003). Quality of life as assessed with the use of the Seattle Angina Questionnaire was significantly improved in the treatment group, as compared with the control group (improvement on a 100-point scale...

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

    OpenAIRE

    A.A. Anderzhanova; J. V. Gavrilov; V. A. Sulimov

    2016-01-01

    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 metoprol...

  8. 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.

  9. 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. The...... therapeutic effect was good in 87% of the patients who experienced considerably reduced frequency of attacks and markedly reduced opioid consumption (p less than 0.00005). Nine of the patients could reduce opioid consumption and 14 out of 27 could cease their otherwise daily opioid consumption. In four...... patients, the therapeutic effect was unsatisfactory. In the first 22 patients in whom a unipolar electrode was introduced, displacement of the electrode and subsequent reoperation was a frequent problem. This problem disappeared after change to multipolar electrodes as slight changes in placing of the...

  10. Unstable attractors induce perpetual synchronization and desynchronization.

    Science.gov (United States)

    Timme, Marc; Wolf, Fred; Geisel, Theo

    2003-03-01

    Common experience suggests that attracting invariant sets in nonlinear dynamical systems are generally stable. Contrary to this intuition, we present a dynamical system, a network of pulse-coupled oscillators, in which unstable attractors arise naturally. From random initial conditions, groups of synchronized oscillators (clusters) are formed that send pulses alternately, resulting in a periodic dynamics of the network. Under the influence of arbitrarily weak noise, this synchronization is followed by a desynchronization of clusters, a phenomenon induced by attractors that are unstable. Perpetual synchronization and desynchronization lead to a switching among attractors. This is explained by the geometrical fact, that these unstable attractors are surrounded by basins of attraction of other attractors, whereas the full measure of their own basin is located remote from the attractor. Unstable attractors do not only exist in these systems, but moreover dominate the dynamics for large networks and a wide range of parameters. PMID:12675444

  11. How Unstable Are Fundamental Quantum Supermembranes?

    OpenAIRE

    Kaku, Michio

    1996-01-01

    String duality requires the presence of solitonic $p$-branes. By contrast, the existence of fundamental supermembranes is problematic, since they are probably unstable. In this paper, we re-examine the quantum stability of fundamental supermembranes in 11 dimensions. Previously, supermembranes were shown to be unstable by approximating them with SU(n) super Yang-Mills fields as $n \\rightarrow \\infty$. We show that this instability persists even if we quantize the continuum theory from the ver...

  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...... infarction in the first year was 2.3 per 100 patient years; the rate was 3.9 per 100 patient years in the subgroup (n = 994) with angiographic confirmation of coronary disease. The clinical and investigative factors most predictive of adverse outcome were comorbidity, diabetes, shorter duration of symptoms......, increasing severity of symptoms, abnormal ventricular function, resting electrocardiogaphic changes, or not having any stress test done. Results of non-invasive stress tests did not significantly predict outcome in the population who had tests done. A score was constructed using the parameters predictive of...

  13. Evaluating Symptoms to Improve Quality of Life in Patients with Chronic Stable Angina

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Young

    2013-01-01

    Full Text Available Chronic stable angina (CSA is a significant problem in the United States that can negatively impact patient quality of life (QoL. An accurate assessment of the severity of a patient’s angina, the impact on their functional status, and their risk of cardiovascular complications is key to successful treatment of CSA. Active communication between the patient and their healthcare provider is necessary to ensure that patients receive optimal therapy. Healthcare providers should be aware of atypical symptoms of CSA in their patients, as patients may continue to suffer from angina despite the availability of multiple therapies. Patient questionnaires and symptom checklists can help patients communicate proactively with their healthcare providers. This paper discusses the prevalence of CSA, its impact on QoL, and the tools that healthcare providers can use to assess the severity of their patients’ angina and the impact on QoL.

  14. Treatment of refractory chest angina with spinal electrical stimulator: literature review

    International Nuclear Information System (INIS)

    There is a group of patients with chronic refractory chest angina, who are not ideal candidates for surgical or percutaneous revascularization and who although having a good medical handling continues to experience severe episodes of angina. The spinal electrical stimulator is a neuromodulators used as an alternative to treat these patients. The objective is to realize a review of scientific literature regarding the spinal electric stimulation in the treatment of chest angina, its mechanism of action, benefits and its cost effectiveness. Materials and methods: using the Cochrane methodology, a search of articles published from January 1980 to January 2007 in Medline using the terms spinal cord stimulation, was realized. The papers considered most pertinent were selected. Conclusions: the anti-ischemic effect of the electrical spinal stimulator reduces the episodes of chest angina, improves the quality of life and the tolerance to exercise, diminishes the hospital stay and delays the appearance of ischemic signs

  15. 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

    , 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......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...... likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease....

  16. Respiratory compromise: a rare complication of transcutaneous electrical nerve stimulation for angina pectoris.

    OpenAIRE

    Mann, C. J.

    1996-01-01

    Electrical stimulation of any muscle group may produce tetany. If the intercostal muscles are involved this may lead to respiratory embarrasment. A case is presented in which transcutaneous electrical nerve stimulation (TENS) treatment for angina pectoris resulted in respiratory arrest.

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    Buckley, B. S.; Simpson, C.R.; McLernon, D.J.; Murphy, A W; Hannaford, P.C.

    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: ...

  19. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study.

    Directory of Open Access Journals (Sweden)

    Birgitta Söder

    Full Text Available Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom.In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis.Of the 1676 subjects, 51 (28 women/23 men had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years, Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16 than the other subjects (p = 0.02. Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01. Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17-4.17 in the association between high calculus index and angina pectoris (p = 0.015.Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study.

  20. Neurostimulation as an adjuvant therapy for patients with intractable angina pectoris.

    OpenAIRE

    Jongste, Michel Johannes Leendert de

    2009-01-01

    In spite of tremendous improvement in treatment of patients with angina pectoris due to significant coronary artery disease, there remains a group of patients who cannot adequately be treated. These patients are considered as having ‘intractale angina’. Patients, suffering from intractable ischemic disease have never been defined as a separate group and no data are available regarding their morbidity and mortality. Furthermore, since their angina was 'intractable’, no therapy was offered to i...

  1. Prognostic value of early post-infarction angina in elderly patients

    OpenAIRE

    Erceg Predrag; Davidović Mladen; Vasiljević Zorana; Mitrović Predrag M.; Vukčević Vladan D.; Milošević Dragoslav P.; Stević Radmila; Rajić Miodrag

    2005-01-01

    Although numerous studies have shown that early post-infarction angina was a predictor of poor prognosis in patients with acute myocardial infarction, not a single study has considered this issue in the elderly. The goal of this study, based on a five-year follow-up of elderly patients with acute myocardial infarction, was to determine whether early post-infarction angina in the elderly had any influence on mortality and the incidence of additional coronary events. The study population consis...

  2. Clinical and angiographic features associated with coronary collateralization in stable angina patients with chronic total occlusion

    OpenAIRE

    Sun, Zhen; Shen, Ying; Lu, Lin; Zhang, Rui-yan; Pu, Li-jin; Zhang, Qi; Yang, Zheng-kun; Hu, Jian; Chen, Qiu-jing; Shen, Wei-Feng

    2013-01-01

    Objective: Coronary collateral circulation is an alternative source of blood supply to myocardium in the presence of advanced coronary artery disease. We sought to determine which clinical and angiographic variables are associated with collateral development in patients with stable angina and chronic total coronary occlusion. Methods: Demographic variables, biochemical measurements, and angiographic findings were collected from 478 patients with stable angina and chronic total coronary occlus...

  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 cohor...... 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. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study

    Science.gov (United States)

    2016-01-01

    Objectives Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom. Methods In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis. Results Of the 1676 subjects, 51 (28 women/23 men) had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years), Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16) than the other subjects (p = 0.02). Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01). Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17–4.17) in the association between high calculus index and angina pectoris (p = 0.015). Conclusion Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study. PMID:27336307

  5. Safety and Efficacy of Ranolazine for the Treatment of Chronic Angina Pectoris

    OpenAIRE

    Mohammed Aldakkak; Stowe, David F; Camara, Amadou K.S.

    2013-01-01

    Coronary heart disease is a global malady and it is the leading cause of death in the United States. Chronic stable angina is the most common manifestation of coronary heart disease and it results from the imbalance between myocardial oxygen supply and demand due to reduction in coronary blood flow. Therefore, in addition to lifestyle changes, commonly used pharmaceutical treatments for angina (nitrates, β-blockers, Ca2+ channel blockers) are aimed at increasing blood flow or decreasing O2 de...

  6. Evaluation of coronary microvascular function in patients with vasospastic angina

    Directory of Open Access Journals (Sweden)

    Ken Ishibashi

    2013-01-01

    Full Text Available AIM: To investigate endothelium-dependent and -independent coronary microvascular functions in patients with vasospastic angina (VSA. METHODS: Thirty-six patients with VSA (30 men and 6 women; mean age, 58 years were enrolled in this study. VSA was defined as ≥ 90% narrowing of the epicardial coronary arteries on angiography performed during a spasm provocation test, presence of chest pain, and/or ST-segment deviation on an electrocardiogram (ECG. Patients (n = 36 with negative spasm provocation test results and those matched for age and sex were enrolled as a control group (nonVSA group. Low-dose acetylcholine (ACh; 3 μg/min was infused into the left coronary ostium for 2 min during the spasm provocation test. Following the spasm provocation test, nitroglycerin (0.2 mg was administered intracoronally. Coronary blood flow (was calculated from quantitative angiography and Doppler flow velocity measurements, and the coronary flow reserve was calculated as the ratio of coronary flow velocity after injection of adenosine triphosphate (20 μg to the baseline value. Changes in the coronary artery diameter in response to ACh and nitroglycerin infusion were expressed as percentage changes from baseline measurements. RESULTS: Body mass index was significantly lower in the VSA group than in the nonVSA group. The frequency of conventional coronary risk factors and the rate of statin use were similar between the 2 groups. The left ventricular ejection fraction as evaluated by echocardiography was similar between the 2 groups. The duration of angina was 9 ± 2 mo. The results of blood chemistry analysis were similar between the 2 groups. Low-dose ACh did not cause coronary spasms. The change in coronary artery diameter in response to ACh was lower in the VSA group (-1.4% ± 9.3% than in the nonVSA group (3.1% ± 6.5%, P < 0.05, whereas nitroglycerin-induced coronary artery dilatation and coronary blood flow increase in response to ACh or coronary flow

  7. Unstable surface waves in running water

    OpenAIRE

    Hur, Vera Mikyoung; Lin, Zhiwu

    2007-01-01

    We consider the stability of periodic gravity free-surface water waves traveling downstream at a constant speed over a shear flow of finite depth. In case the free surface is flat, a sharp criterion of linear instability is established for a general class of shear flows with inflection points and the maximal unstable wave number is found. Comparison to the rigid-wall setting testifies that free surface has a destabilizing effect. For a class of unstable shear flows, the bifurcation of nontriv...

  8. 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.

  9. Unstable electromagnetic modes in strongly magnetized plasmas

    OpenAIRE

    Son, S.; Moon, Sung Joon

    2011-01-01

    The electromagnetic modes possibly unstable in strongly magnetized plasmas are identified. The regime where this instability might stand out compared to the incoherent electron-cyclotron radiation is explored. These modes are relevant to the inertial confinement fusion and the gamma ray burst.

  10. Unstable electromagnetic modes in magnetized Maxwellian plasma

    CERN Document Server

    Son, S

    2011-01-01

    The electromagnetic modes that can be unstable even in a magnetized Maxwellian plasma is studied. The free energy involved in the instability is originated from the gyro-motion. The regime where the radiation via this instability stands out compared to the electron cyclotron radiation is explored. These modes are relevant with the inertial confinement fusion and the gamma ray burst.

  11. 40 CFR 258.15 - Unstable areas.

    Science.gov (United States)

    2010-07-01

    ... determining whether an area is unstable: (1) On-site or local soil conditions that may result in significant... MSWLF unit, because of natural or man-induced events, results in the downslope transport of soil and... to, landslides, avalanches, debris slides and flows, soil fluction, block sliding, and rock fall....

  12. Optical isotope shifts for unstable samarium isotopes

    International Nuclear Information System (INIS)

    Using a tunable dye laser beam intersecting a thermal atomic beam, optical isotope shifts and hyperfine splittings have been measured for the four unstable samarium isotopes between 144Sm and 154Sm, covering the well known transition region from spherical to deformed shapes. (orig.)

  13. Energy of unstable states at long times

    CERN Document Server

    Urbanowski, K

    2009-01-01

    An effect generated by the nonexponential behavior of the survival amplitude of an unstable state in the long time region is considered. In 1957 Khalfin proved that this amplitude tends to zero as $t\\to\\infty$ more slowly than any exponential function of $t$. For a time-dependent decay rate $\\gamma(t)$ Khalfin's result means that this $\\gamma(t)$ is not a constant for large $t$ but that it tends to zero as $t\\to\\infty$. We find that a similar conclusion can be drawn for the instantaneous energy of the unstable state for a large class of models of unstable states: This energy tends to the minimal energy of the system ${\\cal E}_{min}$ as $t\\to\\infty$ which is much smaller than the energy of this state for $t$ of the order of the lifetime of the considered state. Analyzing the transition time region between exponential and non-exponential form of the survival amplitude we find that the instantaneous energy of a considered unstable state can take large values, much larger than the energy of this state for $t$ fro...

  14. 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

  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, Ptrimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration. PMID:25466565

  16. 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

  17. The Fate of Unstable Circumbinary Planets

    Science.gov (United States)

    Kohler, Susanna

    2016-03-01

    What happens to Tattooine-like planets that are instead in unstable orbits around their binary star system? A new study examines whether such planets will crash into a host star, get ejected from the system, or become captured into orbit around one of their hosts.Orbit Around a DuoAt this point we have unambiguously detected multiple circumbinary planets, raising questions about these planets formation and evolution. Current models suggest that it is unlikely that circumbinary planets would be able to form in the perturbed environment close their host stars. Instead, its thought that the planets formed at a distance and then migrated inwards.One danger such planets face when migrating is encountering ranges of radii where their orbits become unstable. Two scientists at the University of Chicago, Adam Sutherland and Daniel Fabrycky, have studied what happens when circumbinary planets migrate into such a region and develop unstable orbits.Producing Rogue PlanetsTime for planets to either be ejected or collide with one of the two stars, as a function of the planets starting distance (in AU) from the binary barycenter. Colors represent different planetary eccentricities. [Sutherland Fabrycky 2016]Sutherland and Fabrycky used N-body simulations to determine the fates of planets orbiting around a star system consisting of two stars a primary like our Sun and a secondary roughly a tenth of its size that are separated by 1 AU.The authors find that the most common fate for a circumbinary planet with an unstable orbit is ejection from the system; over 80% of unstable planets were ejected. This has interesting implications: if the formation of circumbinary planets is common, this mechanism could be filling the Milky Way with a population of free-floating, rogue planets that no longer are associated with their host star.The next most common outcome for unstable planets is collision with one of their host stars (most often the secondary), resulting inaccretion of the planet

  18. How Unstable Are Fundamental Quantum Supermembranes?

    CERN Document Server

    Kaku, M

    1996-01-01

    String duality requires the presence of solitonic $p$-branes. By contrast, the existence of fundamental supermembranes is problematic, since they are probably unstable. In this paper, we re-examine the quantum stability of fundamental supermembranes in 11 dimensions. Previously, supermembranes were shown to be unstable by approximating them with SU(n) super Yang-Mills fields as $n \\rightarrow \\infty$. We show that this instability persists even if we quantize the continuum theory from the very beginning. Second, we speculate how a theory of decaying membranes may still be physically relevant. We present some heuristic arguments showing that light membranes may be too short-lived to be detected, while very massive membranes, with longer lifetimes, may have only very weak coupling to the particles we see in nature. Either way, decaying membranes would not be detectable in the lab.

  19. Evolution in time of moving unstable systems

    International Nuclear Information System (INIS)

    Relativistic quantum theory shows that the known Einstein time dilaton (ED) approximately holds for the decay law of the unstable particle having definite momentum p (DP). A different definition of the moving particle as the state with definite velocity v (DV) is used. It is shown that in this case the decay law is not dilated. On the contrary, it is contracted as compared with the decay law of the particle at rest. It is demonstrated that ED fails in both DP and DV cases for time evolution of the simple unstable system of the kind of oscillating neutrino. Experiments are known which show that ED holds for mesons. The used theory may explain the fact by supposing that the measured mesons are in DP state

  20. Decay law of moving unstable particle

    International Nuclear Information System (INIS)

    Quantum relativistic decay law of moving unstable particle is analytically calculated in the model case of the Breit-Wigner mass distribution. It turns out that Einstein time dilation of the moving particle decay holds approximately at times when the decay is exponential. The related correction is calculated analytically. Being very small at these times it is practically unobservable. It is shown that Einstein dilation fails for large times t when decay is not exponential. An unstable system of the kind of K0 meson (which is the superposition of Ks and Kl) is also considered. In this case, the violation of Einstein dilation is shown to be appreciable at all times under some condition

  1. Transition phenomena in unstably stratified turbulent flows

    OpenAIRE

    Bukai, M.; Eidelman, A.; Elperin, T.; Kleeorin, N.; Rogachevskii, I.; Sapir-Katiraie, I.

    2009-01-01

    We study experimentally and theoretically transition phenomena caused by the external forcing from Rayleigh-Benard convection with the large-scale circulation (LSC) to the limiting regime of unstably stratified turbulent flow without LSC whereby the temperature field behaves like a passive scalar. In the experiments we use the Rayleigh-B\\'enard apparatus with an additional source of turbulence produced by two oscillating grids located nearby the side walls of the chamber. When the frequency o...

  2. Effects on blood pressure in patients with refractory angina pectoris after enhanced external counterpulsation

    DEFF Research Database (Denmark)

    Bondesson, Susanne; Pettersson, Thomas; Ohlsson, Børje Ola Mattias;

    2010-01-01

    OBJECTIVE: Enhanced external counterpulsation (EECP) is a non-invasive technique that has been shown to reduce the frequency and severity of angina pectoris. Little is known how EECP affects the blood pressure. METHODS: 153 patients with refractory angina were treated with either EECP or retained...... on their pharmacological treatment (reference group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and heart rate were measured pre- and post-treatment and at 12 months follow-up. RESULTS: EECP treatment altered the blood pressure in patients with...... refractory angina pectoris. A decrease in the blood pressure was more common in the EECP group compared with the reference group. In the reference group, an increase in the blood pressure was more common. A correlation between a decrease in blood pressure after EECP treatment and a higher baseline MAP, SBP...

  3. Die Bedeutung der Kaliumkanalöffner für die Therapie der Angina pectoris

    Directory of Open Access Journals (Sweden)

    Auer J

    2003-01-01

    Full Text Available In der Behandlung der koronaren Herzkrankheit ist primär die Senkung der Ereignisrate (Mortalität, Koronarletalität, Myokardinfarkt, rezidivierende Angina, Insult, Herzinsuffizienz, Revaskularisationen anzustreben. Zusätzlich ist die Zielsetzung der antianginösen Therapie vor allem die Verbesserung der Belastungstoleranz sowie die Reduktion von ischämiebedingten Folgeerscheinungen. Für die antianginöse Therapie stehen vier Wirkstoffklassen zur Verfügung, die ein differenziertes Vorgehen erlauben und die wahlweise als Monotherapien oder in Kombination in der Therapie der stabilen Angina pectoris zur Anwendung kommen können: Betablocker, Nitrate, Kalziumantagonisten und Kaliumkanalöffner. Im Rahmen der IONA-Studie (Impact Of Nicorandil in Angina wurde rezent überprüft, ob unter einer Therapie mit Nicorandil bei Patienten mit chronisch stabiler Angina pectoris die Häufigkeit schwerwiegender koronarer Ereignisse verringert werden könnte. Mit dieser Studie konnte nun ein eindeutiger Hinweis für eine Reduktion ischämiebezogener klinischer Ereignisse unter Nicorandil bei Patienten mit Angina pectoris nachgewiesen werden. Während für die antianginöse Therapie bisher lediglich eine symptomlindernde Wirkung zweifelsfrei dokumentiert ist, verbessern Maßnahmen zur Verhinderung von Thrombose- und Atheromentwicklung die Prognose (Aspirin, Cumarine, ACE-Hemmer und Lipidsenker [Statine] sowie Lebensstilmodifikation einschließlich Nikotinkarenz. Grundsätzlich sollte darüber hinaus bei Patienten mit Angina-pectoris-Beschwerden immer die Option einer Koronarangiographie und Koronarintervention (PTCA, Stent, Bypass überlegt werden.

  4. [Thiotriazoline in the Treatment of Stable Angina Pectoris of II-III Functional Class].

    Science.gov (United States)

    Kadin, D V; Chumak, B A; Filippov, A E; Shustov, S B

    2015-01-01

    Trimetazidine is a metabolic agent of proven efficacy in improving myocardial ischemia and angina. A comparative international multicenter randomized trial, assessed anti-anginal anti ischemic efficacy and safety of Trimetazidine (60 mg/d) and Thiotriazoline (600 mg/d) in symptomatic patients with chronic ischemic heart disease receiving the first line therapy. The study assessed the efficacy of the two drugs on total exercise duration, time to 1-mm ST segment depression, the number of angina attacks and nitroglycerin tablets consumed amount. Both drugs have demonstrated clinical efficacy equal for all primary and secondary endpoints. PMID:26761968

  5. The fate of unstable gauge flux compactifications

    Energy Technology Data Exchange (ETDEWEB)

    Burgess, C.P. [McMaster Univ., Hamilton, ON (Canada). Dept. of Physics and Astronomy]|[Perimeter Institute for Theoretical Physics, Waterloo, ON (Canada); Parameswaran, S.L. [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Zavala, I. [Bonn Univ. (Germany). Bethe Center for Theoretical Physics and Physikalisches Inst.

    2008-12-15

    Fluxes are widely used to stabilise extra dimensions, but the supporting monopolelike configurations are often unstable, particularly if they arise as gauge flux within a non-abelian gauge sector. We here seek the endpoint geometries to which this instability leads, focussing on the simplest concrete examples: sphere-monopole compactifications in six dimensions. Without gravity most monopoles in non-abelian gauge groups are unstable, decaying into the unique stable monopole in the same topological class. We show that the same is true in Einstein-YM systems, with the new twist that the decay leads to a shrinkage in the size of the extra dimensions and curves the non-compact directions: in D dimensions a Mink{sub D-2} x S{sub 2} geometry supported by an unstable monopole relaxes to AdS{sub D-2} x S{sub 2}, with the endpoint sphere smaller than the initial one. For supergravity the situation is more complicated because the dilaton obstructs such a simple evolution. The endpoint instead acquires a dilaton gradient, thereby breaking some of the spacetime symmetries. For 6D supergravity we argue that it is the 4D symmetries that break, and examine several candidates for the endpoint geometry. By using the trick of dimensional oxidation it is possible to recast the supergravity system as a higher-dimensional Einstein-YM monopole, allowing understanding of this system to guide us to the corresponding endpoint. The result is a Kasner-like geometry conformal to Mink{sub 4} times S{sub 2}, with nontrivial conformal factor and dilaton breaking the maximal 4D symmetry and generating a singularity. Yet the resulting configuration has a lower potential energy than did the initial one, and is perturbatively stable, making it a sensible candidate endpoint for the evolution. (orig.)

  6. The fate of unstable gauge flux compactifications

    International Nuclear Information System (INIS)

    Fluxes are widely used to stabilise extra dimensions, but the supporting monopolelike configurations are often unstable, particularly if they arise as gauge flux within a non-abelian gauge sector. We here seek the endpoint geometries to which this instability leads, focussing on the simplest concrete examples: sphere-monopole compactifications in six dimensions. Without gravity most monopoles in non-abelian gauge groups are unstable, decaying into the unique stable monopole in the same topological class. We show that the same is true in Einstein-YM systems, with the new twist that the decay leads to a shrinkage in the size of the extra dimensions and curves the non-compact directions: in D dimensions a MinkD-2 x S2 geometry supported by an unstable monopole relaxes to AdSD-2 x S2, with the endpoint sphere smaller than the initial one. For supergravity the situation is more complicated because the dilaton obstructs such a simple evolution. The endpoint instead acquires a dilaton gradient, thereby breaking some of the spacetime symmetries. For 6D supergravity we argue that it is the 4D symmetries that break, and examine several candidates for the endpoint geometry. By using the trick of dimensional oxidation it is possible to recast the supergravity system as a higher-dimensional Einstein-YM monopole, allowing understanding of this system to guide us to the corresponding endpoint. The result is a Kasner-like geometry conformal to Mink4 times S2, with nontrivial conformal factor and dilaton breaking the maximal 4D symmetry and generating a singularity. Yet the resulting configuration has a lower potential energy than did the initial one, and is perturbatively stable, making it a sensible candidate endpoint for the evolution. (orig.)

  7. Starting up unstable multivariable controllers safety

    DEFF Research Database (Denmark)

    Stoustrup, J.; Niemann, Hans Henrik

    The problem of superimposing a multivariable controller on a running plant is considered. A simple but effective controller architecture is suggested which allows the transition from a conventional controller to a full multivariable controller to take place in a continuous way. This architecture...... allows for unstable controllers to be handled in a reliable way. Moreover, bandwidth properties can be tuned separately. It is shown how this architecture can be extended to provide a useful tool to implement gain scheduled controllers in the same fashion....

  8. Extended asymptotic theory of unstable resonator modes.

    Science.gov (United States)

    Li, Y Q; Sung, C C

    1990-10-20

    The modes in an unstable resonator can be computed within the limit of a large Fresnel number using the asymptotic expansion of the diffraction integral, as shown by Horwitz, Butts, and Avizonis. The expansion is not valid for the points of interest around or beyond the shadow boundary of the output light. We use a better numerical representation, which extends the regions of use. The comparison of several cases with earlier work shows that the asymptotic theory can be successfully applied for all parameters without restrictions. PMID:20577410

  9. Annular diffraction of very unstable light nuclei

    International Nuclear Information System (INIS)

    Because they are brittle, unstable light nuclei can produce an annular diffraction pattern observed on their decay products with large cross sections. With such a simple model, the 9Li angular distribution observed in the 11Li fragmentation have been reproduced together with the reaction cross-section and the fragmentation yield provided recoil effects from neutron emission are included. It results that for this projectile and for light targets, diffraction is the main source of transverse momentum for 9Li whereas for neutrons it originates from its emission energy in the 11Li center of mass

  10. Unstable Jefferson fractures: Results of transoral osteosynthesis

    Directory of Open Access Journals (Sweden)

    Yong Hu

    2014-01-01

    Full Text Available Background: Majority of C 1 fractures can be effectively treated conservatively by immobilization or traction unless there is an injury to the transverse ligament. Conservative treatment usually involves a long period of immobilization in a halo-vest. Surgical intervention generally involves fusion, eliminating the motion of the upper cervical spine. We describe the treatment of unstable Jefferson fractures designed to avoid these problems of both conservative and invasive methods. Materials and Methods: A retrospective review of 12 patients with unstable Jefferson fractures treated with transoral osteosynthesis of C 1 between July 2008 and December 2011 was performed. A steel plate and C 1 lateral mass screw fixation were used to repair the unstable Jefferson fractures. Our study group included eight males and four females with an average age of 33 years (range 23-62 years. Results: Patients were followed up for an average of 16 months after surgery. Range of motion of the cervical spine was by and large physiologic: Average flexion 35° (range 28-40°, average extension 42° (range 30-48°. Lateral bending to the right and left averaged 30° and 28° respectively (range 12-36° and 14-32° respectively. The average postoperative rotation of the atlantoaxial joint, evaluated by functional computed tomography scan was 60° (range 35-72°. Total average lateral displacement of the lateral masses was 7.0 mm before surgery (range 5-12 mm, which improved to 3.5 mm after surgery (range 1-6.5 mm. The total average difference of the atlanto-dens interval in flexion and extension after surgery was 1.0 mm (range 1-3 mm. Conclusions: Transoral osteosynthesis of the anterior ring using C 1 lateral mass screws is a viable option for treating unstable Jefferson fractures, which allows maintenance of rotation at the C 1-C 2 joint and restoration of congruency of the atlanto-occipital and atlantoaxial joints.

  11. Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients.

    Directory of Open Access Journals (Sweden)

    Jing Wu

    Full Text Available OBJECTIVES: To compare health-related quality of life (HRQoL between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS: A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411 and the general population recruited from 3 Physical Examination Centers (n = 549 was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ. Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS: Compared with the general population (44.2 ± 10 years, 49.9% females, stable angina patients (68.1 ± 12 years, 50.4% females had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05, SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05, and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05. The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6. Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS: Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms

  12. 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

  13. Spinal cord stimulation in chronic intractable angina pectoris : A randomized, controlled efficacy study

    NARCIS (Netherlands)

    Hautvast, RWM; DeJongste, MJL; Staal, MJ; van Gilst, WH; Lie, KI

    1998-01-01

    Background Spinel cord stimulation is known to be a successful treatment for chronic intractable angina pectoris. its effect may be anti-ischemic. It is uncertain if the clinical effect is partly caused by a placebo effect of surgery For implantation of a stimulator. In this study, clinical efficacy

  14. Angina pectoris refractory for conventional therapy - Is neurostimulation a possible alternative treatment?

    NARCIS (Netherlands)

    Hautvast, RWM; DeJongste, MJL; TerHorst, GJ; Blanksma, PK; Lie, KI

    1996-01-01

    The treatment of angina pectoris as a symptom of coronary artery disease usually is focused on restoring the balance between oxygen demand and supply of the myocardium by administration of drugs interfering in heart rate, cardiac pre- and afterload, and coronary vascular tone. For nonresponders to d

  15. 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

    Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report ...

  16. Dynamics and statistics of unstable quantum states

    Energy Technology Data Exchange (ETDEWEB)

    Sokolov, V.V.; Zelevinsky, V.G. (AN SSSR, Novosibirsk. Inst. Yadernoj Fiziki (USSR))

    1989-11-20

    The statistical theory of spectra formulated in terms of random matrices is extended to unstable states. The energies and widths of these states are treated as real and imaginary parts of complex eigenvalues for an effective non-hermitian hamiltonian. Eigenvalue statistics are investigated under simple assumptions. If the coupling through common decay channels is weak we obtain a Wigner distribution for the level spacings and a Porter-Thomas one for the widths, with the only exception for spacings less than widths where level repulsion fades out. Meanwhile in the complex energy plane the repulsion of eigenvalues is quadratic in accordance with the T-noninvariant character of decaying systems. In the opposite case of strong coupling with the continuum, k short-lived states are formed (k is the number of open decay channels). These states accumulate almost the whole total width, the rest of the states becoming long-lived. Such a perestroika corresponds to separation of direct processes (a nuclear analogue of Dicke coherent superradiance). At small channel number, Ericson fluctuations of the cross sections are found to be suppressed. The one-channel case is considered in detail. The joint distribution of energies and widths is obtained. The average cross sections and density of unstable states are calculated. (orig.).

  17. Existence of the fifth unstable nuclide series

    Institute of Scientific and Technical Information of China (English)

    张家骅

    1996-01-01

    The production of derived nuclides by the reaction of 238U with constant nuclear reactor neutron flux for long time is theoretically described.The concentration of each derived nuclide is zero at the beginning.then increases gradually and approaches a saturated value at a certain irradiation time.The whole system(including the parent nuclide 238U and all its derived nuclides)will be in a state of equilibrium.Upon the reaction with neutron flux,the whole system decreases its concentration at the same rate as 238U.It constitutes actually a new type of unstable nuclide series which is in owrk only in the presence of reactor neutron flux.It has been found that the amount of materials consumed by neutron flux reaction is almost converted entrely to fission product.This peculiar property is quite different from the well known four radioactive series,so that it is named the fifth unstable nuclide series.

  18. Transition phenomena in unstably stratified turbulent flows.

    Science.gov (United States)

    Bukai, M; Eidelman, A; Elperin, T; Kleeorin, N; Rogachevskii, I; Sapir-Katiraie, I

    2011-03-01

    We study experimentally and theoretically the transition phenomena caused by external forcing from Rayleigh-Bénard convection with large-scale circulation (LSC) to the limiting regime of unstably stratified turbulent flow without LSC, where the temperature field behaves like a passive scalar. In the experiments we use the Rayleigh-Bénard apparatus with an additional source of turbulence produced by two oscillating grids located near the sidewalls of the chamber. When the frequency of the grid oscillations is larger than 2 Hz, the LSC in turbulent convection is destroyed, and the destruction of the LSC is accompanied by a strong change of the mean temperature distribution. However, in all regimes of the unstably stratified turbulent flow the ratio [(ℓ{x}∇{x}T)²+(ℓ{y}∇{y}T)² + (ℓ{z}∇{z}T)²]/ varies slightly (even in the range of parameters where the behavior of the temperature field is different from that of the passive scalar). Here ℓ{i} are the integral scales of turbulence along the x,y,z directions, and T and θ are the mean and fluctuating parts of the fluid temperature. At all frequencies of the grid oscillations we have detected long-term nonlinear oscillations of the mean temperature. The theoretical predictions based on the budget equations for turbulent kinetic energy, turbulent temperature fluctuations, and turbulent heat flux, are in agreement with the experimental results. PMID:21517582

  19. Effect of Teriparatide on Unstable Pertrochanteric Fractures

    Directory of Open Access Journals (Sweden)

    Tsan-Wen Huang

    2015-01-01

    Full Text Available We retrospectively analyzed the radiographic and clinical outcomes of unstable pertrochanteric fractures (AO/OTA 31-A2 in 44 patients who underwent dynamic hip screw (DHS fixation and compared the results with 29 patients who received teriparatide in addition to DHS fixation. A significantly shorter time for fracture healing was recorded in the teriparatide-treated group than in the control group. Rates of lag screw sliding, femoral shortening, and varus collapse were all significantly reduced in the teriparatide-treated group. There were no significant differences with regard to superficial wound infection, pneumonia, urinary tract infection, mortality, malunion, and cutting of the lag screw. The mean overall mobility scores were significantly better in the teriparatide-treated group at 3 and 6 months (P<0.001 and P<0.001, resp. but not at 12 months or the last follow-up. The pain scores were also significantly better in the teriparatide-treated group at 3 and 6 months (P=0.040 and P=0.041, resp. but not at 12 months or the last follow-up. Teriparatide improves radiographic outcomes and yields better clinical outcomes at 3 and 6 months postoperatively. The improvement in union time may be important for elderly populations with unstable pertrochanteric fractures to enable them to return to daily activities and reduce morbidity and mortality.

  20. CT of hemodynamically unstable abdominal trauma

    International Nuclear Information System (INIS)

    This article is an appraisal of the use of CT in the management of patients with unstable abdominal trauma. We examined 41 patients with abdominal trauma using noncontrast dynamic CT. In 17 patients a postcontrast dynamic CT was also carried out. On CT, 25 patients had hemoperitoneum. Thirteen patients had splenic, 12 hepatic, 6 pancreatic, 8 bowel and mesenteric, 12 renal and 2 vascular injuries. Seven patients had retroperitoneal and 2 patients adrenal hematomas. All but five lesions (three renal, one pancreatic, and one splenic) were hypodense when CT was performed earlier than 8 h following the injury. Postcontrast studies (n = 17), revealed 4 splenic, 3 hepatic, 1 pancreatic, 3 renal, and 2 bowel and mesenteric injuries beyond what was found on noncontrast CT. Surgical confirmation (n = 21) was obtained in 81.81 % of splenic, 66.66 % of hepatic, 83.33 % of pancreatic, 100 % of renal, 100 % of retroperitoneal, and 85.71 % of bowel and mesenteric injuries. The majority of false diagnoses was obtained with noncontrast studies. Computed tomography is a remarkable method for evaluation and management of patients with hemodynamically unstable abdominal trauma, but only if it is revealed in the emergency room. Contrast injection, when it could be done, revealed lesions that were not suspected on initial plain scans. (orig.)

  1. Dynamics and statistics of unstable quantum states

    International Nuclear Information System (INIS)

    The statistical theory of spectra formulated in terms of random matrices is extended to unstable states. The energies and widths of these states are treated as real and imaginary parts of complex eigenvalues for an effective non-hermitian hamiltonian. Eigenvalue statistics are investigated under simple assumptions. If the coupling through common decay channels is weak we obtain a Wigner distribution for the level spacings and a Porter-Thomas one for the widths, with the only exception for spacings less than widths where level repulsion fades out. Meanwhile in the complex energy plane the repulsion of eigenvalues is quadratic in accordance with the T-noninvariant character of decaying systems. In the opposite case of strong coupling with the continuum, k short-lived states are formed (k is the number of open decay channels). These states accumulate almost the whole total width, the rest of the states becoming long-lived. Such a perestroika corresponds to separation of direct processes (a nuclear analogue of Dicke coherent superradiance). At small channel number, Ericson fluctuations of the cross sections are found to be suppressed. The one-channel case is considered in detail. The joint distribution of energies and widths is obtained. The average cross sections and density of unstable states are calculated. (orig.)

  2. Accelerator complex for unstable beams at INS

    International Nuclear Information System (INIS)

    The construction of the prototype facility of the Exotic arena in the Japan Hadron Project (JHP) is started in 1992 at the Institute for Nuclear Study (INS), University of Tokyo. The purpose of this facility is to study the various technical problems of the Exotic arena, and to perform the experiment on nuclear and astrophysics with unstable nuclear beam. The unstable nuclei produced by bombarding a thick target with 40 MeV proton beam from the existing SF cyclotron are ionized in the ion sources, mass-analyzed by an ISOL, and transported to the accelerator complex. The accelerator complex consists of a split coaxial RFQ and an interdigital H type linac. The construction of accelerator will be completed in fiscal year 1994. The development of the SCRFQ and the IH linac which is suitable to the post-accelerator of the SCRFQ are reported. Charge stripper and the beam matching between the SCRFQ and the IH linac are explained. A buncher is necessary for the matching of longitudinal phase space between the SCRFQ and the IH linac. (K.I.)

  3. Manejo de la angina refractaria con estimulación eléctrica espinal: revisión de la literatura Treatment of refractory chest angina with spinal electrical stimulator: literature review

    OpenAIRE

    Omar F Gomezese; Paola Aranda; Luis E Echeverría; José F Saibi; Jaime Calderón; Juan G Barrera

    2008-01-01

    Justificación: existe un grupo de pacientes con angina de pecho crónica refractaria, que no son candidatos a revascularización quirúrgica o percutánea y que a pesar de recibir un manejo médico óptimo, aún experimentan severos episodios de angina. El estimulador eléctrico espinal es un neuromodulador que se emplea como alternativa de manejo en estos pacientes. Objetivos: se realizó una revisión sobre estimulación eléctrica espinal en el manejo de la angina, su mecanismo de acción, sus benefici...

  4. Evaluation of coronary hemodynamics and exercise sup 201 Tl-myocardial scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kentaro; Nakase, Emiko; Haiyama, Tohru; Hasegawa, Akira; Saito, Takayuki (Kyoto Minami Hospital (Japan))

    1992-05-01

    To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina, we performed exercise {sup 201}Tl-myocardial scintigraphy (planar and SPECT) in 72 patients and left coronary digital subtraction angiography (DSA) in 37 patients without significant organic coronary artery stenosis. Coronary artery spasm was documented by coronary angiography in all patients. Fifty-four patients (75%) developed exercise-induced {sup 201}Tl-myocardial perfusion defect on SPECT. {sup 201}Tl pulmonary uptake (L/H) was significantly increased in patients with vasospastic angina. Especially, L/H was higher in patients with multiple small perfusion defect on {sup 201}Tl-SPECT, so that exercise-induced left ventricular dysfunction existed in patients with vasospastic angina and especially in cases of multiple small perfusion defect on {sup 201}Tl-SPECT. The left coronary circulation time (CCT) was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina, but its abnormal coronary circulation had no relation to location of spasm-induced vessels. We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. (author).

  5. Transcoronary sinus administration of autologous bone marrow in patients with chronic refractory stable angina

    International Nuclear Information System (INIS)

    Purpose: Based on our preclinic studies with autologous unfractionated bone marrow (AUBM) via coronary sinus with transitory occlusion, a clinic study in patients with chronic stable angina was designed. The objectives were to evaluate safety, tolerance and feasibility. Methods and materials: A multicenter prospective study with inclusion and exclusion criteria defined by an Independent Clinical Committee was carried out. Fourteen patients underwent transcoronary sinus administration of freshly aspirated and filtered AUBM (60-120 ml). Safety and tolerance were evaluated. Feasibility was evaluated with Seattle Angina Questionnaire (SAQ), Canadian Cardiovascular Society (CCS) angina classification (baseline-Day 180), myocardial perfusion (baseline-Day 90) with independent core laboratory and coronary angiography (baseline and Day 30). Results: There were no changes in the safety and tolerance parameters. Preliminary clinical efficacy at Day 180 disclosed a significant improvement of 38%, evaluated by the SAQ. The CCS angina classification shows that the mean angina class was 3.0±0.55 at baseline and improved to 2.0±0.00 at Day 180 (P<.001). Semiquantitative radionuclide perfusion imaging (core lab) showed a significant improvement at Day 90 in 13/14 patients, with a mean improvement of 24% at rest (P<.01) and 33% at stress (P<.05). Coronary angiography showed more collateral vessels in 9/14 patients. Conclusions: We can conclude that AUBM via coronary sinus with transitory occlusion is tolerable and safe. Significant improvement in the myocardial perfusion at Day 90 and in the quality of life at Day 180 was observed

  6. 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.

  7. VEGF 165 Gene Therapy for Patients with Refractory Angina: Mobilization of Endothelial Progenitor Cells

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Clarissa G. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Duke University Medical Center, Durham, North Carolina (United States); Plentz, Rodrigo D.M. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Dipp, Thiago [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Salles, Felipe B. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Giusti, Imarilde I.; Sant' Anna, Roberto T.; Eibel, Bruna; Nesralla, Ivo A.; Markoski, Melissa [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Beyer, Nance N. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Kalil, Renato A. K., E-mail: kalil.pesquisa@gmail.com [Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil)

    2013-08-15

    Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9{sup th} and 27{sup th} was comparable to that at baseline. We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on 9{sup th} and 27{sup th}days.

  8. 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. PMID:12686334

  9. VEGF 165 Gene Therapy for Patients with Refractory Angina: Mobilization of Endothelial Progenitor Cells

    International Nuclear Information System (INIS)

    Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9th and 27th was comparable to that at baseline. We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on 9th and 27thdays

  10. Management of a patient with unstable angina, left main coronary artery disease, and respiratory insufficiency due to eventration of the diaphragm.

    Science.gov (United States)

    Khanna, Surendra Nath; Paul, Mathews; Bal, Sabyasachi; Karlekar, Anil

    2013-09-01

    The incidence of eventration of diaphragm before cardiac surgery is rare. We describe the management of a patient with eventration of the diaphragm who underwent a coronary artery bypass grafting (CABG) for left main coronary artery disease followed by left diaphragm plication with video-assisted thoracic surgery (VATS) for the postoperative respiratory insufficiency. PMID:23901850

  11. Long-term outcomes for women versus men with unstable angina/non-ST-segment elevation myocardial infarction managed medically without revascularization

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Roe, Matthew T; Hochman, Judith S;

    2015-01-01

    -term ischemic and bleeding outcomes and platelet reactivity for medically managed ACS patients randomized to prasugrel versus clopidogrel plus aspirin. METHODS: Data from 9,326 patients enrolled in TRILOGY ACS were analyzed to determine differences in long-term ischemic and bleeding outcomes between women (n...... = 3,650 [39%]) and men (n = 5,676 [61%]) randomized to prasugrel 10 mg/d (5 mg/d for patients ≥75 years and/or <60 kg) versus clopidogrel 75 mg/d. Sex-specific differences in 30-day platelet reactivity were analyzed in 2,564 (27%) patients participating in a platelet function substudy. RESULTS......-cause mortality (12.2% vs 11.7%; P = .88), and Global Use of Strategies to Open Occluded Arteries severe/life-threatening/moderate bleeding (3.8% vs 2.8%; P = .74) through 30 months were similar in women versus men. After adjustment, women had significantly lower risk for ischemic outcomes and all-cause mortality...

  12. Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

    OpenAIRE

    Coleman, Craig I.; Freemantle, Nick; Kohn, Christine G

    2015-01-01

    Objectives To estimate the cost-effectiveness of ranolazine when added to standard-of-care (SoC) antianginals compared with SoC alone in patients with stable coronary disease experiencing ≥3 attacks/week. Setting An economic model utilising a UK health system perspective, a 1-month cycle-length and a 1-year time horizon. Participants Patients with stable coronary disease experiencing ≥3 attacks/week starting in 1 of 4 angina frequency health states based on Seattle Angina Questionnaire Angina...

  13. Kinetic equations for an unstable plasma

    International Nuclear Information System (INIS)

    In this work, we establish the plasma kinetic equations starting from the Bogoliubov-Born-Green-Kirkwood-Yvon hierarchy of equations. We demonstrate that relations existing between correlation functions may help to justify the truncation of the hierarchy. Then we obtain the kinetic equations of a stable or unstable plasma. They do not reduce to an equation for the one-body distribution function, but generally involve two coupled equations for the one-body distribution function and the spectral density of the fluctuating electric field. We study limiting cases where the Balescu-Lenard equation, the quasi-linear theory, the Pines-Schrieffer equations and the equations of weak turbulence in the random phase approximation are recovered. At last we generalise the H-theorem for the system of equations and we define conditions for irreversible behaviour. (authors)

  14. Unstable Leidenfrost Drops on Roughened Surfaces

    CERN Document Server

    Boreyko, Jonathan B

    2010-01-01

    Drops placed on a surface with a temperature above the Leidenfrost point float atop an evaporative vapor layer. In this fluid dynamics video, it is shown that for roughened surfaces the Leidenfrost point depends on the drop size, which runs contrary to previous claims of size independence. The thickness of the vapor layer is known to increase with drop radius, suggesting that the surface roughness will not be able to penetrate the vapor layer for drops above a critical size. This size dependence was experimentally verified: at a given roughness and temperature, drops beneath a critical size exhibited transition boiling while drops above the critical size were in the Leidenfrost regime. These Leidenfrost drops were unstable; upon evaporation down to the critical size the vapor film suddenly collapsed.

  15. Coulomb dissociation of light unstable nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Toshihiko [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Yabana, Kazuhiro; Suzuki, Yoshiyuki

    1997-05-01

    The aim of this study is that a simulation method applicable to the atomic nucleus with neutron halo structure developed till now is applied to a wider range unstable nucleus containing proton excess nucleus to also attribute understanding of nuclear reaction with interest in astronomical nuclear reaction. The proton dissociation energy in {sup 8}B nucleus is small value of 138 eV, which is thought to have a structure of proton at the most outer shell bound much weakly by core nucleus and spread in thinner thickness. For the coulomb excitation of such weak bound system, quantum theoretical and non-perturbational treatment is important. Therefore, 3-dimensional time-dependent Schroedinger equation on relative wave function of the core nucleus {sup 7}Be and halo proton p will be dissolved in time space and will execute a time developmental simulation. (G.K.)

  16. Pipeline modeling and assessment in unstable slopes

    Energy Technology Data Exchange (ETDEWEB)

    Caceres, Carlos Nieves [Oleoducto Central S.A., Bogota, Cundinamarca (Colombia); Ordonez, Mauricio Pereira [SOLSIN S.A.S, Bogota, Cundinamarca (Colombia)

    2010-07-01

    The OCENSA pipeline system is vulnerable to geotechnical problems such as faults, landslides or creeping slopes, which are well-known in the Andes Mountains and tropical countries like Colombia. This paper proposes a methodology to evaluate the pipe behaviour during the soil displacements of slow landslides. Three different cases of analysis are examined, according to site characteristics. The process starts with a simplified analytical model and develops into 3D finite element numerical simulations applied to the on-site geometry of soil and pipe. Case 1 should be used when the unstable site is subject to landslides impacting significant lengths of pipeline, pipeline is straight, and landslide is simple from the geotechnical perspective. Case 2 should be used when pipeline is straight and landslide is complex (creeping slopes and non-conventional stabilization solutions). Case 3 should be used if the pipeline presents vertical or horizontal bends.

  17. Spectra of thermally unstable slim discs

    CERN Document Server

    Szuszkiewicz, E; Zampieri, L; Szuszkiewicz, Ewa; Turolla, Roberto; Zampieri, Luca

    2000-01-01

    Thermal instability driven by radiation pressure might be relevant for intrinsically bright accreting sources. The most promising candidate where this instability seems to be at work is one of the two known galactic superluminal sources, GRS 1915+105 (Belloni et al. 1997). In spite of being of relevance, this scenario has not yet been confirmed by proper time-dependent modelling. Non-linear time-dependent calculations performed by Szuszkiewicz and Miller (1998) show that thermally unstable discs undergo limit-cycle behaviour with successive evacuation and refilling of the central parts of the disc. This evolution is very similar to the one proposed by Belloni et al. (1997) in their phenomenological model. Further investigations are needed to confirm the thermal instability being operational in this source. First of all the spectra emitted from the disc during its evolution should be calculated and compared with observations. Here such spectra are computed assuming local blackbody emission from the best studie...

  18. 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

  19. PRESENTACIÓN DE UN CASO CON SÍNDROME X O ANGINA MICROVASCULAR / Report of a case with cardiac syndrome X or microvascular angina

    Directory of Open Access Journals (Sweden)

    Dayan A. García Cuesta

    2013-04-01

    Full Text Available Resumen: El término síndrome X o angina microvascular se emplea habitualmente para definir a un grupo de pacientes que presentan dolor torácico característico, depresión del segmento ST durante el esfuerzo y arterias coronarias angiográficamente normales. Muchos datos apuntan a un posible origen isquémico de los síntomas. Es más frecuente en mujeres y en casi el 50 % de ellas, el dolor anginoso se atribuye específicamente a cambios en la microvasculatura coronaria. Debido a que el pronóstico no es tan benigno como se creía hace años, en pacientes con angina y coronarias epicárdicas normales, se impone una evaluación clínica (incluyendo un cuidadoso análisis de los factores de riesgo e imagenológica, con el propósito de detectar isquemia funcionalmente significativa. La enfermedad coronaria microvascular es, por tanto, una enfermedad que requiere atención por parte del médico de asistencia. En este artículo se presenta una paciente con este diagnóstico, y se muestran las imágenes electrocardiográficas, ecocardiográfica, ergométricas y angiográficas. / Abstract: The term cardiac syndrome X or microvascular angina is commonly used to describe a group of patients who show a typical chest pain, ST segment depression during exercise and angiographically normal coronary arteries. Many data suggest the symptoms may have an ischemic origin. It is more common in women, and, in almost 50% of them, anginal pain is specifically attributed to changes in the coronary microvasculature. The prognosis is not as benign as it was believed for years; therefore, in patients with angina and a normal epicardial coronary, a clinical and imaging assessment is necessary (including a careful analysis of risk factors in order to detect a functionally significant ischemia. Therefore, coronary microvascular disease is a condition that requires attention by the attending physician. A patient with this diagnosis is reported in this article, and

  20. Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Trimetazidine European Multicenter Study Group.

    OpenAIRE

    Detry, J M; Sellier, P; Pennaforte, S; D. Cokkinos; Dargie, H; Mathes, P

    1994-01-01

    1. Trimetazidine has a direct anti-ischaemic effect on the myocardium without altering the rate x pressure product or coronary blood flow. 2. The effects of trimetazidine (20 mg three times daily) were compared with those of propranolol (40 mg three times daily) in a double-blind parallel group multicentre study in 149 men with stable angina. 3. Reproducibility of exercise performance was verified during a 3 week run-in placebo washout period. All patients had > 1 mm ST-depression on exercise...

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

    International Nuclear Information System (INIS)

    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.)

  2. 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.)

  3. Association of Low Levels of Vitamin D with Chronic Stable Angina: A Prospective Case-Control Study

    OpenAIRE

    Ab Hameed Raina; Mohammad Sultan Allai; Zafar Amin Shah; Khalid Hamid Changal; Manzoor Ahmad Raina; Fayaz Ahmad Bhat

    2016-01-01

    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. M...

  4. Calcar Preservation Arthroplasty for Unstable Intertrochanteric Femoral Fractures in Elderly

    OpenAIRE

    Celiktas, Mustafa; Togrul, Emre; Kose, Ozkan

    2015-01-01

    Background The treatment of unstable intertrochanteric fractures in elderly is still controversial. The purpose of this study is to present treatment strategies for unstable intertrochanteric fractures with hemiarthroplasty using standard uncemented collared femoral stems and at the same time preserving the fractured calcar fragment. Methods Fifty-four patients aged 75 years or older with unstable intertrochanteric fractures were included in this prospective cohort study. All patients were tr...

  5. Asymptotic behavior of unstable INAR(p) processes

    CERN Document Server

    Barczy, Matyas; Pap, Gyula

    2009-01-01

    In this paper the asymptotic behavior of an unstable integer-valued autoregressive model of order p (INAR(p)) is described. Under a natural assumption it is proved that the sequence of appropriately scaled random step functions formed from an unstable INAR(p) process converges weakly towards a squared Bessel process. We note that this limit behavior is quite different from that of familiar unstable autoregressive processes of order p.

  6. Severe Life Threatening Maxillofacial Infection in Pregnancy Presented as Ludwig's Angina

    Directory of Open Access Journals (Sweden)

    M. Franklin Dolwick

    2006-08-01

    Full Text Available Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. Case. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig's angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. Conclusions. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. Furthermore, the healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.

  7. Chest pain and angina pectoris - or the ugly swan and the beautiful duckling

    Science.gov (United States)

    van Tellingen, C.

    2010-01-01

    The original description of Heberden’s angina pectoris is put forward to stress the importance of proper history-taking in identifying patients. In a market-driven approach to improve cost-effectiveness in healthcare, angina pectoris as an entity seems stripped to its bare minimum: chest and pain. The diagnostic yield of exercise testing, however, depends on the pre-test likelihood of disease and therefore knowledge of its clinical utility and pitfalls is essential to refine an initial and subjective diagnosis based on anamnesis. Nowadays chest pain units attempt to improve diagnostic accuracy by submitting all sorts of patients to the (stress) test. In the end protocol-driven policies like these may very well prove to be contraproductive when fundamentals are ignored. (Neth Heart J 2010;18:561–4.) PMID:21113382

  8. 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.

  9. Steam injection profiling with unstable radioactive isotopes

    International Nuclear Information System (INIS)

    This patent describes a method of determining liquid and vapor phase profiles in a stream injection well. It comprises inserting a well logging tool into a steam injection well at a first location, the logging tool further comprising duel gamma ray detectors separated by a specified distance; measuring a mass flow rate of steam entering the steam injection well; before, during, and after logging the steam injection well; injecting an unstable radioactive isotope into the steam injection well, the isotope being of a type which naturally hydrolyzes from a vapor phase into a liquid phase at a known rate, so that a given time after the isotope injection, the relative proportions of the vapor phase and the liquid phase can be determined; measuring the transit time of the vapor phase isotope and the liquid phase isotope to pass between the gamma ray detectors; moving the logging tool to a second location in the well; calculating vapor phase and liquid phase velocities based on the elapsed time required for the vapor and liquid phase isotopes to pass between the two gamma detectors; and calculating the amount of vapor and liquid entering a formation between the first location and the second location based on the mass flow rate of steam entering the well, the liquid transit times, and the vapor transit times

  10. Unstable mixed convective transport in groundwater

    International Nuclear Information System (INIS)

    This study is an experimental investigation of variable density groundwater flow in homogeneous and lenticular porous media. A solution of 500 mg/l Rhodamine WT dye served as the carrier for various concentrations of solute (NaCl) introduced into a two-dimensional flow tank at concentrations ranging from 1000 to 100,000 mg/l. At the scale of the experiments, mass transport depends upon both forced and free convection. In addition, density differences as low as 0.008 g/cm3 (1000 mg/l NaCl) between a plume of dense water and ambient groundwater in homogeneous medium produces gravitational instabilities at realistic groundwater velocities. These instabilities are manifest by lobe-shaped protuberances that formed first along the bottom edge of the plume and later within the plume. As the density difference increases to 0.0015 g/cm3 (2000 mg/l NaCl), 0.0037 g/cm3 (5000 mg/l NaCl) or higher, this unstable mixing due to convective dispersion significantly alters the spreading process, resulting in a large degree of vertical spreading of the plume. In a lenticular medium the combination of convective dispersion and nonuniform flow due to heterogeneities results in relatively large dispersion. Scale considerations indicate that convective dispersion may provide an important component of mixing at the field scale. (Author) (30 refs., 12 figs., 3 tabs.)

  11. Unstable magnetic moments in Ce compounds

    International Nuclear Information System (INIS)

    The problems which are connected with the appearance or disappearance of local moments in metals are well reflected in the magnetic behaviour of Ce intermetallic compounds. This work describes experiments on two Ce compounds which are typical examples of unstable moment systems. The first of these is CeAl2 which at low temperatures, shows coexistence of antiferromagnetic order and the Kondo effect. Measurements are presented of the magnetization and the susceptibility in different magnetic field and temperature regions. An analysis of these measurements, using a model for the crystal field effects, shows the agreement between the measurements and the calculations to be reasonably good for CeAl2, but this agreement becomes worse upon decreasing Ce concentration. A phenomenological description of the observations is given. The second compound reported on is CeCu2Si2, the first 'heavy-fermion' superconductor to be investigated. The superconducting state is possibly formed by the quasi-particles of a non-magnetic many body singlet state, and not simply by the (sd) conduction electrons. This being a novel phenomenon, a number of experiments were performed to test this picture and to obtain a detailed description of the behaviour of CeCu2Si2. Measurements of the Meissner volume, confirmed the superconductivity to be intrinsic. (Auth.)

  12. Superluminal warp drives are semiclassically unstable

    International Nuclear Information System (INIS)

    Warp drives are very interesting configurations of General Relativity: they provide a way to travel at superluminal speeds, albeit at the cost of requiring exotic matter to build them. Even if one succeeded in providing the necessary exotic matter, it would still be necessary to check whether they would survive to the switching on of quantum effects. Semiclassical corrections to warp-drive geometries created out of an initially flat spacetime have been analyzed in a previous work by the present authors in special locations, close to the wall of the bubble and in its center. Here, we present an exact numerical analysis of the renormalized stress-energy tensor (RSET) in the whole bubble. We find that the the RSET will exponentially grow in time close to the front wall of the superluminal bubble, after some transient terms have disappeared, hence strongly supporting our previous conclusion that the warp-drive geometries are unstable against semiclassical back-reaction. This result seems to implement the chronology protection conjecture, forbiddig the set up of a structure potentially dangerous for causality.

  13. Transition from unstable to stable states

    International Nuclear Information System (INIS)

    The purpose of this paper is to discuss the fluctuation, relaxation and formation of macroscopic order in non-equilibrium systems, particularly near the instability point. The main strategy is to use asymptotic evaluation method on the basis of stochastic processes. There are two types of stochastic calculus, namely Ito type and Stratonovich type, and the latter was extended to the general definition of arbitrary symmetrized integral. Kubo introduced a stochastic Liouville equation. The concept of stochastic linear response is very useful in non-equilibrium many-body systems. A stochastic variable can be separated into two parts due to the central limit theorem in normal situation. The expression of asymptotic temporal behavior leads to the anomalous fluctuation theorem. The Ω-expansion method is not valid near the instability point. A simple typical example was studied, and a scaling function was derived. It is a remarkable point that the normalized fluctuation can be expressed only in terms of a scaling variable. A new kind of scaling law holds in case of the relaxation near the instability point. This argument can be easily extended to more general unstable situation. (Kako, I.)

  14. 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

  15. Can music improve the symptoms of stable angina? A randomized controlled trial

    OpenAIRE

    Premadasa Mudunkotuwa; Kumudu Wijewardena; Ruwan Ekanayaka; Samitha Siritunga

    2013-01-01

    Worldwide, the leading cause of death is ischemic heart disease. Other than medical and surgical management, alternative therapy such as relaxing music has been identified as having an impact on reducing morbidity in ischemic heart disease. Although several studies have been conducted to find out the impact of music on pain, anxiety, heart rate and stress in myocardial ischaemia, literature on the long term impact of music on severity of symptoms associated with stable angina is very sparse....

  16. Beneficial effects of intravenous glyceryl trinitrate in a case of Prinzmetal angina.

    OpenAIRE

    Antman, E; Gunther, S.; Barry, W

    1980-01-01

    A case is described of the successful use of intravenous glyceryl trinitrate in controlling ischaemia-induced high-grade ventricular ectopic activity occurring in a patient during a Prinzmetal angina attack. The intravenous form of glyceryl trinitrate is probably more effective than the sublingual form in controlling arrhythmias arising during acute ischaemic episodes because of prompt delivery of the drug to the coronary circulation where vasodilation occurs. In addition,the ability to contr...

  17. Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation

    Institute of Scientific and Technical Information of China (English)

    Susanne M Bondesson; Marie-Louise Edvinsson; Thomas Pettersson; Lars Edvinsson

    2011-01-01

    Objective To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina.Methods Twenty patients diagnosed with refractory angina were divided into EECP (n =10) or no EECP (n =10) groups.The data were compared to matched healthy subjects (n =20).The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry.The vascular responsiveness to iontophoretic administration of acetylcholine (ACh),sodium nitroprusside (SNP) and local skin warming were studied.Measurements of Canadian Cardiovascular Society (CCS)-class,blood pressure and plasma samples were registered.Results EECP patients showed reduced CCS-class compared to no EECP (P < 0.05).Both EECP and no EECP (P < 0.05) groups had decreased systolic blood pressure (SBP) as compared to SBP at baseline (P < 0.05).There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up.Responses to heating,the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects (P < 0.05).EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class.Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh,SNP and heat compared to healthy subjects.Although EECP reduced the CCS-class,this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.

  18. Prognostic implications of exercise induced and ambulatory ischemia in patients with stable angina pectoris

    OpenAIRE

    Forslund, Lennart

    1999-01-01

    Results from exercise testing and ambulatory ECG registration were studied in 809 patients with stable angina pectoris; special attention was paid to signs of ischemia during both tests. Autonomic nervous system activity was investigated by measurements of heart rate variability (HRV) and catecholamines in plasma and urine. At baseline, the patients were compared with 50 age and sex matched controls. Prognostic implications of HRV, catecholamine levels, signs of ischemia dur...

  19. Treatment of Refractory Angina with Peripheral Blood-derived Stem Cell Using the Transendocardial Injection Route

    OpenAIRE

    Juan Jose González Ferrer; Pilar Jiménez-Quevedo; Maria del Trigo

    2011-01-01

    Despite the development of new anti-ischemic drugs and the improvements in revascularisation techniques, a substantial proportion of patients with ischemic heart disease remain symptomatic with severe debilitating angina. The major aim of therapy for these patients should be aggressive modification of risk factors and optimising medical and interventional treatment. Nevertheless, when disease progresses and standard treatments are not possible, new strategies should be established. In this se...

  20. Extended-release ranolazine: critical evaluation of its use in stable angina

    OpenAIRE

    Melloni C; Newby LK; Truffa AAM

    2011-01-01

    Adriano AM Truffa, L Kristin Newby, Chiara MelloniDuke Clinical Research Institute and Department of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: Coronary heart disease is the major cause of morbidity and mortality throughout the world, and is responsible for approximately one of every six deaths in the US. Angina pectoris is a clinical syndrome characterized by discomfort, typically in the chest, neck, chin, or left arm, induced by physical exertion, emotional stress, o...

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

    Directory of Open Access Journals (Sweden)

    M. A. Popova

    2016-02-01

    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.

  2. 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.

  3. Extended-release ranolazine: critical evaluation of its use in stable angina

    Directory of Open Access Journals (Sweden)

    Melloni C

    2011-08-01

    Full Text Available Adriano AM Truffa, L Kristin Newby, Chiara MelloniDuke Clinical Research Institute and Department of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: Coronary heart disease is the major cause of morbidity and mortality throughout the world, and is responsible for approximately one of every six deaths in the US. Angina pectoris is a clinical syndrome characterized by discomfort, typically in the chest, neck, chin, or left arm, induced by physical exertion, emotional stress, or cold, and relieved by rest or nitroglycerin. The main goals of treatment of stable angina pectoris are to improve quality of life by reducing the severity and/or frequency of symptoms, to increase functional capacity, and to improve prognosis. Ranolazine is a recently developed antianginal with unique methods of action. In this paper, we review the pharmacology of ranolazine, clinical trials supporting its approval for clinical use, and studies of its quality of life benefits. We conclude that ranolazine has been shown to be a reasonable and safe option for patients who have refractory ischemic symptoms despite the use of standard medications (for example, nitrates, beta-adrenergic receptor antagonists, and calcium channel antagonists for treatment of anginal symptoms, and also provides a modestly improved quality of life.Keywords: ranolazine, coronary heart disease, angina, treatment

  4. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    OpenAIRE

    Gilman Robert H; Loret de Mola Christian; Zaman M Justin S; Smeeth Liam; Miranda J Jaime

    2010-01-01

    Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across dif...

  5. Managing risk in an unstable world.

    Science.gov (United States)

    Bremmer, Ian

    2005-06-01

    With emerging markets like China and politically unstable countries like Saudi Arabia figuring more than ever into companies' investment calculations, business leaders are turning to political risk analysis to measure the impact of politics on potential markets, minimize risks, and make the most of global opportunities. But political risk is more subjective than its economic counterpart. It is influenced by the passage of laws, the foibles of government leaders, and the rise of popular movements. So corporate leaders must grapple not just with broad, easily observable trends but also with nuances of society and even quirks of personality. And those hard-to-quantify factors must constantly be pieced together into an ongoing narrative within historical and regional contexts. As goods, services, information, ideas, and people cross borders today with unprecedented velocity, corporations debating operational or infrastructural investments abroad increasingly need objective, rigorous assessments. One tool for measuring and presenting stability data, for example, incorporates 20 composite indicators of risk in emerging markets and scores risk variables according to both their structural and their temporal components. The indicators are then organized into four equally weighted subcategories whose ratings are aggregated into a single stability score. Countries are ranked on a scale of zero (a failed state) to100 (a fully institutionalized, stable democracy). Companies can buy political risk analyses from consultants or, as some large energy and financial services organizations have done, develop them in-house. Either way, a complete and accurate picture of any country's risk requires analysts with strong reportorial skills; timely, accurate data on a variety of social and political trends; and a framework for evaluating the impact of individual risks on stability. PMID:15938438

  6. Visualizing the Mass and Width Spectrum of Unstable Particles

    OpenAIRE

    Harshman, N. L.

    2003-01-01

    Several graphical representations of the mass and width spectrum of unstable subatomic particles are presented. Such plots are useful tools for introducing students to the particle zoo and provide students an alternate way to organize conceptually what can seem like an overwhelming amount of data. In particular, such graphs highlight phenomenological features of unstable particles characteristic of different energy and time scales.

  7. 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

  8. Boundary between Stable and Unstable Regimes of Accretion. Ordered and Chaotic Unstable Regimes

    CERN Document Server

    Blinova, A A; Lovelace, R V E

    2015-01-01

    We search for the boundary between stable and Rayleigh-Taylor unstable regimes of accretion to magnetized stars in a new set of high grid resolution simulations. We found that the boundary between stable and unstable regimes is mainly determined by the ratio of the corotation radius r_cor (where the Keplerian angular velocity in the disc matches the angular velocity of the star) to the magnetospheric radius r_m (where the magnetic stress in the magnetosphere matches the matter stress in the disc). Instability is stronger when r_cor is larger with respect to r_m, that is, when the gravitational force is larger than the centrifugal force at the inner disc. In the cases of a small tilt of the magnetosphere, Theta=5 deg, and a small alpha-parameter of viscosity, alpha=0.02, the boundary is located at r_cor approx. 1.4 r_m. Instability becomes stronger at higher values of viscosity, and occurs at lower values of r_cor/r_m. At higher values of Theta, the variability associated with instability decreases. Simulation...

  9. Neutron Capture Experiments on Unstable Nuclei

    International Nuclear Information System (INIS)

    The overall objective of this project is the measurement of neutron capture cross sections of importance to stewardship science and astrophysical modeling of nucleosynthesis, while at the same time helping to train the next generation of scientists with expertise relevant to U.S. national nuclear security missions and to stewardship science. A primary objective of this project is to study neutron capture cross sections for various stable and unstable isotopes that will contribute to the Science Based Stockpile Stewardship (SBSS) program by providing improved data for modeling and interpretation of nuclear device performance. Much of the information obtained will also be important in astrophysical modeling of nucleosynthesis. Measurements of these neutron capture cross sections are being conducted in collaboration with researchers at the Los Alamos Neutron Science Center (LANSCE) facility using the unique Detector for Advanced Neutron Capture Experiments (DANCE). In our early discussions with the DANCE group, decisions were made on the first cross sections to be measured and how our expertise in target preparation, radiochemical separations chemistry, and data analysis could best be applied. The initial emphasis of the project was on preparing suitable targets of both natural and separated stable europium isotopes in preparation for the ultimate goal of preparing a sufficiently large target of radioactive 155Eu (t1/2 = 4.7 years) and other radioactive and stable species for neutron cross-section measurements at DANCE. Our Annual Report, ''Neutron Capture Experiments on Unstable Nuclei'' by J. M. Schwantes, R. Sudowe, C. M. Folden III, H. Nitsche, and D. C. Hoffman, submitted to NNSA in December 2003, gives details about the initial considerations and scope of the project. During the current reporting period, electroplated targets of natural Eu together with valuable, stable, and isotopically pure 151Eu and 153Eu, and isotopically separated 154Sm were measured for

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Sasa-Satsuma equation, unstable plane waves and heteroclinic connections

    International Nuclear Information System (INIS)

    The Sasa-Satsuma equation is an integrable perturbation of the nonlinear Schroedinger equation which models the effects of third-order dispersion, self-steepening and stimulated Raman scattering in the propagation of ultra-fast pulses in optical fiber transmission systems. The heteroclinic connections of the unstable plane waves are explicitly constructed using an auto-Baecklund transformation obtained from inverse spectral theory. The modulus of the heteroclinic connection can have either a single peak or a double peak, depending on the amplitude of the unstable plane wave, even when only one unstable positive wavenumber is present

  12. Dental Occlusion Influences the Standing Balance on an Unstable Platform.

    Science.gov (United States)

    Julià-Sánchez, Sonia; Álvarez-Herms, Jesús; Gatterer, Hannes; Burtscher, Martin; Pagès, Teresa; Viscor, Ginés

    2015-10-01

    Contradictory results are still reported on the influence of dental occlusion on the balance control. We attempted to determine whether there are differences in balance between opposed dental occlusion (Intercuspal position (ICP)/"Cotton rolls" mandibular position [CR]) for two extreme levels of stability (stable/ unstable). Twenty-five subjects were monitored under both dental occlusion and level of stability conditions using an unstable platform Balance System SD. The resulting stability index suggests that body balance is significantly better when dental occlusion is set in CR (p crowding (p = .006), midline deviation (p dental occlusion for the balance control comes strongly into effect in unstable conditions. PMID:25674772

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

    Directory of Open Access Journals (Sweden)

    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.

  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

    pectoris experienced during the first month following discharge from AMI. METHODS: In all, 803 patients included in the placebo arm of the Danish Verapamil Infarction Trial II were followed up for 18 months in 20 coronary care units in Denmark. The patients were randomized to placebo and were still...... 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. Chest pain after percutaneous coronary intervention in patients with stable angina

    Directory of Open Access Journals (Sweden)

    Chang CC

    2016-08-01

    Full Text Available Chao-Chien Chang,1–3 Yueh-Chung Chen,4,5 Eng-Thiam Ong,1 Wei-Cheng Chen,1 Chia-Hsiu Chang,1 Kuan-Jen Chen,1 Cheng-Wen Chiang1 1Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan, ROC; 2Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan, ROC; 3Department of Pharmacology, Taipei Medical University, Taipei, Taiwan, ROC; 4Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Ren-Ai branch, Taipai, Taiwan, ROC; 5Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC Background: Percutaneous coronary intervention (PCI has been widely used to treat acute coronary syndrome but is only recommended as an additional treatment to medical therapy and risk modification in patients with refractory or progressing angina. The number of PCI in this patient population is still increasing. Post-PCI chest pain (PPCP is one of the common problems of PCI. Its presentation and causes in patients with stable angina are poorly understood.Patients and methods: This study retrospectively collected clinical information of 167 patients who had stable angina and underwent elective PCI, including 70 patients with PPCP 24 hours after procedure and 97 patients without PPCP. The incidence and predictors of PPCP were analyzed.Results: The incidence of PPCP was 41.9% (70/167. Compared with non-PPCP patients, PPCP patients had more abnormal post-PCI electrocardiogram (ECG changes (new Q-waves, ST-segment shifts, or T-waves inversion and serum cardiac troponin I (cTnI elevation, more PCI vessels, and stent placement (all P<0.05. More PPCP patients required repeat revascularization than non-PPCP patients after PCI (P=0.043. PPCP was correlated with abnormal post-PCI ECG changes (P<0.0001, cTnI elevation (P<0.0001, post-PCI serum level of cTnI (P<0.0001, number of stents placed (P=0.009, and pre-PCI cTnI level (P=0.049. The strongest predictors of

  16. 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

  17. 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.

  18. Denucleation rates during Ostwald ripening: Distribution kinetics of unstable clusters

    OpenAIRE

    Madras, Giridhar; McCoy, Benjamin J

    2002-01-01

    During Ostwald ripening in vapor–liquid or liquid–solid systems, unstable clusters, which are smaller than the critical nucleus size, rapidly disappear. This denucleation process is distinct from the reversible dissolution of stable clusters that are larger than the critical size but are more soluble than larger clusters because of the Gibbs–Thomson effect. Thus, ripening involves larger clusters growing, smaller clusters shrinking, and unstable clusters rapidly disintegrating. We show how th...

  19. Particle-unstable nuclei in the Hartree-Fock theory

    CERN Document Server

    Kruppa, A T; Flocard, Hubert; Liotta, R J

    1997-01-01

    Ground state energies and decay widths of particle unstable nuclei are calculated within the Hartree-Fock approximation by performing a complex scaling of the many-body Hamiltonian. Through this transformation, the wave functions of the resonant states become square integrable. The method is implemented with Skyrme effective interactions. Several Skyrme parametrizations are tested on four unstable nuclei: 10He, 12O, 26O and 28O.

  20. Momentum broadening in unstable quark-gluon plasma

    OpenAIRE

    Carrington, M. E.; Mrówczyński, St.; Schenke, B.

    2016-01-01

    Quark-gluon plasma produced at the early stage of ultrarelativistic heavy ion collisions is unstable, if weakly coupled, due to the anisotropy of its momentum distribution. Chromomagnetic fields are spontaneously generated and can reach magnitudes much exceeding typical values of the fields in equilibrated plasma. We consider a high energy test parton traversing an unstable plasma that is populated with strong fields. We study the momentum broadening parameter $\\hat q$ which determines the ra...

  1. Investigation for Electromechanical Coupling Unstability of Rolling Mill

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The unsteady condition of rolling Mill vibration that was caused by flexural vibration of strip was investigated. The parametric flexural vibration equation of rolled strip was established. The parametric flexural vibration stability of rolled strip was studied and region of stability and unstability was determined based on Floquet theory and perturbation method. The flexural-vibration of strip was unstable if the frequency of variable tension was twice as the natural frequency of flexural-vibration strip. ...

  2. Unstable analogues of the Lichtenbaum-Quillen conjecture

    OpenAIRE

    Anton, Marian; Roberts, Joshua

    2012-01-01

    This survey is mostly concerned with unstable analogues of the Lichtenbaum-Quillen Conjecture. The Lichtenbaum-Quillen Conjecture (now implied by the Voevodsky-Rost Theorem) attempts to describe the algebraic K-theory of rings of integers in number fields in terms of much more accessible "etale models". Suitable versions of the conjecture predict the cohomology of infinite general linear groups of rings of S-integers over suitable number fields; our survey focuses on an unstable version of th...

  3. Neutron Capture Experiments on Unstable Nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Jon M. Schwantes; Ralf Sudowe; Heino Nitsche; Darleane C. Hoffman

    2003-12-16

    A primary objective of this project is to study neutron capture cross sections for various stable and unstable isotopes that will contribute to the Science Based Stockpile Stewardship (SBSS) program by providing improved data for modeling and interpretation of nuclear device performance. The information obtained will also be important in astrophysical modeling of nucleosynthesis. During this reporting period, the emphasis has been on preparing a radioactive target of {sup 155}Eu (half-life = 4.7 years), and several stable targets, including isotopically separated {sup 154}Sm, {sup 151}Eu, and {sup 153}Eu. Measurements of their neutron capture cross sections will be conducted in collaboration with researchers at the Los Alamos Neutron Science Center (LANSCE) facility using the Detector for Advanced Neutron Capture Experiments (DANCE). A suitable backing material (beryllium) for the targets has been selected after careful calculations of its contribution to the background of the measurements. In addition, a high voltage plating procedure has been developed and optimized. Stable targets of {sup 151}Eu and {sup 153}Eu and a target of natural Eu ({approx}50% {sup 151}Eu and {approx}50% {sup 153}Eu) have each been plated to a mass thickness of >1 mg/cm{sup 2} and delivered to the DANCE collaboration at Los Alamos National Laboratory (LANL). Natural Eu targets will be tested first to confirm that the target dimensions and backing are appropriate prior to performing measurements on the extremely valuable targets of separated isotopes. In order to prepare a target of the radioactive {sup 155}Eu, it must first be separated from the {sup 154}Sm target material that was irradiated in a very high neutron flux of 1.5x1015 neutrons/cm{sup 2}/s for 50 days. The reaction is {sup 154}Sm (n,f){sup 155}Sm (half-life = 22 minutes) {sup 155}Eu. Considerable progress has been made in developing a suitable high-yield and high-purity separation method for separating Eu from targets

  4. Analysis of unstable modes distinguishes mathematical models of flagellar motion.

    Science.gov (United States)

    Bayly, P V; Wilson, K S

    2015-05-01

    The mechanisms underlying the coordinated beating of cilia and flagella remain incompletely understood despite the fundamental importance of these organelles. The axoneme (the cytoskeletal structure of cilia and flagella) consists of microtubule doublets connected by passive and active elements. The motor protein dynein is known to drive active bending, but dynein activity must be regulated to generate oscillatory, propulsive waveforms. Mathematical models of flagellar motion generate quantitative predictions that can be analysed to test hypotheses concerning dynein regulation. One approach has been to seek periodic solutions to the linearized equations of motion. However, models may simultaneously exhibit both periodic and unstable modes. Here, we investigate the emergence and coexistence of unstable and periodic modes in three mathematical models of flagellar motion, each based on a different dynein regulation hypothesis: (i) sliding control; (ii) curvature control and (iii) control by interdoublet separation (the 'geometric clutch' (GC)). The unstable modes predicted by each model are used to critically evaluate the underlying hypothesis. In particular, models of flagella with 'sliding-controlled' dynein activity admit unstable modes with non-propulsive, retrograde (tip-to-base) propagation, sometimes at the same parameter values that lead to periodic, propulsive modes. In the presence of these retrograde unstable modes, stable or periodic modes have little influence. In contrast, unstable modes of the GC model exhibit switching at the base and propulsive base-to-tip propagation. PMID:25833248

  5. Relativistic many body theory for unstable nuclei and supernova

    International Nuclear Information System (INIS)

    The motivation of applying the relativistic many-body theory comes from the recent experimental development of unstable nuclear beam facilities. Many interesting phenomena may be found in the study of unstable nuclei. Already in light nuclei, neutron halos and neutron skins have been found. The relativistic many-body theory was selected for studying on the structures of unstable nuclei up to the drip lines. The recent work on nuclear matters with the relativistic Brueckner Hartree-Fock (RBHF) theory is introduced. When RBHF was applied to finite nuclei as 16O and 40Ca, it also provided promising results. The relativistic mean field (RMF) theory was taken, and its parameters were to be fixed so that it reproduced the results of the RBHF theory as closely as possible. After summarizing the results for unstable nuclei with the standard NL-1 parameter set, the effort of getting a new parameter set is discussed. The unstable nuclei with deformation were also calculated successfully. The large difference between the self energy of nucleons in nuclear matters and that of RBHF is discussed. The introduction of a nonlinear term for omega mesons is explained. The new parameter set named TMI is able to describe the nuclear properties of unstable nuclei and the nuclear matters obtained by the RBHF. The relativity is the key ingredient of the success in the description of nuclei. (K.I.)

  6. 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

    microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing. METHODS AND RESULTS: After screening 3568 women, 963 women with angina-like chest pain and a diagnostic coronary angiogram without significant coronary....... 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 of...

  7. Management of stable angina: A commentary on the European Society of Cardiology guidelines.

    Science.gov (United States)

    Ambrosio, Giuseppe; Komajda, Michel; Mugelli, Alessandro; Lopez-Sendón, José; Tamargo, Juan; Camm, John

    2016-09-01

    In 2013 the European Society of Cardiology (ESC) released new guidelines on the management of stable coronary artery disease. These guidelines update and replace the previous ESC guidelines on the management of stable angina pectoris, issued in 2006. There are several new aspects in the 2013 ESC guidelines compared with the 2006 version. This opinion paper provides an in-depth interpretation of the ESC guidelines with regard to these issues, to help physicians in making evidence-based therapeutic choices in their routine clinical practice. The first new element is the definition of stable coronary artery disease itself, which has now broadened from a 'simple' symptom, angina pectoris, to a more complex disease that can even be asymptomatic. In the first-line setting, the major changes in the new guidelines are the upgrading of calcium channel blockers, the distinction between dihydropyridines and non-dihydropyridine calcium channel blockers, and the presence of important statements regarding the combination of calcium channel blockers with beta-blockers. In the second-line setting, the 2013 ESC guidelines recommend the addition of long-acting nitrates, ivabradine, nicorandil or ranolazine to first-line agents. Trimetazidine may also be considered. However, no clear distinction is made among different second-line drugs, despite different quality of evidence in favour of these agents. For example, the use of ranolazine is supported by strong and recent evidence, while data supporting the use of the traditional agents appear relatively scanty. PMID:27222385

  8. 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.

  9. Ranolazine: Drug overview and possible role in primary microvascular angina management.

    Science.gov (United States)

    Cattaneo, Mattia; Porretta, Alessandra Pia; Gallino, Augusto

    2015-02-15

    Ranolazine is a novel well-tolerated anti-ischemic drug, which selectively inhibits late sodium current and exerts metabolic properties without any hemodynamic effect. Ranolazine has been approved as a second-line medical treatment for symptomatic stable coronary artery disease. Primary microvascular angina (MVA) is suspected when angina symptoms occur in patients with demonstrated myocardial ischemia, absence of myocardial disease and normal coronary artery angiography. Recent clinical data suggest that MVA represents a complex entity, which has been increasingly recognized as a significant cause of morbidity. High variability and low response to traditional anti-anginal treatment characterize primary MVA. Despite the fact that clinical and preclinical evidence provides information regarding ranolazine usefulness in primary MVA management, only three recent small randomized trials have investigated this issue. By selecting peer-reviewed literature in Pubmed and Cochrane Library, this review provides an overview on ranolazine pharmacology and efficacy, focusing on recent evidence suggesting its usefulness in management of primary MVA. PMID:25555283

  10. Projection-free approximate balanced truncation of large unstable systems

    CERN Document Server

    Flinois, Thibault L B; Schmid, Peter J

    2015-01-01

    In this article, we show that the projection-free, snapshot-based, balanced truncation method can be applied directly to unstable systems. We prove that even for unstable systems, the unmodified balanced proper orthogonal decomposition algorithm theoretically yields a converged transformation that balances the Gramians (including the unstable subspace). We then apply the method to a spatially developing unstable system and show that it results in reduced-order models of similar quality to the ones obtained with existing methods. Due to the unbounded growth of unstable modes, a practical restriction on the final impulse response simulation time appears, which can be adjusted depending on the desired order of the reduced-order model. Recommendations are given to further reduce the cost of the method if the system is large and to improve the performance of the method if it does not yield acceptable results in its unmodified form. Finally, the method is applied to the linearized flow around a cylinder at Re = 100...

  11. Angina - discharge

    Science.gov (United States)

    ... Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a ... Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol . 2007 Aug ...

  12. Microvascular Angina

    Science.gov (United States)

    ... Privacy Policy What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

  13. Stable angina

    Science.gov (United States)

    ... and prasugrel). Your provider may recommend a cardiac rehabilitation program to help improve your heart's fitness. SURGICAL ... and the American Association for Thoracic Surgery, Preventive ... Society for Cardiovascular Angiography and Interventions, ...

  14. Ludwig's angina

    Science.gov (United States)

    ... the emergency room or call your local emergency number (such as 911) right away. Call your health care provider if you have symptoms of this condition, or if symptoms do not get better after treatment. Prevention Visit the dentist for regular checkups. Treat symptoms of mouth or ...

  15. Angina - discharge

    Science.gov (United States)

    ... Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a ... Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ...

  16. 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; Maeng, Michael; Tilsted, Hans-Henrik; Bøtker, Hans E; Ravkilde, Jan; Madsen, Morten; Sørensen, Henrik T; Thuesen, Leif; Lassen, Jens F; Jensen, Lisette O

    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...

  17. 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.

  18. 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...

  19. 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 be...

  20. STIMULATION CHARACTERISTICS, COMPLICATIONS, AND EFFICACY OF SPINAL-CORD STIMULATION SYSTEMS IN PATIENTS WITH REFRACTORY ANGINA - A PROSPECTIVE FEASIBILITY STUDY

    NARCIS (Netherlands)

    DEJONGSTE, MJL; NAGELKERKE, D; HOOYSCHUUR, CM; JOURNEE, HL; MEYLER, PWJ; STAAL, MJ; DEJONGE, P; LIE, KI

    1994-01-01

    Objectives: In a prospective study with a 1-year follow-up we evaluated: (1) the feasibility of a method for the adjustment of spinal cord stimulator (SCS) parameters, (2) complications of SCS, and (3) efficacy of SCS. Methods: In patients receiving an SCS for severe angina unresponsive to standard

  1. Spinal cord stimulation in the treatment of refractory angina : systematic review and meta-analysis of randomised controlled trials

    NARCIS (Netherlands)

    Taylor, Rod S.; De Vries, Jessica; Buchser, Eric; DeJongste, Mike J. L.

    2009-01-01

    Background: The aim of this paper was undertake a systematic review and meta-analysis of the use of spinal cord stimulation ( SCS) in the management of refractory angina. Methods: We searched a number of electronic databases including Medline, Embase and Cochrane Library up to February 2008 to ident

  2. Computing unstable manifolds of periodic orbits in delay differential equations

    International Nuclear Information System (INIS)

    We present the first algorithm for computing unstable manifolds of saddle-type periodic orbits with one unstable Floquet multiplier in systems of autonomous delay differential equations (DDEs) with one fixed delay. Specifically, we grow the one-dimensional unstable manifold Wu(q) of an associated saddle fixed point q of a Poincare map defined by a suitable Poincare section Σ. Starting close to q along the linear approximation to Wu(q) given by the associated eigenfunction, our algorithm grows the manifold as a sequence of points, where the distance between points is governed by the curvature of the one-dimensional intersection curve Wu(q intersection Σ of Wu(q) with Σ. Our algorithm makes it possible to study global bifurcations in DDEs. We illustrate this with the break-up of an invariant torus and a subsequent crisis bifurcation to chaos in a DDE model of a semiconductor laser with phase-conjugate feedback

  3. Symmetry energy, unstable nuclei and neutron star crusts

    Energy Technology Data Exchange (ETDEWEB)

    Iida, Kei [Kochi University, Department of Natural Science, Kochi (Japan); RIKEN Nishina Center, Saitama (Japan); Oyamatsu, Kazuhiro [RIKEN Nishina Center, Saitama (Japan); Aichi Shukutoku University, Department of Human Informatics, Aichi (Japan)

    2014-02-15

    The phenomenological approach to inhomogeneous nuclear matter is useful to describe fundamental properties of atomic nuclei and neutron star crusts in terms of the equation of state of uniform nuclear matter. We review a series of researches that we have developed by following this approach. We start with more than 200 equations of state that are consistent with empirical masses and charge radii of stable nuclei and then apply them to describe matter radii and masses of unstable nuclei, proton elastic scattering and total reaction cross sections off unstable nuclei, and nuclei in neutron star crusts including nuclear pasta. We finally discuss the possibility of constraining the density dependence of the symmetry energy from experiments on unstable nuclei and even observations of quasi-periodic oscillations in giant flares of soft gamma-ray repeaters. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Energy Loss in Unstable Quark-Gluon Plasma

    OpenAIRE

    Carrington, Margaret E.; Deja, Katarzyna; Mrowczynski, Stanislaw

    2015-01-01

    The momentum distribution of quark-gluon plasma at the early stage of a relativistic heavy-ion collision is anisotropic and consequently the system, which is assumed to be weakly coupled, is unstable due chromomagnetic plasma modes. We consider a high-energy parton which flies across such an unstable plasma, and the energy transfer between the parton and the medium is studied as an initial value problem. In the case of equilibrium plasmas, the well-known formula of collisional energy loss is ...

  6. TREATMENT OF UNSTABLE THORACOLUMBAR FRACTURES IN PEDIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Roberto Chapa Sosa

    2015-09-01

    Full Text Available Objective:To analyze the characteristics of unstable thoracolumbar fractures in the pediatric population.Methods:A retrospective cross-sectional study was conducted with pediatric patients (0 to 15 years who presented with unstable thoracolumbar fracture with or without neurological damage. Twenty-four operated patients were analyzed: 13 male and 11 female.Results:Falls from height are the most common cause, being the thoracolumbar junction the anatomical site most frequently injured.Conclusion:The thoracolumbar fractures are rare in the pediatric population, as well as post-surgical instrumentation structural deformities.

  7. Error behaviour of multistep methods applied to unstable differential systems

    Science.gov (United States)

    Brown, R. L.

    1978-01-01

    The problem of modelling a dynamic system described by a system of ordinary differential equations which has unstable components for limited periods of time is discussed. It is shown that the global error in a multistep numerical method is the solution to a difference equation initial value problem, and the approximate solution is given for several popular multistep integration formulae. Inspection of the solution leads to the formulation of four criteria for integrators appropriate to unstable problems. A sample problem is solved numerically using three popular formulae and two different stepsizes to illustrate the appropriateness of the criteria.

  8. Novel features of unstable nuclei studied with AMD

    International Nuclear Information System (INIS)

    Formulation of AMD (antisymmetrized molecular dynamics) is briefly explained. It is explained that AMD can describe both mean field structure and cluster structure and also their coexistence. As an example to show this fact the results of the study of 12C are reported. Then it is shown that AMD is useful for the study of unstable nuclei which show many unexpected features different from stable nuclei. Nobel features of unstable nuclei we discuss include molecular orbits in Be isotopes, novel type of clustering in B isotope, and different deformation of proton and neutron distributions in C isotopes. (author)

  9. Nitrate-Induced Headache in Patients with Stable Angina Pectoris: Beneficial Effect of Starting on a Low Dosage.

    Science.gov (United States)

    Cleophas, Ton J.M.; Niemeyer, Menco G.; van Der Wall, Ernst E.

    1996-12-01

    BACKGROUND: Nitrates, although important for the management of angina pectoris, cause significant headache in many patients. METHODS: In a randomized, double-blind crossover study, 89 patients with stable angina pectoris were used to compare two different dosage strategies of isosorbide-5-mononitrate (5-ISMN). Patients were randomized to either 60 mg 5-ISMN once daily (o.d.) for 2 weeks or 30 mg 5-ISMN o.d. for 1 week followed by 60 mg 5-ISMN o.d. for 1 week. A 2-week placebo wash-out ensued, after which the alternative treatment was given. We assessed the occurrence of angina pectoris and headache by diary cards while taking into account the numbers of isosorbide dinitrate sublingual puffs and paracetamole tables required. Data were assessed for carryover and time effects. RESULTS: The two dosage regimens were equally efficient for the relief of angina pectoris without development of tolerance. Thirty percent of the patients never experienced headache from the given dosages. The remainder showed a highly significant time-effect: The total numbers of headache attacks in the 1st period of active treatment were 2,380 vs 1,400 attacks is the 2nd period (p < 0.003), yet significantly fewer patients had headaches on low dosages than high ones (45 vs 57, p < 0.02). CONCLUSIONS: Starting on a low dosage was associated with reduced frequency and severity of headache and did not notably influence the beneficial effect of nitrates on angina pectoris. One in three patients never experienced headache from the given dosages. The overall number of headache attacks in the 1st period of active treatment was significantly higher than that of the 2nd period, irrespective of the dosages given. PMID:11862241

  10. 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%.

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

    Directory of Open Access Journals (Sweden)

    N. P. Kutishenko

    2015-12-01

    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.

  12. Energy loss in unstable quark-gluon plasma

    Science.gov (United States)

    Carrington, Margaret E.; Deja, Katarzyna; Mrówczyński, Stanisław

    2015-10-01

    The momentum distribution of quark-gluon plasma at the early stage of a relativistic heavy-ion collision is anisotropic; consequently, the system, which is assumed to be weakly coupled, is unstable owing to chromomagnetic plasma modes. We consider a high-energy parton which flies across such an unstable plasma, and the energy transfer between the parton and the medium is studied as an initial value problem. In the case of equilibrium plasmas, the well-known formula of collisional energy loss is reproduced. The unstable plasma case is much more complex, and the parton can lose or gain energy depending on the initial conditions. The extremely prolate and extremely oblate systems are considered as examples of unstable plasmas, and two classes of initial conditions are discussed. When the initial chromodynamic field is uncorrelated with the color state of the parton, it typically looses energy, and the magnitude of the energy loss is comparable to that in an equilibrium plasma of the same density. When the initial chromodynamic field is induced by the parton, it can be either accelerated or decelerated depending on the relative phase factor. With a correlated initial condition, the energy transfer grows exponentially in time and its magnitude can much exceed the absolute value of energy loss in an equilibrium plasma. The energy transfer is also strongly directionally dependent. Consequences of our findings for the phenomenology of jet quenching in relativistic heavy-ion collisions are briefly discussed.

  13. Energy Loss in Unstable Quark-Gluon Plasma

    CERN Document Server

    Carrington, Margaret E; Mrowczynski, Stanislaw

    2015-01-01

    The momentum distribution of quark-gluon plasma at the early stage of a relativistic heavy-ion collision is anisotropic and consequently the system, which is assumed to be weakly coupled, is unstable due chromomagnetic plasma modes. We consider a high-energy parton which flies across such an unstable plasma, and the energy transfer between the parton and the medium is studied as an initial value problem. In the case of equilibrium plasmas, the well-known formula of collisional energy loss is reproduced. The unstable plasma case is much more complex, and the parton can lose or gain energy depending on the initial conditions. The extremely prolate and extremely oblate systems are considered as examples of unstable plasmas, and two classes of initial conditions are discussed. When the initial chromodynamic field is uncorrelated with the color state of the parton, it typically looses energy, and the magnitude of the energy loss is comparable to that in an equilibrium plasma of the same density. When the initial c...

  14. Theoretical studies on reaction mechanisms of unstable nuclei

    International Nuclear Information System (INIS)

    Recent studies on reactions of unstable nuclei by means of the continuum-discretized coupled-channels method (CDCC) are briefly reviewed. The topics covered are: four-body breakup processes for 6He induced reaction, microscopic description of projectile breakup processes, and new approach to inclusive breakup processes. (author)

  15. Mirage cosmology with an unstable probe D3-brane

    OpenAIRE

    Jeong, Dong Hyeok; Kim, Jin Young

    2005-01-01

    We consider the mirage cosmology by an unstable probe brane whose action is represented by BDI action with tachyon. We study how the presence of tachyon affects the evolution of the brane inflation. At the early stage of the brane inflation, the tachyon kinetic term can play an important role in curing the superluminal expansion in mirage cosmology.

  16. Mirage cosmology with an unstable probe D3-brane

    International Nuclear Information System (INIS)

    We consider the mirage cosmology by an unstable probe brane whose action is represented by Dirac-Born-Infeld action with tachyon. We study how the presence of tachyon affects the evolution of the brane inflation. At the early stage of the brane inflation, the tachyon kinetic term can play an important role in curing the superluminal expansion in mirage cosmology

  17. Properties of the false vacuum as the quantum unstable state

    CERN Document Server

    Urbanowski, K

    2016-01-01

    We analyze properties of unstable vacuum states from the point of view of the quantum theory. In the literature one can find some suggestions that some of false (unstable) vacuum states may survive up to times when their survival probability has a non-exponential form. At asymptotically late times the survival probability as a function of time $t$ has an inverse power--like form. We show that at this time region the energy of the false vacuum states tends to the energy of the true vacuum state as $1/t^{2}$ for $t \\to \\infty$. This means that the energy density in the unstable vacuum state should have analogous properties and hence the cosmological constant $\\Lambda = \\Lambda (t)$ too. The conclusion is that $\\Lambda$ in the Universe with the unstable vacuum should have a form of the sum of the "bare" cosmological constant and of the term of a type $1/t^{2}$: $\\Lambda(t) \\equiv \\Lambda_{bare} + d/ t^{2}$ (where $\\Lambda_{bare}$ is the cosmological constant for the Universe with the true vacuum).

  18. Rayleigh-Taylor Unstable Flames -- Fast or Faster?

    CERN Document Server

    Hicks, E P

    2015-01-01

    Rayleigh-Taylor (RT) unstable flames play a key role in the explosions of Type Ia supernovae. However, the dynamics of these flames is still not well-understood. RT unstable flames are affected by both the RT instability of the flame front and by RT-generated turbulence. The coexistence of these factors complicates the choice of flame speed subgrid models for full-star Type Ia simulations. Both processes can stretch and wrinkle the flame surface, increasing its area and, therefore, the burning rate. In past research, subgrid models have been based on either the RT instability or turbulence setting the flame speed. We evaluate both models, checking their assumptions and their ability to correctly predict the turbulent flame speed. Specifically, we analyze a large parameter study of 3D direct numerical simulations of RT unstable model flames. This study varies both the simulation domain width and the gravity in order to probe a wide range of flame behaviors. We show that RT unstable flames are different from tr...

  19. Rayleigh-Taylor Unstable Flames -- Fast or Faster?

    Science.gov (United States)

    Hicks, E. P.

    2015-04-01

    Rayleigh-Taylor (RT) unstable flames play a key role in the explosions of supernovae Ia. However, the dynamics of these flames are still not well understood. RT unstable flames are affected by both the RT instability of the flame front and by RT-generated turbulence. The coexistence of these factors complicates the choice of flame speed subgrid models for full-star Type Ia simulations. Both processes can stretch and wrinkle the flame surface, increasing its area and, therefore, the burning rate. In past research, subgrid models have been based on either the RT instability or turbulence setting the flame speed. We evaluate both models, checking their assumptions and their ability to correctly predict the turbulent flame speed. Specifically, we analyze a large parameter study of 3D direct numerical simulations of RT unstable model flames. This study varies both the simulation domain width and the gravity in order to probe a wide range of flame behaviors. We show that RT unstable flames are different from traditional turbulent flames: they are thinner rather than thicker when turbulence is stronger. We also show that none of the several different types of turbulent flame speed models accurately predicts measured flame speeds. In addition, we find that the RT flame speed model only correctly predicts the measured flame speed in a certain parameter regime. Finally, we propose that the formation of cusps may be the factor causing the flame to propagate more quickly than predicted by the RT model.

  20. Velocity Spectra in the Unstable Planetary Boundary Layer

    DEFF Research Database (Denmark)

    Højstrup, Jørgen

    1982-01-01

    Models for velocity spectra of all three components in the lower half of the unstable PBL are presented. The model spectra are written as a sum of two parts, nS(n) = A(fi, z/zi)w*2 + B(f, z/zi)u*02, a mixed layer part with a stability dependence, and a surface layer part without stability...

  1. Characterization of Unstable Rock Slopes Through Passive Seismic Measurements

    Science.gov (United States)

    Kleinbrod, U.; Burjanek, J.; Fäh, D.

    2014-12-01

    Catastrophic rock slope failures have high social impact, causing significant damage to infrastructure and many casualties throughout the world each year. Both detection and characterization of rock instabilities are therefore of key importance. An analysis of ambient vibrations of unstable rock slopes might be a new alternative to the already existing methods, e.g. geotechnical displacement measurements. Systematic measurements have been performed recently in Switzerland to study the seismic response of potential rockslides concerning a broad class of slope failure mechanisms and material conditions. Small aperture seismic arrays were deployed at sites of interest for a short period of time (several hours) in order to record ambient vibrations. Each measurement setup included a reference station, which was installed on a stable part close to the instability. Recorded ground motion is highly directional in the unstable parts of the rock slope, and significantly amplified with respect to stable areas. These effects are strongest at certain frequencies, which were identified as eigenfrequencies of the unstable rock mass. In most cases the directions of maximum amplification are perpendicular to open cracks and in good agreement with the deformation directions obtained by geodetic measurements. Such unique signatures might improve our understanding of slope structure and stability. Thus we link observed vibration characteristics with available results of detailed geological characterization. This is supported by numerical modeling of seismic wave propagation in fractured media with complex topography.For example, a potential relation between eigenfrequencies and unstable rock mass volume is investigated.

  2. Control of an under activated unstable nonlinear object

    DEFF Research Database (Denmark)

    Andersen, Nils Axel; Skovgaard, L.; Ravn, Ole

    2001-01-01

    This paper presents a comprehensive comparative study of several nonlinear controllers for stabilisation of the under actuated unstable nonlinear object known as the Acrobot in the literature. The object is a two DOF robot arm only actuated at the elbow. The study compares several control...

  3. Note About Unstable D-Brane with Dynamical Tension

    CERN Document Server

    Kluson, J

    2016-01-01

    We propose an action for unstable Dp-brane with dynamical tension. We show that the equations of motion are equivalent to the equations of motion derived from DBI and WZ actions for non-BPS Dp-brane. We also find Hamiltonian formulation of this action and analyze properties of the solutions corresponding to the tachyon vacuum and zero tension solution.

  4. Study on breakup mechanism of unstable nuclei with CDCC

    CERN Document Server

    Matsumoto, T

    2015-01-01

    The continuum-discretized coupled-channels method (CDCC) has been successful in describing breakup reactions involving unstable nuclei. Moreover, CDCC is a useful method for evaluation of nuclear data, which are important for nuclear engineering. In this article, we present the theoretical foundation of CDCC and some results of CDCC analyses.

  5. A numerical study of unstable Hele-Shaw flow

    DEFF Research Database (Denmark)

    Hansen, Erik Bent; Rasmussen, Henning

    1999-01-01

    A numerical procedure which is based on an integral equation for the normal velocity at the interface is developed for the unstable flow with surface tension in a Hele-Shaw cell. The procedure has been validated by comparing solutions obtained by it with published results. It has also been applie...

  6. On unstable cohomology classes of SL(Z).

    Science.gov (United States)

    Lee, R

    1978-01-01

    From algebraic K-theory, we show that there exists a spectral sequence that has real cohomology of SL(n)(Z) as its E(1)-terms and converges to the tensor product of a polynomial algebra and an exterior algebra. On the basis of this spectral sequence, we discovered several families of real unstable cohomology classes of SL(n)(Z). PMID:16592485

  7. On unstable cohomology classes of SLn(Z)

    Science.gov (United States)

    Lee, Ronnie

    1978-01-01

    From algebraic K-theory, we show that there exists a spectral sequence that has real cohomology of SLn(Z) as its E1-terms and converges to the tensor product of a polynomial algebra and an exterior algebra. On the basis of this spectral sequence, we discovered several families of real unstable cohomology classes of SLn(Z). PMID:16592485

  8. Shearing box simulations in the Rayleigh unstable regime

    CERN Document Server

    Nauman, Farrukh

    2015-01-01

    We study the stability properties of Rayleigh unstable flows both in the purely hydrodynamic and magnetohydrodynamic (MHD) regimes for two different values of the shear $q=2.1, 4.2$ ($q = - d\\ln\\Omega / d\\ln r$) and compare it with the Keplerian case $q=1.5$. The Rayleigh stability criterion states that hydrodynamic shear flows are stable for $q2$ regime as the volume averaged velocities ($k=0$ mode) are unstable in this regime but the advantage of using a pseudospectral code is that the $k=0$ mode is conserved. We find that the $q>2$ regime is unstable to turbulence both in the hydrodynamic and in the MHD limit (with an initially weak magnetic field). In the $q>2$ regime, the velocity fluctuations dominate the magnetic fluctuations whereas in the $q2$ regime the instability produces primarily velocity fluctuations that cause magnetic fluctuations, with the causality reversed for the $q<2$ MRI unstable regime. We also find that the magnetic field correlation is increasingly localized as the shear is increa...

  9. Unstable Dynamical Properties of Spiral Cloud Bands in Tropical Cyclones

    Institute of Scientific and Technical Information of China (English)

    HUANG Hong; ZHANG Ming

    2009-01-01

    A nondivergent barotropic model (Model 1) and a barotropic primitive equation vortex model (Model 2) are linearized respectively in this paper. Then their perturbation wave spectrums are computed with a normal mode approach to study the instability problem on an appointed tropical cyclone (TC)-like vortex, thereby, the dynamic instability properties of spiral cloud bands of TCs are discussed. The results show that the unstable mode of both models exhibits a spiral band-like structure that propagates away from the vortex outside the radius of maximum winds. The discrete modal instability of the pure vortex Rossby wave can account for the generation of the eyewall and the inner spiral band. The unstable mode in Model 2 has three parts, i.e., eyewall, inner and outer spiral bands. This mode can be interpreted as a mixed vortex Rossby-inertia gravitational wave. The unbalanced property of the wave outside the stagnation radius of the vortex Rossby wave is one of the important reasons for the formation of the outer spiral band in TCs. Accordingly, the outer spiral band can be identified to possess properties of an inertial-gravitational wave.When the formation of unstable inner and outer spiral bands is studied, a barotropic vortex model shall be used. In this model, the most unstable perturbation bears the attributes of either the vortex Rossby wave or the inertial-gravitational wave, depending on the vortex radius. So such perturbations shall be viewed as an unbalanced and unstable mixed wave of these two kinds of waves.

  10. A novel approach to modeling unstable EOR displacements. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Peters, E.J.

    1994-04-01

    Most enhanced oil recovery schemes involve the displacement of a more dense and more viscous oil by a less dense and less viscous fluid in a heterogeneous porous medium. The interaction of heterogeneity with the several competing forces, namely, viscous, capillary, gravitational, and dispersive forces, can conspire to make the displacements unstable and difficult to model and to predict. The objective of this research was to develop a systematic methodology for modeling unstable fluid displacements in heterogeneous media. Flow visualization experiments were conducted using X-ray computed tomography imaging and a video imaging workstation to gain insights into the dynamics of unstable displacements, acquire detailed quantitative experimental image data for calibrating numerical models of unstable displacements, and image and characterize heterogeneities in laboratory cores geostatistically. High-resolution numerical models modified for use on vector-architecture supercomputers were used to replicate the image data. Geostatistical models of reservoir heterogeneity were incorporated in order to study the interaction of hydrodynamic instability and heterogeneity in reservoir displacements. Finally, a systematic methodology for matching the experimental data with the numerical models and scaling the laboratory results to other systems were developed. The result is a new method for predicting the performance of unstable EOR displacements in the field based on small-scale displacements in the laboratory. The methodology is general and can be applied to forecast the performance of most processes that involve fluid flow and transport in porous media. Therefore, this research should be of interest to those involved in forecasting the performance of enhanced oil recovery processes and the spreading of contaminants in heterogeneous aquifers.

  11. 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....

  12. Effect of Atorvastatin and Pioglitazone on Plasma Levels of Adhesion Molecules in Non-Diabetic Patients With Hypertension or Stable Angina or Both

    OpenAIRE

    Pattan, Vishwanath; Seth, Sandeep; Jehangir, Waqas; Bhargava, Balram; Maulik, Subir Kumar

    2015-01-01

    Background It was to study the effect of atorvastatin, pioglitazone and their combination on plasma levels of adhesion molecules in patients with hypertension or stable angina or both. Methods It was an open-label, randomized parallel-group study. Forty-five atorvastatin-naive patients with hypertension or stable angina or both, were randomized to receive either atorvastatin (19 patients; 10 mg OD for 12 weeks) or pioglitazone (26 patients; 30 mg OD for 12 weeks). Another group of 30 patients...

  13. Resolution of Angina Pectoris and Improvement of the Coronary Flow Reserve after Ranolazine Treatment in a Woman with Isolated Impaired Coronary Microcirculation

    OpenAIRE

    Alessandro Santoro; Vincenzo Schiano Lomoriello; Ciro Santoro; Riccardo Muscariello; Maurizio Galderisi

    2013-01-01

    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 pati...

  14. Long-Term Preservation of Left Ventricular Systolic Function in Patients With Refractory Angina Pectoris and Inducible Myocardial Ischemia on Optimal Medical Therapy.

    Science.gov (United States)

    Slavich, Massimo; Maranta, Francesco; Fumero, Andrea; Godino, Cosmo; Giannini, Francesco; Oppizzi, Michele; Colombo, Antonio; Fragasso, Gabriele; Margonato, Alberto

    2016-05-15

    Refractory angina pectoris (RAP) represents a clinical condition characterized by frequent episodes of chest pain despite therapy optimization. According to myocardial stunning and myocardial hibernation definitions, RAP should represent the ideal condition for systolic dysfunction development. We aim to investigate the evolution of left ventricular (LV) function in patients with RAP. A retrospective study which encompasses 144 patients with RAP referred to our institution from 1999 to December 2014 was performed. Of them, 88 met the inclusion criteria, and LV function was assessed by echocardiography. All of them had persistent angina episodes on top of optimal medical therapy and evidence of significant inducible myocardial ischemia and no further revascularization options. Nitrates consumption rate, time of angina duration, and the number of angina attacks were evaluated. In the whole population, ejection fraction (EF) was 44% ± 2. EF was significantly lower in patients with previous myocardial infarction (41% ± 1.5 vs 51% ± 1.8, p 5 years (5 years 44% ± 2 [n = 44]; p 0.02). Long-term LV function in patients with RAP is generally preserved. A previous history of myocardial infarction is the only determinant in the development of systolic dysfunction. In conclusion, frequent angina attacks and a long-term history of angina are not apparently associated to worse LV function. PMID:27055755

  15. 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. PMID:25360837

  16. 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

    (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65%) than men (32%) had no obstructive CAD (P<0.001). In Cox's models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or...... 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.......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...

  17. Stabilization of switched nonlinear systems with unstable modes

    CERN Document Server

    Yang, Hao; Cocquempot, Vincent

    2014-01-01

    This book provides its reader with a good understanding of the stabilization of switched nonlinear systems (SNS), systems that are of practical use in diverse situations: design of fault-tolerant systems in space- and aircraft; traffic control; and heat propagation control of semiconductor power chips. The practical background is emphasized throughout the book; interesting practical examples frequently illustrate the theoretical results with aircraft and spacecraft given particular prominence. Stabilization of Switched Nonlinear Systems with Unstable Modes treats several different subclasses of SNS according to the characteristics of the individual system (time-varying and distributed parameters, for example), the state composition of individual modes and the degree and distribution of instability in its various modes. Achievement and maintenance of stability across the system as a whole is bolstered by trading off between individual modes which may be either stable or unstable, or by exploiting areas of part...

  18. Crisis and unstable dimension variability in the bailout embedding map

    Indian Academy of Sciences (India)

    N Nirmal Thyagu; Neelima Gupta

    2008-06-01

    The dynamics of inertial particles in 2-d incompressible flows can be modeled by 4-d bailout embedding maps. The density of the inertial particles, relative to the density of the fluid, is a crucial parameter which controls the dynamical behaviour of the particles. We study here the dynamical behaviour of aerosols, i.e. particles heavier than the flow. An attractor widening and merging crisis is seen in the phase space in the aerosol case. Crisis-induced intermittency is seen in the time series and the laminar length distribution of times before bursts give rise to a power law with the exponent = -1/3. The maximum Lyapunov exponent near the crisis fluctuates around zero indicating unstable dimension variability (UDV) in the system. The presence of unstable dimension variability is confirmed by the behaviour of the probability distributions of the finite time Lyapunov exponents.

  19. Non-shell unstable particles in thermal field theory

    International Nuclear Information System (INIS)

    Using (nonrigorous) operator-algebraic and group-theoretic techniques the particle structure of interacting real-time thermal field theory is investigated. A description in terms of elementary unstable entities without a dispersion relation is arrived at. The asymptotic fields are found to be two-parameter generalized free fields. Contact with the Licht-field description of on-shell unstable particles is thereby achieved. Poincare-symmetry breaking and the rearrangement of spin to helicity at finite temperature are fully discussed and incorporated. A unique thermal Gell-Mann/Low formula is obtained. Feynman rules and renormalization conditions pertaining to non-shell thermal particles are given. Dissipation thereby naturally emerges. All relevant esoteric mathematics is explained. copyright 1988 Academic Press, Inc

  20. Non-Abelian magnetized blackholes and unstable attractors

    International Nuclear Information System (INIS)

    Fluctuations of non-Abelian gauge fields in a background magnetic flux contain tachyonic modes and hence the background is unstable. We extend these results to the cases where the background flux is coupled to Einstein gravity and show that the corresponding spherically symmetric geometries, which in the absence of a cosmological constant are of the form of Reissner-Nordstroem blackholes or the AdS2 x S2, are also unstable. We discuss the relevance of these instabilities to several places in string theory including various string compactifications and the attractor mechanism. Our results for the latter imply that the attractor mechanism shown to work for the extremal Abelian charged blackholes, cannot be applied in a straightforward way to the extremal non-Abelian colored blackholes. (author)

  1. Traveling circumferential unstable wave of cylindrical flame front

    Science.gov (United States)

    Trilis, A. V.; Vasiliev, A. A.; Sukhinin, S. V.

    2016-06-01

    The researches of stability of cylindrical front of deflagration combustion in an annular combustion chamber were made using phenomenological model. The flame front is described as discontinuity of gasdynamic parameters. It is considered that the combustion products are under chemical equilibrium. The combustible mixture and the combustion products are ideal gases. The velocity of deflagration combustion is determined using the Chapman-Jouget theory. It depends on the temperature of combustible mixture only. It is found that the combustible flame front is unstable for several types of small disturbances in the system Mechanics of instabilities are examined using both the numeric and analytical methods. The cases of evolution of the unstable waves rotating in circular channel are presented.

  2. External Fixation of Unstable Distal Radius Fracture. A Case Report

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez

    2014-12-01

    Full Text Available Unstable fracture of the distal radius is a common injury. If not properly treated, it can cause major disturbance in the radiocarpal joint and impaired hand function. A case of a 42-year-old patient of rural origin without a history of previous conditions treated at the Gustavo Aldereguía Lima Hospital in Cienfuegos is presented. He suffered a fall on the outstretched hand, which led to an unstable fracture of the left distal radius. Emergency surgery consisting of manual fracture reduction under general anesthesia and fixation with RALCA minifixator plus a percutaneously placed Kirschner wire was performed. Since this fracture is often inadequately treated, the presentation of this case can be helpful to many orthopedic surgeons.

  3. Stabilization of unstable steady states by variable delay feedback control

    CERN Document Server

    Gjurchinovski, Aleksandar

    2008-01-01

    We report on a dramatic improvement of the performance of the classical time-delayed autosynchronization method (TDAS) to control unstable steady states, by applying a time-varying delay in the TDAS control scheme in a form of a deterministic or stochastic delay-modulation in a fixed interval around a nominal value $T_0$. The successfulness of this variable delay feedback control (VDFC) is illustrated by a numerical control simulation of the Lorenz and R\\"{o}ssler systems using three different types of time-delay modulations: a sawtooth wave, a sine wave, and a uniform random distribution. We perform a comparative analysis between the VDFC method and the standard TDAS method for a sawtooth-wave modulation by analytically determining the domains of control for the generic case of an unstable fixed point of focus type.

  4. γ-unstable nuclei in the sdg boson model

    International Nuclear Information System (INIS)

    Following the recent Pt(p,p') experiments which indicated the need for g bosons to reproduce the E4 data, we have extended the O(6) limit of the sd boson model to the sdg bosons. It is shown that a γ-unstable Hamiltonian in the sdg model consisting of a quadrupole interaction and a g boson energy leads to results that are very similar to the O(6) limit. Deviations from the empirical energy spectrum that stem from the γ-unstable nature of the Hamiltonian can be improved by including a consistent hexadecapole interaction which induces triaxiality. The same hexadecapole operator can also account for the strong E4 transitions to the 4+ states presumed to be g boson states. Specific applications are made to the Xe and Pt isotopes. 12 refs., 2 tabs., 4 figs

  5. Study of structure of light unstable nuclei by AMD

    International Nuclear Information System (INIS)

    We applied an antisymmetrized molecular dynamics method (AMD), at the first time, to investigate the nuclear structure and succeeded the description of light nuclei with unstable nuclei. The wave function of one nucleus by AMD makes possible to describe various kinds of structure from cluster to the shell model by the configuration of the wave packet. The results of Li, Be, B and C isotopes (without odd-odd nucleus) by AMD were shown. The bond-energy, the magnetic dipole moment, the electric quadrupole moment and E2 transition strength were reappeared by the experimental values, but the abnormal large reaction radius of unstable nucleus was not. The internal structure was investigated on the basis of these values. (S.Y.)

  6. Stable and unstable thermo -current states of high temperature superconductors

    International Nuclear Information System (INIS)

    Formation peculiarities of the stable and unstable states of high-Tc superconductors are discussed. To understand the basic physical trends, which are characteristic for the current penetration mechanism in high temperature superconductors, the operating states of Bi2212 slab without stabilizing matrix placed in DC external magnetic fields at low coolant temperature are theoretically investigated. It is proved that the temperature of a high-Tc superconductor is not equals to the coolant temperature before instability onset. Therefore, the voltage-current characteristic of a high-Tc superconductor has only a positive slope during continuous current charging. As a result, it does not allow one to find the boundary between stable and unstable thermo - current states. This peculiarity has to be considered during experiments at which the critical current of high-Tc superconductors is defined

  7. Predictors of coronary intervention-related myocardial infarction in stable angina patients pre-treated with statins

    OpenAIRE

    Veselka, Josef; Hájek, Petr; Malý, Martin; Zemánek, David; Adlová, Radka; Tomašov, Pavol; Martinkovičová, Lucie; Tesař, David; Červinka, Pavel

    2011-01-01

    Introduction Peri-procedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This study was designed to determine the predictors of PMI in patients pre-treated with statins. Material and methods A total of 418 stable angina pectoris patients taking statins and aspirin were included. All the patients underwent PCI. Serum concentrations of creatine kinase (CK-MB mass) and troponin I (TnI) were measured prior to and...

  8. Richtlinien zur Diagnostik und Therapie der instabilen Angina pectoris und des Non-Q-Wave-Myokardinfarktes: vorgeschlagene Revisionen

    OpenAIRE

    Huber K; Gaul G; Glogar HD; Kaliman J; Mlczoch J

    2000-01-01

    Die letzten Praxis-Empfehlungen der United States Agency for Health Care Policy and Research zum Thema "Diagnose und Behandlung der instabilen Angina Pectoris (IAP)" stammen aus dem Jahre 1994 und wurden trotz der rasanten Fortschritte auf diesem Gebiet in den vergangenen 5 Jahren nicht erneuert. Das International Cardiology Forum (ICF) hat Ende 1998 die existierenden Richtlinien diskutiert und Vorschläge gemacht, in welchen Bereichen die Diagnostik und die Therapie der IAP aufgrund der mittl...

  9. Periodontal disease in relation to selected parameters of the cardiovascular system in a group of patients with stable angina pectoris

    OpenAIRE

    Włosowicz, Monika; Wożakowska-Kapłon, Beata; Górska, Renata

    2014-01-01

    Introduction Periodontal diseases (PD), which are the cause of chronic inflammatory processes, can develop increased susceptibility to vascular diseases through atherosclerosis. Due to the raised inflammatory and thrombotic risk, PD can have a significant influence on the course and results of stable angina pectoris (SAP). Objectives The aim of the study is to evaluate the influence of chosen PD parameters on selected cardiovascular system parameters, and the correlation between chosen parame...

  10. The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina

    OpenAIRE

    Sadeghi, Masoumeh; Tavasoli, Aliakbar; Roohafza, Hamidreza; Sarrafzadegan, Nizal

    2010-01-01

    BACKGROUND Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina. METHODS This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic informatio...

  11. A controlled comparison of oxyfedrine, isosorbide dinitrate and placebo in the treatment of patients suffering attacks of angina pectoris.

    OpenAIRE

    Whittington, J; Raftery, E B

    1980-01-01

    1 In a group of 23 patients with documented ischaemic heart disease who experienced angina pectoris, oral oxyfedrine (24 mg three times daily) was compared with isosorbide dinitrate (10 mg three times daily) and placebo in a double-blind double-crossover clinical trial. 2 Isosorbide dinitrate appeared no better than placebo, either in terms of symptomatic relief or ECG responses to exercise. Thirty eight per cent of patients complained of headaches and 28% had to cease taking the drug for thi...

  12. Drug efficacy in treating stable angina pectoris: a protocol for network meta-analysis of randomised controlled trials

    OpenAIRE

    Jia, Yongliang; Leung, Siu-wai

    2014-01-01

    Introduction There were 11 pairwise meta-analysis on the efficacy of β-blockers (including atenolol, propranolol, bisoprolol, metoprolol and nadolol), calcium channel blockers (including amlodipine, diltiazem, felodipine, nifedipine and verapamil), and nitrates (including isosorbide dinitrate, isosorbide mononitrate and nitroglycerin) in treating stable angina pectoris. No network meta-analytic study has been published to evaluate the efficacies of these antianginal drugs. Current clinical gu...

  13. 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.

  14. Traces of stable and unstable manifolds in heat flux patterns

    International Nuclear Information System (INIS)

    Experimental observations of heat fluxes on divertor plates of tokamaks show typical structures (boomerang wings) for varying edge safety factors. The heat flux patterns follow from general principles of nonlinear dynamics. The pattern selection is due to the unstable and stable manifolds of the hyperbolic fixed points of the last intact island chain. Based on the manifold analysis, the experimental observations can be explained in full detail. Quantitative results are presented in terms of the penetration depths of field lines

  15. Calcar Preservation Arthroplasty for Unstable Intertrochanteric Femoral Fractures in Elderly

    Science.gov (United States)

    Togrul, Emre; Kose, Ozkan

    2015-01-01

    Background The treatment of unstable intertrochanteric fractures in elderly is still controversial. The purpose of this study is to present treatment strategies for unstable intertrochanteric fractures with hemiarthroplasty using standard uncemented collared femoral stems and at the same time preserving the fractured calcar fragment. Methods Fifty-four patients aged 75 years or older with unstable intertrochanteric fractures were included in this prospective cohort study. All patients were treated with calcar preserving hemiarthroplasty using cementless collored femoral stems. Fractured calcar fragment was stabilized either by compaction between the implant and femur or fixed with cable grip system. Follow-up evaluations were performed at least 24 months and later. Palmer and Parker mobility score and visual analogue scale (VAS) pain score were assessed. We also analyzed radiographs of the operated hip at each follow-up visit. Results The patients were 15 males and 39 females with a mean age of 81.3 years (range, 75 to 93 years). The average operative time was 86.6 minutes. The mean transfused blood units were 1.2 units. The average duration of hospital stay was 5.3 days. The preoperative mean mobility score was 6.20. This score was found to be 4.96 on postoperative third day and 5.90 at 24 months postoperatively. The results of the statistical analysis revealed significant increase in the mobility scores at each follow-up after three days. Radiological interpretation revealed no loosening in the cable-grip systems, and no significant subsidence (> 5 mm) of prosthesis was observed. Conclusions Calcar preservation arthroplasty is a good option for elderly patients with severe osteoporosis, frail constitution and the patients who are at higher risk for second operation due to unstable intertrochanteric fractures. PMID:26640625

  16. Dynamics of bubble growth for Rayleigh--Taylor unstable interfaces

    International Nuclear Information System (INIS)

    A statistical model is analyzed for the growth of bubbles in a Rayleigh--Taylor unstable interface. The model is compared to solutions of the full Euler equations for compressible two phase flow, using numerical solutions based on the method of front tracking. The front tracking method has the distinguishing feature of being a predominantly Eulerian method in which sharp interfaces are preserved with zero numerical diffusion. Various regimes in the statistical model exhibiting qualitatively distinct behavior are explored

  17. Distributed Beacon Drifting Detection for Localization in Unstable Environments

    OpenAIRE

    Ming Xia; Peiliang Sun; Xiaoyan Wang; Yan Jin; Qingzhang Chen

    2013-01-01

    Localization is a fundamental research issue in wireless sensor networks (WSNs). In most existing localization schemes, several beacons are used to determine the locations of sensor nodes. These localization mechanisms are frequently based on an assumption that the locations of beacons are known. Nevertheless, for many WSN systems deployed in unstable environments, beacons may be moved unexpectedly; that is, beacons are drifting, and their location information will no longer be reliable. As a...

  18. Inherently unstable networks collapse to a critical point

    Science.gov (United States)

    Sheinman, M.; Sharma, A.; Alvarado, J.; Koenderink, G. H.; MacKintosh, F. C.

    2015-07-01

    Nonequilibrium systems that are driven or drive themselves towards a critical point have been studied for almost three decades. Here we present a minimalist example of such a system, motivated by experiments on collapsing active elastic networks. Our model of an unstable elastic network exhibits a collapse towards a critical point from any macroscopically connected initial configuration. Taking into account steric interactions within the network, the model qualitatively and quantitatively reproduces results of the experiments on collapsing active gels.

  19. Characterization of Unstable Rock Slopes Through Passive Seismic Measurements

    Science.gov (United States)

    Kleinbrod, Ulrike; Burjánek, Jan; Fäh, Donat

    2014-05-01

    Catastrophic rock slope failures have high social impact, causing significant damage to infrastructure and many casualties throughout the world each year. Both detection and characterization of rock instabilities are therefore of key importance. Analysing unstable rock slopes by means of ambient vibrations might be a new alternative to the already existing methods as for example geotechnical displacement measurements. A systematic measurement campaign has been initiated recently in Switzerland in order to study the seismic response of potential rockslides concerning a broad class of slope failure mechanisms and material conditions. First results are presented in this contribution. Small aperture seismic arrays were deployed at sites of interest for a short period of time (several hours) in order to record ambient vibrations. During each measurement a reference station was installed on a stable part close to the instability. The total number of stations used varies from 16 down to 2, depending on the site scope and resource availability. Instable rock slopes show a highly directional ground motion which is significantly amplified with respect to stable areas. These effects are strongest at certain frequencies which are identified as eigenfrequencies of the unstable rock mass. The eigenfrequencies and predominant directions have been estimated by frequency dependent polarization analysis. Site-to-reference spectral ratios have been calculated as well in order to estimate the relative amplification of ground motion at unstable parts. The retrieved results were compared with independent in-situ observations and other available data. The directions of maximum amplification are in most cases perpendicular to open cracks mapped on the surface and in good agreement with the deformation directions obtained by geodetic measurements. The interpretation of the observed wave field is done through numerical modelling of seismic wave propagation in fractured media with complex

  20. Unstable states produced in collisions among complex nuclei

    International Nuclear Information System (INIS)

    A theory about resonant elastic dispersion is formulated and the wave function of unstable states associated with the resonances observed in the differential and total sections is studied. The object of this theory is to extend to the elastic collisions among complex nuclei interesting case, the methods and formalism of the dispersion of particles without structure by an external potential, following an idea originally formulated by H. Feshbach. (author)

  1. Momentum broadening in unstable quark-gluon plasma

    CERN Document Server

    Carrington, M E; Schenke, B

    2016-01-01

    Quark-gluon plasma produced at the early stage of ultrarelativistic heavy ion collisions is unstable, if weakly coupled, due to the anisotropy of its momentum distribution. Chromomagnetic fields are spontaneously generated and can reach magnitudes much exceeding typical values of the fields in equilibrated plasma. We consider a high energy test parton traversing an unstable plasma that is populated with strong fields. We study the momentum broadening parameter $\\hat q$ which determines the radiative energy loss of the test parton. We develop a formalism which gives $\\hat q$ as the solution of an initial value problem, and we focus on extremely oblate plasmas which are physically relevant for relativistic heavy ion collisions. The parameter $\\hat q$ is found to be strongly dependent on time. For short times it is of the order of the equilibrium value, but at later times $\\hat q$ grows exponentially due to the interaction of the test parton with unstable modes and becomes much bigger than the value in equilibri...

  2. Quantum demolition filtering and optimal control of unstable systems.

    Science.gov (United States)

    Belavkin, V P

    2012-11-28

    A brief account of the quantum information dynamics and dynamical programming methods for optimal control of quantum unstable systems is given to both open loop and feedback control schemes corresponding respectively to deterministic and stochastic semi-Markov dynamics of stable or unstable systems. For the quantum feedback control scheme, we exploit the separation theorem of filtering and control aspects as in the usual case of quantum stable systems with non-demolition observation. This allows us to start with the Belavkin quantum filtering equation generalized to demolition observations and derive the generalized Hamilton-Jacobi-Bellman equation using standard arguments of classical control theory. This is equivalent to a Hamilton-Jacobi equation with an extra linear dissipative term if the control is restricted to Hamiltonian terms in the filtering equation. An unstable controlled qubit is considered as an example throughout the development of the formalism. Finally, we discuss optimum observation strategies to obtain a pure quantum qubit state from a mixed one. PMID:23091216

  3. Unstable periodic orbits and noise in chaos computing.

    Science.gov (United States)

    Kia, Behnam; Dari, Anna; Ditto, William L; Spano, Mark L

    2011-12-01

    Different methods to utilize the rich library of patterns and behaviors of a chaotic system have been proposed for doing computation or communication. Since a chaotic system is intrinsically unstable and its nearby orbits diverge exponentially from each other, special attention needs to be paid to the robustness against noise of chaos-based approaches to computation. In this paper unstable periodic orbits, which form the skeleton of any chaotic system, are employed to build a model for the chaotic system to measure the sensitivity of each orbit to noise, and to select the orbits whose symbolic representations are relatively robust against the existence of noise. Furthermore, since unstable periodic orbits are extractable from time series, periodic orbit-based models can be extracted from time series too. Chaos computing can be and has been implemented on different platforms, including biological systems. In biology noise is always present; as a result having a clear model for the effects of noise on any given biological implementation has profound importance. Also, since in biology it is hard to obtain exact dynamical equations of the system under study, the time series techniques we introduce here are of critical importance. PMID:22225394

  4. Evidence of a cellular protective effect by antecedent angina independent of collateral flow recruitment during coronary angioplasty in humans

    International Nuclear Information System (INIS)

    The main aim of this study was to elucidate whether the beneficial effect of antecedent angina is a cellular protective effect or the result of an increase of collateral flow. Of 42 patients with angina who underwent percutaneous transluminal coronary angioplasty (PTCA) for proximal left anterior descending artery (LAD) stenosis, 22 had experienced antecedent anginal pain (AP) within 7 days prior to PTCA. 99mTc-sestamibi was injected during balloon inflation, and quantitative analysis of ischemic severity during coronary occlusion was calculated (SS). An electrocardiogram was recorded during ballooning to calculate the sum of ST elevation (ΣST). ΣST was significantly reduced in patients with AP compared with patients without AP (1.88±0.89 mV vs 1.18±0.74 mV, p=0.0088); however, no difference was observed in defect severity. A close correlation was observed between SS and ΣST in both groups. The multivariate regression model demonstrated that both a large SS (p<0.0001) and the absence of preceding AP (p=0.001) were significantly related to the elevation of ΣST. Recent angina can render the myocardium more resistant to subsequent ischemia during angioplasty and is true preconditioning rather than simply an increase of flow. (author)

  5. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    Directory of Open Access Journals (Sweden)

    Gilman Robert H

    2010-10-01

    Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as

  6. Typische Angina pectoris-Symptomatik bei normalem Koronarangiogramm: Gibt es geschlechtsspezifische Unterschiede?

    Directory of Open Access Journals (Sweden)

    Graf S

    2008-01-01

    Full Text Available 10–30 % aller Patientinnen und Patienten mit typischer Angina pectoris-Symptomatik und positivem Belastungstest weisen angiographisch unauffällige epikardiale Koronarien auf. Diese Befundkonstellation wird auch als Syndrom X bezeichnet. In der folgenden Übersicht soll auf geschlechtsspezifische Unterschiede sowie mögliche Ursachen dieses Krankheitsbildes eingegangen werden. So konnte gezeigt werden, dass die diagnostische Wertigkeit nicht-invasiver Tests wie Ergometrie und Myokardszintigraphie bei Frauen und Männern unterschiedlich ist und ein "falsch positiver" Test durch geschlechtsspezifische methodische Probleme hervorgerufen sein kann. Ein weiterer Grund für falsch positive Ergebnisse nicht-invasiver Tests kann das Vorliegen einer mikrovaskulären koronaren Herzkrankheit darstellen. Auf die Häufigkeit und Geschlechtsverteilung dieser Erkrankung und deren Prognose sowie mögliche Therapieansätze wird in der folgenden Übersicht eingegangen. Des Weiteren wird auf mögliche ursächliche Zusammenhänge, im Besonderen mit der Bedeutung des Risikofaktorenprofils, hingewiesen.

  7. Der Einsatz von niedermolekularen Heparinen bei instabiler Angina pectoris und nicht-transmuralem Myokardinfarkt

    Directory of Open Access Journals (Sweden)

    Huber K

    1999-01-01

    Full Text Available Im vorliegenden Artikel wird die Anwendung unterschiedlicher niedermolekularer Heparine bei instabiler Angina und nicht-transmuralem Infarkt auf dem neuesten Stand der internationalen Datenlage besprochen. Dabei scheint Enoxaparin die höchste Effektivität unter den getesteten LMW-Heparinen in der Akutphase der Erkrankung zu besitzen, da zwei durchgeführte Studien (ESSENCE, TIMI-11B signifikante Vorteile gegenüber Standard-Heparin nachgewiesen haben. Demgegenüber scheint Dalteparin Vorteile in der längerdauernden Anwendung nach der Akutphase zu haben (FRISC-II. Da die Patientenpopulationen in den bisher durchgeführten Studien aber nicht sicher vergleichbar sind, da zu wenig Daten über die mögliche klinische Bedeutung pharmakologischer Unterschiede der verschiedenen LMW-Heparine vorliegen, und vor allem, weil es keine prospektiven, randomisierten Vergleichsstudien zwischen verschiedenen LMW-Heparinen gibt, kann derzeit nicht, durch wissenschaftliche Daten abgesichert, einem der untersuchten LMW-Heparine der Vorteil gegenüber einem anderen in dieser Indikation gegeben werden.

  8. Adaptation and validation of the Iranian version of Angina Pectoris characteristics questionnaire.

    Science.gov (United States)

    Najafi-Ghezeljeh, Tahereh; Ekman, Inger; Nikravesh, Mansoureh Yadavar; Emami, Azita

    2008-12-01

    Research aimed at evaluating Angina Pectoris (AP) symptoms in patients with Coronary Heart Disease (CHD) requires a comprehensive assessment tool applicable to this population. Because no single existing measure assessed the full range of symptom characteristics important to our study, we combined two measures (the modified Rose Questionnaire (MRQ), and the Short Form-McGill Pain Questionnaire (SF-MPQ) and added one item to examine specific aspects of AP symptoms (Accompanying Symptom Checklist). The purposes of this study are: (i) to describe the process of translating the SF-MPQ, MRQ and accompanying symptom checklist from English to the Farsi language; and (ii) to evaluate substantial psychometric works (content and construct validity) for the entire instrument and each part of it (SF-MPQ, MRQ and accompanying symptom checklist). A cross-cultural adaptation of the instrument was carried out before developing the final version of it. To these ends, one hundred and 10 CHD patients with AP were assessed by this hybrid measure in an initial study. An analysis of the results indicated that a content valid instrument had been developed. There was a significantly high correlation between scores in the SF-MPQ and there were associations between items in the MRQ. The Iranian version of AP characteristics questionnaire is valid; it is capable of describing characteristics of AP symptoms. However, the reliability of the instrument needs to be assessed through further research. PMID:19126076

  9. Vasospastic angina pectoris complicated by acute myocardial infarction and complete atrioventricular block

    Directory of Open Access Journals (Sweden)

    Pavlović Milan

    2011-01-01

    Full Text Available Background. A prolonged coronary artery spasm with interruption of coronary blood flow can lead to myocardial necrosis and increase of cardiospecific enzymes and can be complicated with cardiac rhythm disturbances, syncopc, or even sudden cardiac death. Case report. A 55-year old male felt a severe retrosternal pain when exposing himself to cold weather. The pain lasted for 20 minutes and was followed by the loss of conscience. Electrocardiogram (ECG showed a complete antrioventricular (AV block with nodal rhythm and marked elevation of ST segment in inferior leads. Electrocardiogram was soon normalized, but serum activities of cardiospecific enzymes were increased. Coronarography showed normal findings for the left coronary artery and a narrowing at the middle part of the right coronary artery, which disappeared after intracoronary application of nitroglycerine. The following therapy was prescribed: Diltiazem, Amlodipin, Isosorbid mononitrate, Molisdomin, Atrovastatin, Aspirin and Nitroglycerine spray. After 7 months medicaments were abandoned and the patient experienced again reccurent chest pain episodes at rest. Transitory ST segment elevation was recorded in inferior leads of ECG, but without increase of cardiospecific enzymes serum activities. After restoration of the medicament therapy anginal episodes ceased. Conclusion. Coronary dilators in maximal doses can prevent attacks of vasospastic angina.

  10. Therapeutic efficacy of a new transdermal system containing nitroglycerin in patients with angina pectoris.

    Science.gov (United States)

    Georgopoulos, A J; Markis, A; Georgiadis, H

    1982-01-01

    The results of a placebo-controlled, double-blind cross-over study in 13 patients with angina pectoris demonstrated that daily application of a newly developed, transdermal therapeutic system for the administration of nitroglycerin (NTG-TTS) over a period of 14 days reduced the daily frequency of anginal attacks by 67%, and the daily consumption of nitrates by 63%. Systolic and diastolic blood pressures were significantly lowered by 10 mmHg and 7.5 mmHg, respectively. The exercise-induced increase in blood pressure was not influenced by NTG-TTS, but it occurred at a lower level. Heart rate was not increased by NTG-TTS, either at rest or upon exercise. Exercise-induced depression of the ST segment diminished by about 50%, and anginal attacks were distinctly less severe and of shorter duration NTG application. Development of tolerance was not detected; on the contrary, the anti-anginal effect was more pronounced in the second than in the first week of medication. NTG had no effect on haematological parameters or blood chemistry, and methaemoglobin formation was not observed. Cutaneous tolerability of the system was good and its application posed no major problem. PMID:6813126

  11. 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).

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

    International Nuclear Information System (INIS)

    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)

  13. Nitric Oxide Synthetic Pathway in Patients with Microvascular Angina and Its Relations with Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Benedetta Porro

    2014-01-01

    Full Text Available A decreased nitric oxide (NO bioavailability and an increased oxidative stress play a pivotal role in different cardiovascular pathologies. As red blood cells (RBCs participate in NO formation in the bloodstream, the aim of this study was to outline the metabolic profile of L-arginine (Arg/NO pathway and of oxidative stress status in RBCs and in plasma of patients with microvascular angina (MVA, investigating similarities and differences with respect to coronary artery disease (CAD patients or healthy controls (Ctrl. Analytes involved in Arg/NO pathway and the ratio of oxidized and reduced forms of glutathione were measured by LC-MS/MS. The arginase and the NO synthase (NOS expression were evaluated by immunofluorescence staining. RBCs from MVA patients show increased levels of NO synthesis inhibitors, parallel to that found in plasma, and a reduction of NO synthase expression. When summary scores were computed, both patient groups were associated with a positive oxidative score and a negative NO score, with the CAD group located in a more extreme position with respect to Ctrl. This finding points out to an impairment of the capacity of RBCs to produce NO in a pathological condition characterized mostly by alterations at the microvascular bed with no significant coronary stenosis.

  14. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

    Directory of Open Access Journals (Sweden)

    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.

  15. Control of unstable steady states by extended time-delayed feedback

    OpenAIRE

    Dahms, Thomas; Hoevel, Philipp; Schoell, Eckehard

    2007-01-01

    Time-delayed feedback methods can be used to control unstable periodic orbits as well as unstable steady states. We present an application of extended time delay autosynchronization introduced by Socolar et al. to an unstable focus. This system represents a generic model of an unstable steady state which can be found for instance in a Hopf bifurcation. In addition to the original controller design, we investigate effects of control loop latency and a bandpass filter on the domain of control. ...

  16. Strategy switching in the stabilization of unstable dynamics.

    Directory of Open Access Journals (Sweden)

    Jacopo Zenzeri

    Full Text Available In order to understand mechanisms of strategy switching in the stabilization of unstable dynamics, this work investigates how human subjects learn to become skilled users of an underactuated bimanual tool in an unstable environment. The tool, which consists of a mass and two hand-held non-linear springs, is affected by a saddle-like force-field. The non-linearity of the springs allows the users to determine size and orientation of the tool stiffness ellipse, by using different patterns of bimanual coordination: minimal stiffness occurs when the two spring terminals are aligned and stiffness size grows by stretching them apart. Tool parameters were set such that minimal stiffness is insufficient to provide stable equilibrium whereas asymptotic stability can be achieved with sufficient stretching, although at the expense of greater effort. As a consequence, tool users have two possible strategies for stabilizing the mass in different regions of the workspace: 1 high stiffness feedforward strategy, aiming at asymptotic stability and 2 low stiffness positional feedback strategy aiming at bounded stability. The tool was simulated by a bimanual haptic robot with direct torque control of the motors. In a previous study we analyzed the behavior of naïve users and we found that they spontaneously clustered into two groups of approximately equal size. In this study we trained subjects to become expert users of both strategies in a discrete reaching task. Then we tested generalization capabilities and mechanism of strategy-switching by means of stabilization tasks which consist of tracking moving targets in the workspace. The uniqueness of the experimental setup is that it addresses the general problem of strategy-switching in an unstable environment, suggesting that complex behaviors cannot be explained in terms of a global optimization criterion but rather require the ability to switch between different sub-optimal mechanisms.

  17. Unstable particles in non-relativistic quantum mechanics?

    International Nuclear Information System (INIS)

    The Schroedinger equation is up-to-a-phase invariant under the Galilei group. This phase leads to the Bargmann's superselection rule, which forbids the existence of the superposition of states with different mass and implies that unstable particles cannot be described consistently in non-relativistic quantum mechanics (NRQM). In this paper we claim that Bargmann's rule neglects physical effects and that a proper description of non-relativistic quantum mechanics requires to take into account this phase through the Extended Galilei group and the definition of its action on spacetime coordinates.

  18. Quantum field theory of classically unstable Hamiltonian dynamics

    International Nuclear Information System (INIS)

    We study a class of dynamical systems for which the motions can be described in terms of geodesics on a manifold (ordinary potential models can be cast into this form by means of a conformal map). It is rigorously proven that the geodesic deviation equation of Jacobi, constructed with a second covariant derivative, is unitarily equivalent to that of a parametric harmonic oscillator, and we study the second quantization of this oscillator. The excitations of the Fock space modes correspond to the emission and absorption of quanta into the dynamical medium, thus associating unstable behavior of the dynamical system with calculable fluctuations in an ensemble with possible thermodynamic consequences

  19. Porter-Thomas distribution in unstable many-body systems

    International Nuclear Information System (INIS)

    We use the continuum shell model approach to explore the resonance width distribution in unstable many-body systems. The single-particle nature of a decay, the few-body character of the interaction Hamiltonian, and the collectivity that emerges in nonstationary systems due to the coupling to the continuum of reaction states are discussed. Correlations between the structures of the parent and daughter nuclear systems in the common Fock space are found to result in deviations of decay width statistics from the Porter-Thomas distribution.

  20. On the definition of entropy for quantum unstable states

    International Nuclear Information System (INIS)

    The concept of entropy is central to the formulation of the quantum statistical mechanics, and it is linked to the definition of the density operator and the associated probabilities of occupation of quantum states. The extension of this scheme to accommodate for quantum decaying states is conceptually difficult, because of the nature of these states. Here we present a way to treat quantum unstable states in the context of statistical mechanics. We focuss on the definition of the entropy and avoid the use of complex temperatures

  1. Stability conditions of complex switched systems with unstable subsystems

    Institute of Scientific and Technical Information of China (English)

    肖扬

    2004-01-01

    New stability conditions for complex switched systems are presented. We propose the concepts of attractive region and semi-attractive region, which are used as a tool for analyzing the stability of switched systems with unstable subsystems. Based on attractive region the sufficient conditions with less conservative for stability of switched systems have been established, there is no limitation for all members of the system set to be stable. Since our results have considered and utilized the decreasing span of oscillating solutions of the switched systems, they are more practical than the other presented ones of stability of switched systems, and need not resort to multiple Lyapunov functions.

  2. Chromohydrodynamic approach to the unstable quark-gluon plasma

    International Nuclear Information System (INIS)

    We derive hydrodynamic-like equations that are applicable to short-time-scale color phenomena in the quark-gluon plasma. The equations are solved in the linear response approximation, and the gluon polarization tensor is derived. As an application, we study the collective modes in a two-stream system and find plasma instabilities when the fluid velocity is larger than the speed of sound in the plasma. The chromohydrodynamic approach, discussed here in detail, should be considered as simpler over other approaches and well-designed for numerical studies of the dynamics of an unstable quark-gluon plasma

  3. Chromohydrodynamic approach to the unstable quark-gluon plasma

    Science.gov (United States)

    Manuel, Cristina; Mrówczyński, Stanisław

    2006-11-01

    We derive hydrodynamic-like equations that are applicable to short-time-scale color phenomena in the quark-gluon plasma. The equations are solved in the linear response approximation, and the gluon polarization tensor is derived. As an application, we study the collective modes in a two-stream system and find plasma instabilities when the fluid velocity is larger than the speed of sound in the plasma. The chromohydrodynamic approach, discussed here in detail, should be considered as simpler over other approaches and well-designed for numerical studies of the dynamics of an unstable quark-gluon plasma.

  4. Dipole Excitations of Unstable Neutron-Rich Nuclei

    International Nuclear Information System (INIS)

    Coulomb breakup of high-energy secondary beams of unstable nuclei serves in nuclear structure investigations of neutron-rich isotopes. A summary of the respective research activities at GSI is presented, covering isotopes from helium to oxygen. The breakup is mediated through dipole excitations in to the continuum. Non-resonant excitations in to the continuum near the dissociation threshold deliver information on the single-particle ground-state structure. Resonant excitation into the giant resonance domain is also observed. In addition, a brief outlook on future activities at GSI is given. (author)

  5. Unstable volatility functions: the break preserving local linear estimator

    DEFF Research Database (Denmark)

    Casas, Isabel; Gijbels, Irene

    The objective of this paper is to introduce the break preserving local linear (BPLL) estimator for the estimation of unstable volatility functions. Breaks in the structure of the conditional mean and/or the volatility functions are common in Finance. Markov switching models (Hamilton, 1989) and...... threshold models (Lin and Terasvirta, 1994) are amongst the most popular models to describe the behaviour of data with structural breaks. The local linear (LL) estimator is not consistent at points where the volatility function has a break and it may even report negative values for finite samples. The...

  6. Studies of Unstable Nuclei with Spin-Polarized Proton Target

    Science.gov (United States)

    Sakaguchi, Satoshi; Uesaka, Tomohiro; Wakui, Takashi; Chebotaryov, Sergey; Kawahara, Tomomi; Kawase, Shoichiro; Milman, Evgeniy; Tang, Tsz Leung; Tateishi, Kenichiro; Teranishi, Takashi

    2016-02-01

    Roles of spin-dependent interactions in unstable nuclei have been investigated via the direct reaction of radioactive ions with a solid spin-polarized proton target. The target has a unique advantage of a high polarization of 20-30% under low magnetic field of 0.1 T and at a high temperature of 100 K, which allow us to detect recoil protons with good angular resolution. Present status of on-going experimental studies at intermediate energies, such as proton elastic scattering and (p, 2p) knockout reaction, and new physics opportunities expected with low-energy RI beams are overviewed.

  7. A numerical study of unstable Hele-Shaw flow

    DEFF Research Database (Denmark)

    Hansen, Erik Bent; Rasmussen, Henning

    A numerical procedure which is based on an integral equation for the normal velocity at the interface is developed for the unstable flow with surface tension in a Hele-Shaw cell. The procedure has been validated by comparing solutions obtained by it with published results. It has also been applied...... to a study of the effect of small changes in the initial data on the later profiles and it was found that even very small differences can lead to large differences in the profiles at later times. (C) 1999 Elsevier Science Ltd. All rights reserved....

  8. Asymptotic behavior of CLS estimators for unstable INAR(2) models

    CERN Document Server

    Barczy, Matyas; Pap, Gyula

    2012-01-01

    In this paper the asymptotic behavior of the conditional least squares estimators of the autoregressive parameters $(\\alpha, \\beta)$ and of the stability parameter $\\varrho := \\alpha + \\beta$ for an unstable integer-valued autoregressive process $X_k = \\alpha \\circ X_{k-1} + \\beta \\circ X_{k-2} + \\varepsilon_k$, $k\\in\\NN$, is described. The limit distributions and the scaling factors are different according to the following three cases: (i) decomposable, (ii) indecomposable but not positively regular, and (iii) positively regular models.

  9. Innovative aspects of strategic management in conditions of unstable economy

    Directory of Open Access Journals (Sweden)

    Bohdan Andrushkiv

    2013-11-01

    Full Text Available The main directions of strategic planning and management of activities of enterprises in conditions of unstable economy are shown in the article. The experience of industrialized countries at the level of organizations, businesses, corporations was generalized. The basic innovative aspects of strategic management process improvement which consist in creation of flexible planning structures and tactical - operational management are defined. Stages of strategic planning, which can be used by enterprises or other economic entities in the process of strategic programs elaboration at present conditions, are proposed.

  10. Hydrodynamic instability of convectively unstable atmospheres in shear flow

    International Nuclear Information System (INIS)

    Results are presented concerning the interaction between regions of convectively unstable fluid, bounded above and below by stable fluid, with a basic horizontal flow field, sheared in a vertical direction. The analysis is conveniently based on the definition of the mechanical energy flux associated with wave motion in a stratified compressible fluid, and enables bounds to be placed on the real and complex phase velocities of overstable modes, in addition to some general results on the net upward wave energy flux. It is shown that purely exponentially growing modes (with horizontal wavevectors spanwise to the shear) do not exist. A known sufficient condition for the stability of stable atmospheres is reproduced here with an interesting modification, and details of energy-flux discontinuities at certain singular points of the equations are given. The work is relevant to any astrophysical and geophysical situations in which convectively unstable regions and shear flows are likely to be together present, but the special motivation here is that of describing some aspects of the interaction between supergranular flow and granular convection. (Auth.)

  11. Critical Phenomena in Neutron Stars I: Linearly Unstable Nonrotating Models

    CERN Document Server

    Radice, David; Kellermann, Thorsten

    2010-01-01

    We consider the evolution in full general relativity of a family of linearly unstable isolated spherical neutron stars under the effects of very small, perturbations as induced by the truncation error. Using a simple ideal-fluid equation of state we find that this system exhibits a type-I critical behaviour, thus confirming the conclusions reached by Liebling et al. [1] for rotating magnetized stars. Exploiting the relative simplicity of our system, we are able carry out a more in-depth study providing solid evidences of the criticality of this phenomenon and also to give a simple interpretation of the putative critical solution as a spherical solution with the unstable mode being the fundamental F-mode. Hence for any choice of the polytropic constant, the critical solution will distinguish the set of subcritical models migrating to the stable branch of the models of equilibrium from the set of subcritical models collapsing to a black hole. Finally, we study how the dynamics changes when the numerically pertu...

  12. Boundary Between Stable and Unstable Regimes of Accretion

    Directory of Open Access Journals (Sweden)

    Blinova A. A.

    2014-01-01

    Full Text Available We investigated the boundary between stable and unstable regimes of accretion and its dependence on different parameters. Simulations were performed using a “cubed sphere" code with high grid resolution (244 grid points in the azimuthal direction, which is twice as high as that used in our earlier studies. We chose a very low viscosity value, with alpha-parameter α=0.02. We observed from the simulations that the boundary strongly depends on the ratio between magnetospheric radius rm (where the magnetic stress in the magnetosphere matches the matter stress in the disk and corotation radius rcor (where the Keplerian velocity in the disk is equal to the angular velocity of the star. For a small misalignment angle of the dipole field, Θ = 5°, accretion is unstable if rcor/rm> 1.35, and is stable otherwise. In cases of a larger misalignment angle of the dipole, Θ = 20°, instability occurs at slightly larger values, rcor/rm> 1.41

  13. A chaotic system with a single unstable node

    Energy Technology Data Exchange (ETDEWEB)

    Sprott, J.C. [Department of Physics, University of Wisconsin, Madison, WI 53706 (United States); Jafari, Sajad, E-mail: sajadjafari@aut.ac.ir [Biomedical Engineering Department, Amirkabir University of Technology, Tehran 15875-4413 (Iran, Islamic Republic of); Pham, Viet-Thanh [School of Electronics and Telecommunications, Hanoi University of Science and Technology, 01 Dai Co Viet, Hanoi (Viet Nam); Hosseini, Zahra Sadat [Biomedical Engineering Department, Amirkabir University of Technology, Tehran 15875-4413 (Iran, Islamic Republic of)

    2015-09-25

    This paper describes an unusual example of a three-dimensional dissipative chaotic flow with quadratic nonlinearities in which the only equilibrium is an unstable node. The region of parameter space with bounded solutions is relatively small as is the basin of attraction, which accounts for the difficulty of its discovery. Furthermore, for some values of the parameters, the system has an attracting torus, which is uncommon in three-dimensional systems, and this torus can coexist with a strange attractor or with a limit cycle. The limit cycle and strange attractor exhibit symmetry breaking and attractor merging. All the attractors appear to be hidden in that they cannot be found by starting with initial conditions in the vicinity of the equilibrium, and thus they represent a new type of hidden attractor with important and potentially problematic engineering consequences. - Highlights: • An unusual example of a three-dimensional dissipative chaotic flow is introduced. • In this system the only equilibrium is an unstable node. • For some values of the parameters, the system has an attracting torus. • This torus can coexist with a strange attractor or with a limit cycle. • These properties are uncommon in three-dimensional systems.

  14. Predictors of early outcome in unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    Ramesh K Sen; Nirmal Raj Gopinathan; Tajir Tamuk; Rajesh Kumar; Vibhu Krishnan; Radheshyam Sament

    2013-01-01

    Objective:To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures.Methods:This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research,Chandigarh,with unstable pelvic injuries.Results:In the present study of 36 patients,29 were managed surgically.Surgical duration was 2 hours in patients operated on within 1 week and 3.4 hours in those operated on after 1 week.The blood loss was 550 ml when surgery was done after a week,but when done within a week it was 350 ml.The average blood loss through Pfanenstial approach was 360 ml,through posterior approach was 408 ml and through combined approach was 660 ml which was significantly high.Conclusion:Anterior approach to the pelvis would cause significantly more amount of blood loss than posterior approach and external fixation.Surgical approaches do not have any influence on the surgical duration or the infection rate.The blood loss significantly increases when the surgical time is more than 1 h.The infection rate is not influenced by the duration of surgery.Presence or absence of associated injuries to the head,chest or abdomen is the main determinants of patient's survival and it greatly influences the duration of hospital stay.

  15. CEPHALOMEDULLARYS FRACTURE FIXATION IN THE MANAGEMENT OF UNSTABLE HIP FRACTURES.

    Directory of Open Access Journals (Sweden)

    Fonseca-Caro John Fredy

    2015-12-01

    Full Text Available Introduction: unstable hip fractures in elderly people are a public health problem. The treatment is carried out with osteolysis and cephalomedullarys bone nails of which there are others designs. Objective: to determine in the clinical results whether there are differences between PF Targon bone nails and TFN spiral plate. Methods: prospective study was carried out in 69 patients who presented unstable intertrochanteric fracture. The patients were taken to surgery for osteosynthesis with cephalomedullarys bone nails. They were divided in two groups: [A] Two screws fixation in neck (PF Targon and [B] (TFN spiral plate. For both groups were performed by conventional surgical technique and evaluated the surgical time, the bleeding, the intraoperative complications, the functionality results, clinical and radiological consolidation. Results: the procedure was followed in an average of 23 months. No differences were observed in the return of functionality between the use of an implant or other. Complications with Cut Out were more frequent and PF Targon not in the right position without significant difference. Surgical time was lower with TFN, 62.4 ± 15.7 minutes, while with Targon-PF was 86.5 ± 31.7 minutes p<0.0002. Conclusion: no significant differences were observed in the clinical results between the use of PF Targon bone nails and TFN spiral plate. Rev. cienc.biomed. 2015;6(2:265-271 KEY WORDS Bone Nails, Fracture Fixation, Hip.

  16. Are There Unstable Planetary Systems Around White Dwarfs?

    CERN Document Server

    Debes, J H; Debes, John H.; Sigurdsson, Steinn

    2002-01-01

    The presence of planets around solar-type stars suggests that many white dwarfs should have relic planetary systems. While planets closer than $\\sim$ 5~AU will most likely not survive the post-main sequence lifetime of its parent star, any planet with semimajor axis $>$ 5~AU will survive, and its semimajor axis will increase as the central star loses mass. Since the stability of adjacent orbits to mutual planet-planet perturbations depends on the ratio of the planet mass to the central star's mass, some planets in previously stable orbits around a star undergoing mass loss will become unstable. We show that when mass loss is slow, systems of two planets that are marginally stable can become unstable to close encounters, while for three planets the timescale for close approaches decreases significantly with increasing mass ratio. These processes could explain the presence of anomalous IR excesses around white dwarfs that cannot be explained by close companions, such as G29-38, and may also be an important fact...

  17. 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

    OpenAIRE

    Mayo, M.; Pallarés, J; C. Villalaín; A. Moreno-Gázquez; M. A. Canos; Almenar, L.

    2004-01-01

    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 ...

  18. Excimer laser coronary angioplasty: experience with a prototype multifibre catheter in patients with stable angina pectoris.

    Science.gov (United States)

    Kochs, M; Haerer, W; Eggeling, T; Hoeher, M; Schmidt, A; Hombach, V

    1992-03-01

    Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first group of 20 patients with stable angina pectoris caused by significant coronary stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French multifibre catheters with 18-20 quartz fibres of 100 microns diameter, concentrically arranged around a central lumen for taking up a guide wire, were coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one patient the lesion could be passed by the catheter. Percent diameter stenosis decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were frequently observed, intracoronary thrombus formation in eight instances, dissection in six patients and spasm in five cases, causing total vessel occlusion in five procedures. All complications could be managed efficaciously by thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA was performed in case of complication or insufficient stenosis reduction after ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%). Long-term follow-up angiography, which could be performed in 16 of 19 laser treatments, demonstrated significant restenosis in only three patients. Our preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions is feasible in most cases. However, compared with PTCA, stenosis reduction is significantly less, and the acute complication rate is much higher. Thus, further improvements of the catheter system are necessary in order to realize the advantages of excimer laser ablation, which can be demonstrated by experimental studies. PMID:1597220

  19. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

    Directory of Open Access Journals (Sweden)

    N. S. Krylova

    2014-01-01

    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.

  20. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

    Directory of Open Access Journals (Sweden)

    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.

  1. Angina pectoris-like pain provoked by intravenous adenosine in healthy volunteers.

    Science.gov (United States)

    Sylvén, C; Beermann, B; Jonzon, B; Brandt, R

    1986-07-26

    In a study to characterise the chest pain induced by adenosine this agent was given as a bolus into a peripheral vein to six healthy volunteers (five men) aged 30-44. On the first day the maximum tolerable dose was determined in each case. On the second day three doses of adenosine (one third, two thirds, and the full maximum tolerable dose) and three doses of saline were given single blind in randomised order. Thereafter aminophylline 5 mg/kg was given and the procedure repeated in a different randomised order. On the third day between two thirds and the full maximum tolerable dose was given followed by 10 mg dipyridamole intravenously and a second injection of the same dose of adenosine. Heart rate and atrioventricular blocks were recorded by electrocardiography. One minute after each dose of adenosine the chest pain was scored. The maximum tolerable dose of adenosine ranged from 10.6 to 37.1 mg. All subjects experienced uneasy central chest pain provoking anxiety. The pain radiated to the shoulders, ulnar aspect of the arms, epigastric area, back, and into the throat. The pain began about 20 seconds after the injection and lasted 10-15 seconds. Increasing the dose of adenosine increased the intensity of the pain. Administration of aminophylline reduced the pain significantly. Second degree heart block was recorded in five of the six subjects during the time that the pain was experienced. After aminophylline no block was observed. Dipyridamole increased the intensity of pain. The duration of second degree heart block increased in four of the subjects, and in two of these third degree heart block occurred. These findings suggest that adenosine released from the myocardium during ischaemia induces angina pectoris by stimulating theophylline sensitive receptors. PMID:3089465

  2. Exercise testing in patients with variant angina: results, correlation with clinical and angiographic features and prognostic significance

    International Nuclear Information System (INIS)

    Eighty-two patients with variant angina underwent a treadmill exercise test using 14 ECG leads, and 67 also underwent exercise thallium-201 scans. The test induced ST elevation in 25 patients (30%), ST depression in 21 (26%) and no ST-segment abnormality in 36 (44%). ST elevation during exercise occurred in the same ECG leads as during spontaneous attacks at rest, and was always associated with a large perfusion defect on the exercise thallium scan. In contrast, exercise-induced ST depression often did not occur in the leads that exhibited ST elevation during episodes at rest. The ST-segment response to exercise did not accurately predict coronary anatomy: Coronary stenoses greater than or equal to 70% were present in 14 of 25 patients (56%) with ST elevation, in 13 of 21 (62%) with ST depression and in 14 of 36 (39%) with no ST-segment abnormality (NS). However, the degree of disease activity did correlate with the result of the exercise test: ST elevation occurred during exercise in 11 of 14 patients who had an average of more than two spontaneous attacks per day, in 12 of 24 who had between two attacks per day and two per week, and in only two of 31 who had fewer than two attacks per week (p<0.005). ST elevation during exercise was reproducible in five of five patients retested during an active phase of their disease, but not in three of three patients who had been angina-free for a least 1 month before the repeat test. We conclude that in variant angina patients, the results of an exercise test correlate well with the degree of disease activity but not with coronary anatomy, and do not define a high-risk subgroup

  3. Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography Improves Diagnostics of Coronary Artery Stenosis in Stable Angina Pectoris

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Hoffmann, Soren; Mogelvang, Rasmus;

    2014-01-01

    BACKGROUND: Two-dimensional strain echocardiography detects early signs of left ventricular dysfunction; however, it is unknown whether myocardial strain analysis at rest in patients with suspected stable angina pectoris predicts the presence of coronary artery disease (CAD). METHODS AND RESULTS......<0.001) and remained an independent predictor of CAD after multivariable adjustment for baseline data, exercise test, and conventional echocardiography (odds ratio, 1.25 [P=0.016] per 1% decrease). Area under receiver operating characteristic curve for exercise test and global longitudinal peak...

  4. Novel variant of dual left anterior descending artery arising from single right coronary artery anomaly presenting with angina inversa

    Science.gov (United States)

    Arslan, Gokhan; Iyisoy, Atilla; Bingol, Hakan

    2015-01-01

    A 55-year-old female without a history of coronary artery disease, hypertensive for the past 17 years, was admitted with resting chest pain. Electrocardiography revealed a negative T-wave in anterior chest leads. Coronary angiography visualised anomalous coronary anatomy, with a common origin of the right coronary artery and the left main coronary artery in the right sinus of Valsalva serving as a common coronary trunk. It should be emphasised that T-wave abnormalities and chest angina may be related to this congenital coronary anomaly. PMID:26702282

  5. Relevance of 123I-BMIPP delayed scintigraphic imaging for patients with angina pectoris – a pilot study

    OpenAIRE

    Koyama, Kohei; Akashi, Yoshihiro J.; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

    2011-01-01

    Introduction The study was designed to clarify the role of 123I-β-methyl-iodophenylpentadecanoic acid (123I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). Material and methods Ten controls (mean age: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic imag...

  6. Prinzmetal's variant angina evolved in inferior myocardial infarction with involvement of the right ventricle: Sequential radionuclide evaluation

    International Nuclear Information System (INIS)

    A patient with Prinzmetal's variant angina (PVA) who developed an inferolateral myocardial infarction with right-ventricle involvement was studied using sequential radionuclide imaging until 5 months after the acute event. The patient also underwent-contrast ventriculography and coronary-artery angiography. Equilibrium-gated radionuclide angiography (EGRA) revealed the localization of ventricular dysfunction, the results obtained being in agreement with haemodynamic data. We emphasize the usefulness of the parameters obtained using EGRA (regional wall motion, systolic and diastolic parameters) in planing therapy and follow-up. (orig.)

  7. Ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Greece: a cost-utility study

    OpenAIRE

    Kourlaba, Georgia; Vlachopoulos, Charalambos; Parissis, John; Kanakakis, John; Gourzoulidis, George; Maniadakis, Nikos

    2015-01-01

    Background To conduct an economic evaluation comparing ranolazine as add-on therapy to standard-of-care (SoC) with SoC alone in patients with stable angina who did not respond adequately to first line therapy, in Greece. Methods A decision tree model was locally adapted in the Greek setting to evaluate the cost-utility of ranolazine during a 6-month period. The analysis was conducted from a third-party payer perspective. The clinical inputs were extracted from the published literature. The co...

  8. Are negative aspects of social relations predictive of angina pectoris? A 6-year follow-up study of middle-aged Danish women and men

    DEFF Research Database (Denmark)

    Lund, Rikke; Rod, Naja Hulvej; Christensen, Ulla

    2011-01-01

    after adjustment for age, gender, social class, cohabitation status and depression in a dose-response manner. For example, experiencing excessive demands or worries always/often from different roles in the social relations was associated with an increased risk: partner OR=3.53 (1.68 to 7.43), children...... OR=2.19 (1.04 to 4.61), other family OR=1.91 (1.24 to 2.96). Except for frequent conflicts with the partner and neighbours, conflicts with the social relations was not a risk factor for angina. The authors found no interaction of negative aspects of social relations with gender, age, social class......, cohabitation status or depression in terms of angina. Conclusion Excessive demands and serious worries from significant others seem to be important risk factors for development of angina pectoris....

  9. Metamorphosis Of Tachyon Profile In Unstable D9-Branes

    CERN Document Server

    Hashimoto, K; Hashimoto, Koji; Hirano, Shinji

    2002-01-01

    We explored a variety of brane configurations in our previous paper within the two derivative truncation of the unstable D9-brane effective theory. In this paper we extend our previous results with emphasis on the inclusion of the higher derivative corrections for the tachyon and the gauge fields computed in the boundary string field theories. We give the exact solutions to BPS brane configurations studied in our previous paper and find remarkable exact agreements of their energies and RR-charges with the expected results. We further find a few more solutions that we could not construct in the two derivative truncations, such as a (F,D6) bound state ending on a D8-brane whose existence turns out to be due to a higher derivative effect and also the dielectric brane of Emparan and Myers as a nonsupersymmetric example. These are also in exact agreement with the results obtained in the effective theory of supersymmetric D-branes.

  10. Neutron Capture Measurements on Unstable Nuclei at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J.; Haight, R.; Wilhelmy, J.; Fowler, M.; Rundberg, R.; Miller, G.

    1998-11-04

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on {sup 169}Tm and {sup 171}Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements.

  11. Stable and unstable crack growth in pressure vessel models

    International Nuclear Information System (INIS)

    Three identical steel pressure vessels with 254-mm (10-in.) dia, 38-mm (1.5-in.) wall thicknesses and long, deep machined and sharpened axially oriented flaws were tested at three different temperatures. The vessels were assembled by electron-beam welding cylindrical sections with substantially different toughnesses due to different heat treatments. Crack extension initiated in relatively brittle sections, and the cracks extended both stably and unstably, depending on test temperature, toward the tougher sections where crack arrest did and did not occur. Charpy impact specimens and both slow-bend and dynamic precracked Charpy specimens were used for material characterization. The behavior of the vessels is described and related to the Charpy data

  12. Mixed convection in turbulent channels with unstable stratification

    CERN Document Server

    Pirozzoli, Sergio; Verzicco, Roberto; Orlandi, Paolo

    2016-01-01

    We study turbulent flows in planar channels with unstable thermal stratification, using direct numerical simulations in a wide range of Reynolds and Rayleigh numbers and reaching flow conditions which are representative of asymptotic developed turbulence. The combined effect of forced and free convection produces a peculiar pattern of quasi--streamwise rollers occupying the full channel thickness with aspect--ratio considerably higher than unity; it has been observed that they have an important redistributing effect on temperature and momentum. The mean values and the variances of the flow variables do not appear to follow Prandtl's scaling in the flow regime near free convection, except for the temperature and vertical velocity fluctuations, which are more affected by turbulent plumes. Nevertheless, we find that the Monin--Obukhov theory still yields a useful representation of the main flow features. In particular, the widely used Businger--Dyer relationships provide a convenient way of accounting for the bu...

  13. Cosmological implications of massive, unstable neutrinos (new and improved)

    International Nuclear Information System (INIS)

    The cosmological consequences are considered of the existence of massive, neutral, weakly interacting leptons (nu/sub H/). Bounds are calculated on the nu/sub H/ mass, lifetime, and allowed interaction strength by assuming minimal modification of the standard big bang model. The chief conclusions are: The nu/sub H/ may be stable if its mass is greater than a few GeV. For intermediate masses, for which the nu/sub H/ must be unstable, if its principal decay mode creates photons, masses less than 10-2 MeV are ruled out and its lifetime must be less than one year. If the nu/sub H/ decays exclusively into neutrinos, it may have a considerably longer lifetime and give rise to a present day energy density sufficiently high to make the universe radiation dominated and closed

  14. Synthesis of unstable cyclic peroxides for chemiluminescence studies

    Energy Technology Data Exchange (ETDEWEB)

    Bartoloni, Fernando H.; Oliveira, Marcelo A. de; Augusto, Felipe A.; Ciscato, Luiz Francisco M.L.; Bastos, Erick L.; Baader, Wilhelm J., E-mail: wjbaader@iq.usp.br [Universidade de Sao Paulo (USP), SP (Brazil). Inst. de Quimica. Dept. de Quimica Fundamental

    2012-11-15

    Cyclic four-membered ring peroxides are important high-energy intermediates in a variety of chemi and bioluminescence transformations. Specifically, a-peroxy lactones (1,2-dioxetanones) have been considered as model systems for efficient firefly bioluminescence. However, the preparation of such highly unstable compounds is extremely difficult and, therefore, only few research groups have been able to study the properties of these substances. In this study, the synthesis, purification and characterization of three 1,2-dioxetanones are reported and a detailed procedure for the known synthesis of diphenoyl peroxide, another important model compound for the chemical generation of electronically excited states, is provided. For most of these peroxides, the complete spectroscopic characterization is reported here for the first time. (author)

  15. Particle Acceleration in an Evolving Network of Unstable Current Sheets

    CERN Document Server

    Vlahos, L; Lepreti, F

    2004-01-01

    We study the acceleration of electrons and protons interacting with localized, multiple, small-scale dissipation regions inside an evolving, turbulent active region. The dissipation regions are Unstable Current Sheets (UCS), and in their ensemble they form a complex, fractal, evolving network of acceleration centers. Acceleration and energy dissipation are thus assumed to be fragmented. A large-scale magnetic topology provides the connectivity between the UCS and determines in this way the degree of possible multiple acceleration. The particles travel along the magnetic field freely without loosing or gaining energy, till they reach a UCS. In a UCS, a variety of acceleration mechanisms are active, with the end-result that the particles depart with a new momentum. The stochastic acceleration process is represented in the form of Continuous Time Random Walk (CTRW), which allows to estimate the evolution of the energy distribution of the particles. It is found that under certain conditions electrons are heated a...

  16. Quantization of black hole entropy from unstable circular null geodesics

    Science.gov (United States)

    Wei, Shao-Wen; Liu, Yu-Xiao; Fu, Chun-E.

    2016-04-01

    The quasinormal mode frequencies can be understood from the massless particles trapped at the unstable circular null geodesics and slowly leaking out to infinity. Based on this viewpoint, in this paper, we semiclassically construct the entropy spectrum of the static and stationary black holes from the null geodesics. The result shows that the spacing of the entropy spectrum only depends on the property of the black hole in the eikonal limit. Moreover, for a black hole far from the extremal case, the spacing is found to be smaller than 2πħ for any dimension, which is very different from the result of the previous work by using the usual quasinormal mode frequencies.

  17. One Loop Mass Renormalization of Unstable Particles in Superstring Theory

    CERN Document Server

    Sen, Ashoke

    2016-01-01

    Most of the massive states in superstring theory are expected to undergo mass renormalization at one loop order. Typically these corrections should contain imaginary parts, indicating that the states are unstable against decay into lighter particles. However in such cases, direct computation of the renormalized mass using superstring perturbation theory yields divergent result. Previous approaches to this problem involve various analytic continuation techniques, or deforming the integral over the moduli space of the torus with two punctures into the complexified moduli space near the boundary. In this paper we use insights from string field theory to describe a different approach that gives manifestly finite result for the mass shift satisfying unitarity relations. The procedure is applicable to all states of (compactified) type II and heterotic string theories. We illustrate this by computing the one loop correction to the mass of the first massive state on the leading Regge trajectory in SO(32) heterotic st...

  18. Neutron Capture Measurements on Unstable Nuclei at LANSCE

    International Nuclear Information System (INIS)

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on 169Tm and 171Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements

  19. Active Feedback Control of Unstable Wells at the Brage Field

    Directory of Open Access Journals (Sweden)

    Morten Dalsmo

    2005-04-01

    Full Text Available In this paper we will present new results on stabilization of horizontal wells with gas lift. The stabilization is achieved by a novel dynamic feedback control solution using the production choke at the wellhead. The primary input to the dynamic feedback controller is a measurement of the downhole pressure. The field results to be presented are from the Brage field operated by Norsk Hydro in the North sea. Production at Brage began in 1993 and the field went off plateau in 1998. As the production has decreased, the problems related to unstable production from some of the wells have escalated steadily. The results from the extensive field tests on the Brage wells arc very promising. The tests have confirmed the stabilization feature of the control solution. The pressure and flow variations have been dramatically reduced, and it is possible to produce the wells at a lower downhole pressure leading to increased production.

  20. Interdigital-H linac for unstable nuclei at INS

    International Nuclear Information System (INIS)

    In the prototype facility of the Exotic-arena at INS, unstable nuclei with a charge-to-mass ratio greater than 1/10 is accelerated from 170 to 1046 keV/u by an interdigital-H linac. Designed IH linac consists of four acceleration tanks and three sets of quadrupole triplets placed between tanks. Output energy is continuously variable by changing rf power and phase of the last operating tank. A high shunt impedance is expected from an equivalent circuit analysis. The rf measurement on the low power models is now in progress. Preliminary results of the tank-4 model shows that a resonant frequency and a shunt impedance roughly agree with the design values. (author)

  1. Virtual-source theory of unstable resonator modes.

    Science.gov (United States)

    Southwell, W H

    1981-10-01

    A new method for understanding and calculating unstable resonator modes has been developed. It consists of propagating an initial uniform plane wave N round trips through the resonator, as in the Fox and Li [Bell Syst. Tech. J. 40, 453 (1961)] approach. The propagation, however, is performed entirely in collimated space that results from unfolding the resonator into its virtual images of the feedback mirror. In this unfolded space, the field after N round trips consists of a single plane-wave propagation plus the sum of diffracted waves from N pairs of virtual sources (for the strip-resonator case). The edge-diffraction function is determined from an asymptotic solution to the Huygens-Fresnel integral for an incident plane wave. The advantages of the method are that it is conceptually simple and numerically accurate and requires only minimal computer time. PMID:19710746

  2. Revealing Bell's Nonlocality for Unstable Systems in High Energy Physics

    CERN Document Server

    Hiesmayr, Beatrix C; Curceanu, Catalina; Gabriel, Andreas; Huber, Marcus; Larsson, Jan-Ake; Moskal, Pawel

    2011-01-01

    Entanglement and its consequences - in particular the violation of Bell inequalities, which defies our concepts of realism and locality - have been proven to play key roles in Nature by many experiments for various quantum systems. Entanglement can also be found in systems not consisting of ordinary matter and light, i.e. in massive meson--antimeson systems. Bell inequalities have been discussed for these systems, but up to date no direct experimental test to conclusively exclude local realism was found. This mainly stems from the fact that one only has access to a restricted class of observables and that these systems are also decaying. In this Letter we put forward a Bell inequality for unstable systems which can be tested at accelerator facilities with current technology. Herewith, the long awaited proof that such systems at different energy scales can reveal the sophisticated "dynamical" nonlocal feature of Nature in a direct experiment gets feasible. Moreover, the role of entanglement and CP violation, a...

  3. 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.

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. 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.

  6. [Exercise tolerance in angina patients 3 and 24 hours after administration of a new delayed-action preparation of metoprolol].

    Science.gov (United States)

    Giusti, C; Verdecchia, P; Pentimone, F; Regoli, F; Cordoni, M; Bongini, A M

    1981-01-01

    To assess the duration of improved exercise tolerance by metoprolol given in a new sustained-release formulation, 40 in-patients affected by stable exercise-induced angina pectoris received single-blind placebo in day 1 and thereafter, in double-blind cross-over once daily administration, metoprolol RETARD 100 mg and 200 mg in days 3 and 5. Symptom-limited cycloergometric exercise tests were performed at 3 and 24 hours after placebo and after each of the two doses of metoprolol RETARD. Duration of exercise, maximal workload and total work performed did significantly increase at 3 and 24 hours after metoprolol RETARD 100 mg (P less than 0.01) and 200 mg (P less than 0.01), without any significant difference between the two doses. Peak systolic arterial pressure and heart rate were lowered by metoprolol RETARD 200 mg at 3 (P less than 0.01) and 24 (P less than 0.01) hours, whereas only the peak heart rate at 3 hours was lowered (P less than 0.05) by the 100 mg dose. It is concluded that in patients with stable exercise-induced angina pectoris, metoprolol RETARD 200 mg appears to be able to increase exercise tolerance and to reduce exercise-induced myocardial oxygen consumption throughout 24 hours period. This may justify a once daily dosing schedule of the 200 mg dose, aimed at improving patient compliance. PMID:7343379

  7. Behavior of right and left ventricles during episodes of variant angina in relation to the site of coronary vasospasm

    International Nuclear Information System (INIS)

    The effects of single-vessel coronary occlusion on simultaneously evaluated right (RV) and left ventricular (LV) performance were assessed and compared with LV perfusion patterns in 25 patients with variant angina. Coronary spasm involved the right coronary artery in 15 patients (group 1) and the left anterior descending coronary artery in 10 patients (group 2). Biventricular function was assessed by radionuclide angiography under basal conditions, during spontaneous or ergonovine-induced ischemia, and after resolution of the ischemic attack. Myocardial perfusion was assessed by thallium 201 scintigraphy in 21 patients of this series during superimposable ischemic episodes. In group 1, ischemia caused RV (14 of 15 patients) and LV (13 of 15 patients) regional dysfunction with significant reduction in RV and LV ejection fractions. The interventricular spetum was involved in six of 15 patients, causing a more pronounced LV impairment. In group 2, all patients showed septal dyssynergies associated with a reduction of LV ejection fraction; absent or trivial RV involvement was observed. In both groups, LV perfusion defects were present in all patients with LV wall motion abnormalities during ischemia, matching the site of regional dyssynergies. Thus, in a group of patients with variant angina and single-vessel disease, transient occlusion of the right coronary artery directly caused RV and LV impairment; in these patients, the extent of LV but not RV dysfunction appeared related to the presence of septal ischemia. Vasospasm of the left anterior descending coronary artery consistently caused LV dysfunction not associated with secondary effects on RV systolic function

  8. The Impact of Remote Ischemic Preconditioning on Arterial Stiffness and Heart Rate Variability in Patients with Angina Pectoris.

    Science.gov (United States)

    Zagidullin, Naufal; Scherbakova, Elena; Safina, Yuliana; Zulkarneev, Rustem; Zagidullin, Shamil

    2016-01-01

    Remote ischemic preconditioning (RIPC) is the set of ischemia episodes that protects against subsequent periods of prolonged ischemia through the cascade of adaptive responses; however, the mechanisms of RIPC are not entirely clear. Here, we aimed to study the impact of RIPC in patients with stable angina pectoris and compare it with healthy individuals with respect to arterial stiffness and heart rate variability. In the randomized, sham-controlled, crossover blind design study, a group of 30 coronary heart disease (CHD) patients (63.9 ± 1.6 years) with stable angina pectoris NYHA II-III and a control group of 20 healthy individuals (58.2 ± 2.49) were both randomly allocated for remote RIPC or sham RIPC. Arterial stiffness, pulse wave velocity (Spygmacor, Australia), and heart rate variability (HRV) were recorded before and after the procedure followed by the crossover examination. In the group of healthy individuals, RIPC showed virtually no impact on the cardiovascular parameters, while, in the CHD group, the systolic and central systolic blood pressure, central pulse pressure, and augmentation decreased, and total power of HRV improved. We conclude that ischemic preconditioning reduces not only systolic blood pressure, but also reduces central systolic blood pressure and improves arterial compliance and heart rate modulation reserve, which may be associated with the antianginal effect of preconditioning. PMID:27348009

  9. The effects of lidoflazine on exercise performance and thallium stress scintigraphy in patients with stable angina pectoris

    International Nuclear Information System (INIS)

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a 7-month study, 36 patients with stable angina pectoris were tested during a 3-month single-blind placebo phase. Nineteen were then randomized by double-blind methods to lidoflazine and 17 to placebo therapy. The lidoflazine group had a significant (p < 0.01) reduction in anginal attacks; the placebo group did not. Exercise testing demonstrated that lidoflazine therapy was associated with a 34% increase in total work performance and a 15.6% increase in peak calculated oxygen uptake during double-blind treatment (both p < 0.004 compared with the placebo group). Heart rate was significantly reduced at submaximal levels of exercise during lidoflazine therapy (p < 0.04). Nitroglycerin consumption and electrocardiographic changes at the end of exercise did not change during the double-blind phase. In a second study of six similar patients, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise

  10. 以不稳定型心绞痛为首发表现的真性红细胞增多症一例%Polycythemia Vera with Unstable Angina as Its Initial Symptom:A clinical case report

    Institute of Scientific and Technical Information of China (English)

    张少阳; 武宗寅

    2013-01-01

    真性红细胞增多症是一种以红细胞异常增殖为主的克隆性慢性骨髓增殖性疾病.该病表现为外周血以红细胞为主的二系或三系血细胞增多,临床常有皮肤红紫、头晕、头痛、高血压、肝脾肿大等表现,严重患者可出现血管、神经并发症,其血栓发生率高于正常.本文以1例不稳定型心绞痛为首发表现的真性红细胞增多症患者为例,讨论该病的病因及该类患者的治疗策略选择.

  11. Peso bisoprolol joint simvastatin treatment of elderly unstable angina effect analysis%联用比索洛尔和辛伐他汀治疗老年不稳定型心绞痛的效果分析

    Institute of Scientific and Technical Information of China (English)

    刘查

    2015-01-01

    目的:探讨分析联用比索洛尔和辛伐他汀治疗老年不稳定型心绞痛的临床效果.方法:选取近年来我院收治的100例老年不稳定型心绞痛患者作为研究对象,将其随机分为对照组和实验组,单纯使用辛伐他汀为对照组患者进行治疗,联用比索洛尔和辛伐他汀为实验组患者进行治疗,然后观察对比两组患者的临床疗效,并将对比的结果及两组患者的临床资料进行回顾性的分析.结果:实验组患者的心电图改善情况明显优于对照组患者,实验组患者的临床疗效明显优于对照组患者,差异显著(P<0.05),具有统计学意义.结论:联用比索洛尔和辛伐他汀治疗老年不稳定型心绞痛的临床效果显著,值得在临床上推广应用.

  12. 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

  13. Metamorphosis of tachyon profile in unstable D9-branes

    International Nuclear Information System (INIS)

    We explored a variety of brane configurations in our previous paper within the two derivative truncation of the unstable D9-brane effective theory. In this paper we extend our previous results with emphasis on the inclusion of the higher derivative corrections for the tachyon and the gauge fields computed in the boundary string field theories. We give the exact solutions to Bogomol'nyi-Prasad-Sommerfield (BPS) brane configurations studied in our previous paper and find remarkable exact agreement of their energies and Ramond-Ramond charges with the expected results. We further find a few more solutions that we could not construct in the two derivative truncations, such as a (F,D6) bound state ending on a D8-brane whose existence turns out to be due to a higher derivative effect and also the dielectric brane of Emparan and Myers as a nonsupersymmetric example. These are also in exact agreement with the results obtained in the effective theory of supersymmetric D-branes

  14. Generalization in adaptation to stable and unstable dynamics.

    Directory of Open Access Journals (Sweden)

    Abdelhamid Kadiallah

    Full Text Available Humans skillfully manipulate objects and tools despite the inherent instability. In order to succeed at these tasks, the sensorimotor control system must build an internal representation of both the force and mechanical impedance. As it is not practical to either learn or store motor commands for every possible future action, the sensorimotor control system generalizes a control strategy for a range of movements based on learning performed over a set of movements. Here, we introduce a computational model for this learning and generalization, which specifies how to learn feedforward muscle activity in a function of the state space. Specifically, by incorporating co-activation as a function of error into the feedback command, we are able to derive an algorithm from a gradient descent minimization of motion error and effort, subject to maintaining a stability margin. This algorithm can be used to learn to coordinate any of a variety of motor primitives such as force fields, muscle synergies, physical models or artificial neural networks. This model for human learning and generalization is able to adapt to both stable and unstable dynamics, and provides a controller for generating efficient adaptive motor behavior in robots. Simulation results exhibit predictions consistent with all experiments on learning of novel dynamics requiring adaptation of force and impedance, and enable us to re-examine some of the previous interpretations of experiments on generalization.

  15. Gravitationally Unstable Flames: Rayleigh-Taylor Stretching versus Turbulent Wrinkling

    Science.gov (United States)

    Hicks, E. P.; Rosner, R.

    2013-07-01

    In this paper, we provide support for the Rayleigh-Taylor-(RT)-based subgrid model used in full-star simulations of deflagrations in Type Ia supernovae explosions. We use the results of a parameter study of two-dimensional direct numerical simulations of an RT unstable model flame to distinguish between the two main types of subgrid models (RT or turbulence dominated) in the flamelet regime. First, we give scalings for the turbulent flame speed, the Reynolds number, the viscous scale, and the size of the burning region as the non-dimensional gravity (G) is varied. The flame speed is well predicted by an RT-based flame speed model. Next, the above scalings are used to calculate the Karlovitz number (Ka) and to discuss appropriate combustion regimes. No transition to thin reaction zones is seen at Ka = 1, although such a transition is expected by turbulence-dominated subgrid models. Finally, we confirm a basic physical premise of the RT subgrid model, namely, that the flame is fractal, and thus self-similar. By modeling the turbulent flame speed, we demonstrate that it is affected more by large-scale RT stretching than by small-scale turbulent wrinkling. In this way, the RT instability controls the flame directly from the large scales. Overall, these results support the RT subgrid model.

  16. GRAVITATIONALLY UNSTABLE FLAMES: RAYLEIGH-TAYLOR STRETCHING VERSUS TURBULENT WRINKLING

    International Nuclear Information System (INIS)

    In this paper, we provide support for the Rayleigh-Taylor-(RT)-based subgrid model used in full-star simulations of deflagrations in Type Ia supernovae explosions. We use the results of a parameter study of two-dimensional direct numerical simulations of an RT unstable model flame to distinguish between the two main types of subgrid models (RT or turbulence dominated) in the flamelet regime. First, we give scalings for the turbulent flame speed, the Reynolds number, the viscous scale, and the size of the burning region as the non-dimensional gravity (G) is varied. The flame speed is well predicted by an RT-based flame speed model. Next, the above scalings are used to calculate the Karlovitz number (Ka) and to discuss appropriate combustion regimes. No transition to thin reaction zones is seen at Ka = 1, although such a transition is expected by turbulence-dominated subgrid models. Finally, we confirm a basic physical premise of the RT subgrid model, namely, that the flame is fractal, and thus self-similar. By modeling the turbulent flame speed, we demonstrate that it is affected more by large-scale RT stretching than by small-scale turbulent wrinkling. In this way, the RT instability controls the flame directly from the large scales. Overall, these results support the RT subgrid model.

  17. GRAVITATIONALLY UNSTABLE FLAMES: RAYLEIGH-TAYLOR STRETCHING VERSUS TURBULENT WRINKLING

    Energy Technology Data Exchange (ETDEWEB)

    Hicks, E. P. [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and the Department of Physics and Astronomy, Northwestern University, Evanston, IL 60208 (United States); Rosner, R., E-mail: eph2001@columbia.edu [Computation Institute, University of Chicago, 5735 S. Ellis Ave., Chicago, IL 60637 (United States)

    2013-07-10

    In this paper, we provide support for the Rayleigh-Taylor-(RT)-based subgrid model used in full-star simulations of deflagrations in Type Ia supernovae explosions. We use the results of a parameter study of two-dimensional direct numerical simulations of an RT unstable model flame to distinguish between the two main types of subgrid models (RT or turbulence dominated) in the flamelet regime. First, we give scalings for the turbulent flame speed, the Reynolds number, the viscous scale, and the size of the burning region as the non-dimensional gravity (G) is varied. The flame speed is well predicted by an RT-based flame speed model. Next, the above scalings are used to calculate the Karlovitz number (Ka) and to discuss appropriate combustion regimes. No transition to thin reaction zones is seen at Ka = 1, although such a transition is expected by turbulence-dominated subgrid models. Finally, we confirm a basic physical premise of the RT subgrid model, namely, that the flame is fractal, and thus self-similar. By modeling the turbulent flame speed, we demonstrate that it is affected more by large-scale RT stretching than by small-scale turbulent wrinkling. In this way, the RT instability controls the flame directly from the large scales. Overall, these results support the RT subgrid model.

  18. Unstable femoral neck fractures in children - A new treatment option

    Directory of Open Access Journals (Sweden)

    Pruthi K

    2006-01-01

    Full Text Available Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.

  19. Unstable-unit tensegrity plate: modeling and design

    Science.gov (United States)

    Zaslavsky, Ron; de Oliveira, Mauricio C.; Skelton, Robert E.

    2003-08-01

    A new topology for a prestressed tensegrity plate, the unstable-unit tensegrity plate (UUTP), is introduced, together with a detailed algorithm for its design. The plate is a truss made of strings (flexible elements) and bars (rigid elements), which are loaded in tension and compression, respectively, where bars do not touch each other. Given the outline dimensions of the desired plate, and the number of bars along the plate's width and length, the algorithm solves for the nodes' positions and the prestress forces that make a plate in equilibrium. This is done by solving a non-linear matrix equation via Newton's method. This equation reflects static equilibrium conditions. We've designed several such plates, proving the feasibility of the proposed topology and the effectiveness of its design algorithm. Two such plates are characterized in detail, both statically and dynamically (via simulation). The proposed algorithm may be extended to solve for other tensegrity structures having different topologies and/or different shapes. The UUTP may be used as a building block of many types of structures, both uncontrolled and controlled, either large-scale or miniature-scale.

  20. Unstable mutations: cause of some neurological hereditary diseases

    International Nuclear Information System (INIS)

    Unstable mutations or amplification of triplets constitute a kind of genetic alteration discovered during the last decade. They had been found inside or near genes important for the normal neurological function of the human being. In some cases, the presence of the amplification causes the inactivation of the gene or the synthesis of a new product which functions different from the original protein. Some common characteristics of diseases caused by the amplification of triplets are that it affects the nervous system and are degenerative in nature. The expression of the manifestations varies according to age. Most of them show genetic anticipation in which the severity of the manifestations increases with each generation and appear at an earlier age. In most cases, the severity of the symptoms is correlated positively to the size of the amplification. The diagnosis of an affected individual in a family may indicate the presence of an altered gene in other relatives. These relatives may not present evident signs of the illness either because it is of late onset or because they carry premutations. The molecular diagnosis of these mutations is important to estimate the risk of developing the disease and/or of transmitting the illness to the descendants and to eliminate the fears of healthy relatives who have inherited normal copies of the gene. (Author)

  1. The migration of gas giant planets in gravitationally unstable discs

    CERN Document Server

    Stamatellos, Dimitris

    2015-01-01

    Planets form in the discs of gas and dust that surround young stars. It is not known whether gas giant planets on wide orbits form the same way as Jupiter or by fragmentation of gravitationally unstable discs. Here we show that a giant planet, which has formed in the outer regions of a protostellar disc, initially migrates fast towards the central star (migration timescale ~10,000 yr) while accreting gas from the disc. However, in contrast with previous studies, we find that the planet eventually opens up a gap in the disc and the migration is essentially halted. At the same time, accretion-powered radiative feedback from the planet, significantly limits its mass growth, keeping it within the planetary mass regime (i.e. below the deuterium burning limit) at least for the initial stages of disc evolution. Giant planets may therefore be able to survive on wide orbits despite their initial fast inward migration, shaping the environment in which terrestrial planets that may harbour life form.

  2. Survival of habitable planets in unstable planetary systems

    CERN Document Server

    Carrera, Daniel; Johansen, Anders

    2016-01-01

    Many observed giant planets lie on eccentric orbits. Such orbits could be the result of strong scatterings with other giant planets. The same dynamical instability that produces giant planet scatterings can also alter the orbits of terrestrial planets. For example, a habitable rocky planet in the system can be ejected or transported to an orbit outside the habitable zone. Therefore, there is a link between observed giant planets and the habitability of smaller planets in the system. We say that a habitable planet has resilient habitability if it is able to avoid ejections and collisions and its orbit remains inside the habitable zone. Here we model the orbital evolution of rocky planets in planetary systems where giant planets become dynamically unstable. We measure the resilience of habitable planets as a function of the observed, present-day masses and orbits of the giant planets. We find that the survival rate of habitable planets depends strongly on the giant planet architecture. Systems with three Jupite...

  3. Phosphatidylcholine, an edible carrier for nanoencapsulation of unstable thiamine.

    Science.gov (United States)

    Juveriya Fathima, Syeda; Fathima, Irum; Abhishek, Virat; Khanum, Farhath

    2016-04-15

    Lipid nanoparticles have been used for carrying different therapeutic agents because of the advantage in improved absorption, bioavailability, targeted deliveries and reduction in the quantity of drugs required. The aim of the study was to prepare and characterize nanoliposomes containing thiamine hydrochloride and study their physicochemical stability as this vitamin is highly unstable. Phosphatidylcholine (PC) was used as an edible encapsulant. The average size of nanoliposomes was found to be 150 nm and zeta potential was -34 mV. The encapsulation efficiency was 97%. Atomic force microscopy (AFM) and scanning electron microscopy (SEM) confirmed the size, spherical nature and smooth surface of the nanoliposomes. Differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) evidenced that the nanoliposomes were stable up to 300°C. The functional groups present were determined by Fourier transformed infrared spectroscopy (FTIR) and the presence of vitamin was confirmed in final formulation by biochemical analysis. The crystalline nature of thiamine was analyzed by X-ray diffraction studies. Storage studies indicated that the nanoliposomes were highly stable up to 3 months at different temperatures. Thus, phosphatidylcholine can be used as carrier vehicle of nutrients especially vitamins, as it can form stable nanoliposomes with 97% encapsulation efficiency. PMID:26616989

  4. Differential rotation of the unstable nonlinear r-modes

    CERN Document Server

    Friedman, John L; Lockitch, Keith H

    2016-01-01

    At second order in perturbation theory, the $r$-modes of uniformly rotating stars include an axisymmetric part that can be identified with differential rotation of the background star. If one does not include radiation-reaction, the differential rotation is constant in time and has been computed by S\\'a. It has a gauge dependence associated with the family of time-independent perturbations that add differential rotation to the unperturbed equilibrium star: For stars with a barotropic equation of state, one can add to the time-independent second-order solution arbitrary differential rotation that is stratified on cylinders (that is a function of distance $\\varpi$ to the axis of rotation). We show here that the gravitational radiation-reaction force that drives the $r$-mode instability removes this gauge freedom: The expontially growing differential rotation of the unstable second-order $r$-mode is unique. We derive a general expression for this rotation law for Newtonian models and evaluate it explicitly for s...

  5. Differential rotation of the unstable nonlinear r -modes

    Science.gov (United States)

    Friedman, John L.; Lindblom, Lee; Lockitch, Keith H.

    2016-01-01

    At second order in perturbation theory, the r -modes of uniformly rotating stars include an axisymmetric part that can be identified with differential rotation of the background star. If one does not include radiation reaction, the differential rotation is constant in time and has been computed by Sá. It has a gauge dependence associated with the family of time-independent perturbations that add differential rotation to the unperturbed equilibrium star: For stars with a barotropic equation of state, one can add to the time-independent second-order solution arbitrary differential rotation that is stratified on cylinders (that is a function of distance ϖ to the axis of rotation). We show here that the gravitational radiation-reaction force that drives the r -mode instability removes this gauge freedom; the exponentially growing differential rotation of the unstable second-order r -mode is unique. We derive a general expression for this rotation law for Newtonian models and evaluate it explicitly for slowly rotating models with polytropic equations of state.

  6. Large eddy simulation predictions of absolutely unstable round hot jet

    Science.gov (United States)

    Boguslawski, A.; Tyliszczak, A.; Wawrzak, K.

    2016-02-01

    The paper presents a novel view on the absolute instability phenomenon in heated variable density round jets. As known from literature the global instability mechanism in low density jets is released when the density ratio is lower than a certain critical value. The existence of the global modes was confirmed by an experimental evidence in both hot and air-helium jets. However, some differences in both globally unstable flows were observed concerning, among others, a level of the critical density ratio. The research is performed using the Large Eddy Simulation (LES) method with a high-order numerical code. An analysis of the LES results revealed that the inlet conditions for the velocity and density distributions at the nozzle exit influence significantly the critical density ratio and the global mode frequency. Two inlet velocity profiles were analyzed, i.e., the hyperbolic tangent and the Blasius profiles. It was shown that using the Blasius velocity profile and the uniform density distribution led to a significantly better agreement with the universal scaling law for global mode frequency.

  7. A heavy ion linac complex for unstable nuclei

    International Nuclear Information System (INIS)

    A heavy ion linac complex for unstable nuclei is under construction at INS. The linac complex consists of a 25.5-MHz split coaxial RFQ (SCRFQ), a charge-stripper section, and a 51-MHz interdigital-H (IH) linac. The SCRFQ with modulated vanes, 0.9 m in diameter and 8.6 m in length, accelerates ions with a charge-to-mass ratio (q/A) greater than 1/30 from 2 to 170 keV/u. The stripper is a carbon foil. The IH linac, 1.34 m in diameter and 5.54 m in total length, comprises four cavities and three magnetic quadrupole triplets placed between cavities, accelerates ions with q/A ≥ 1/10, and varies the output energy continuously in the range 0.17 - 1.05 MeV/u. The duty factor of the linac complex is 30% for q/A = 1/30 ions. (author)

  8. High temperature QCD and QED with unstable excitations

    International Nuclear Information System (INIS)

    We consider the partition functions of QCD and QED at high temperature assuming small coupling constants, and present arguments in favor of an improved perturbative expansion in terms of unstable excitations. Our effective propagators are derived from spectral functions with a constant width. These spectral functions describe screening and damping of gluons (photons) as well as 'Brownian' motion of quarks (electrons). BRST-invariance allows us to reduce the number of independent with parameters to three. These are determined in a self-consistent way from the one-loop self energy and polarization tensor in the infrared limit thus rendering this limit finite. All spectral width parameters are found to be proportional to gT. We reproduce the well known expression for the electric 'Debye'-screnning mass. The transverse (magnetic) gluons (photons) are found to interact only at nonzero momentum or energy, at least to leading order. As a consequence their spectral function acuires a width only away from the infrared limit. Finally, plasmon modes are determined and found to be strongly damped. (orig.)

  9. Revealing Bell's nonlocality for unstable systems in high energy physics

    Science.gov (United States)

    Hiesmayr, Beatrix C.; Di Domenico, Antonio; Curceanu, Catalina; Gabriel, Andreas; Huber, Marcus; Larsson, Jan-Åke; Moskal, Pawel

    2012-01-01

    Entanglement and its consequences—in particular the violation of Bell inequalities, which defies our concepts of realism and locality—have been proven to play key roles in Nature by many experiments for various quantum systems. Entanglement can also be found in systems not consisting of ordinary matter and light, i.e. in massive meson-antimeson systems. Bell inequalities have been discussed for these systems, but up to date no direct experimental test to conclusively exclude local realism was found. This mainly stems from the fact that one only has access to a restricted class of observables and that these systems are also decaying. In this Letter we put forward a Bell inequality for unstable systems which can be tested at accelerator facilities with current technology. Herewith, the long awaited proof that such systems at different energy scales can reveal the sophisticated " dynamical" nonlocal feature of Nature in a direct experiment gets feasible. Moreover, the role of entanglement and mathcal{CP} violation, an asymmetry between matter and antimatter, is explored, a special feature offered only by these meson-antimeson systems.

  10. Thermal conduction in a mirror-unstable plasma

    Science.gov (United States)

    Komarov, S. V.; Churazov, E. M.; Kunz, M. W.; Schekochihin, A. A.

    2016-07-01

    The plasma of galaxy clusters is subject to firehose and mirror instabilities at scales of order the ion Larmor radius. The mirror instability generates fluctuations of magnetic-field strength δB/B ˜ 1. These fluctuations act as magnetic traps for the heat-conducting electrons, suppressing their transport. We calculate the effective parallel thermal conductivity in the ICM in the presence of the mirror fluctuations for different stages of the evolution of the instability. The mirror fluctuations are limited in amplitude by the maximum and minimum values of the field strength, with no large deviations from the mean value. This key property leads to a finite suppression of thermal conduction at large scales. We find suppression down to ≈0.2 of the Spitzer value for the secular phase of the perturbations' growth, and ≈0.3 for their saturated phase. The effect operates in addition to other suppression mechanisms and independently of them. Globally, fluctuations δB/B ˜ 1 can be present on much larger scales, of the order of the scale of turbulent motions. However, we do not expect large suppression of thermal conduction by these, because their scale is considerably larger than the collisional mean free path of the ICM electrons. The obtained suppression of thermal conduction by a factor of ˜5 appears to be characteristic and potentially universal for a weakly collisional mirror-unstable plasma.

  11. Unstable periodic orbits and attractor of the barotropic ocean model

    Directory of Open Access Journals (Sweden)

    E. Kazantsev

    1998-01-01

    Full Text Available A numerical method for detection of unstable periodic orbits on attractors of nonlinear models is proposed.  The method requires similar techniques to data assimilation.  This fact facilitates its implementation for geophysical models.  This method was used to find numerically several low-period orbits for the barotropic ocean model in a square.  Some numerical particularities of application of this method are discussed. Knowledge of periodic orbits of the model helps to explain some of these features like bimodality of probability density functions (PDF of principal parameters.  These PDFs have been reconstructed as weighted averages of periodic orbits with weights proportional to the period of the orbit and inversely proportional to the sum of positive Lyapunov exponents. The fraction of time spent in the vicinity of each periodic orbit has been compared with its instability characteristics. The relationship between these values shows the 93% correlation.  The attractor dimension of the model has also been approximated as a weighted average of local attractor dimensions in vicinities of periodic orbits.

  12. Big bang nucleosynthesis constraints on massive, unstable neutrinos

    International Nuclear Information System (INIS)

    The tau-neutrino, if sufficiently massive, must be unstable. Big Bang Nucleosynthesis (BBN) can provide constraints on the ντ mass and lifetime. The modification to the energy density of the early Universe in the case of a massive τ-neutrino which decays via ντ→νμ+φ (where φ is a weakly coupled massless scalar) is described and the results of BBN production of the light elements is presented. Consistency with the primordial abundances of D, 3He, 7Li and, especially, 4He leads to constraints on the mass (mντ) and lifetime (τντ) of the tau-neutrino. Very massive ντ (mντ≥5-10MeV), up to the ARGUS bound of 31MeV, are only allowed for short lifetimes (≤qslant40sec). Much lighter (mντ≤qslant0.01MeV) ντ are permitted for lifetimes longer than similar 0.01sec but, mντ(MeV)≤qslant10τν(sec) for shorter lifetimes. ((orig.))

  13. Sequential comparison of therapy with beta-blockers and calcium channel blockers with celiprolol therapy in patients with angina pectoris, hypertension, or both

    NARCIS (Netherlands)

    Cleophas, TJM; Niemeyer, MG; Bernink, PJLM; Zwinderman, KH; Wijk, AV; Wall, EEVD

    1996-01-01

    Unlike patients with either hypertension (HT) of angina pectoris (AP) alone, patients with both HT and AP usually have a reduced left ventricular compliance and may, therefore, have an impaired capability to cope with acute hemodynamic changes generated by standard beta-blockers or calcium channel b

  14. Incidence and impact on prognosis of peri-procedural myocardial infarction in 2760 elective patients with stable angina pectoris in a historical prospective follow-up study

    DEFF Research Database (Denmark)

    Christensen, Martin Kirk; Huang, Hui; Torp-Pedersen, Christian;

    2016-01-01

    elevated biomarkers after elective PCI in patients with stable angina pectoris using the defined cut-off (>5 x URL) was 15.2 % using cTnT and 4.1 % using CK-MBmass. The independent prognostic value for both cardiac biomarkers of any cut-off showed no statistical significance for all-cause mortality...

  15. 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

    OpenAIRE

    Chiu Wen Shian; Sandro Gonçalves de Lima; Brivaldo Markman Filho

    2007-01-01

    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 ...

  16. The Transition to Turbulence of Rayleigh-Taylor Unstable Flames

    Science.gov (United States)

    Hicks, Elizabeth P.; Rosner, R.

    2011-01-01

    Part of the uncertainty surrounding the explosion mechanism of Type 1A supernovae is the extent to which the turbulence created by the flame front can speed the flame up. A premixed flame moving against a sufficiently strong gravitational field becomes deformed and creates vorticity. If gravity is strong enough, this vorticity is shed and deposited behind the flame front. We have completed some two-dimensional direct numerical simulations of this shedding process for various values of the gravitational force. If gravity is weak enough, the flame front remains flat and no vorticity is created. If gravity is slightly stronger, the flame front becomes cusped and creates vorticity; long vortices attach to the flame front and extend behind it. For even larger values of gravity, the far end of these vortices becomes unstable and sheds more vortices. For simulations with increased gravity, the position of the shedding instability moves closer to the flame front. Next, the vortex shedding disturbs the flame front, causing the flame to pulsate. These pulsations lose their left/right symmetry and the period of oscillation doubles. For even higher values of gravity, an additional frequency is introduced into the system as the Rayleigh-Taylor instability begins to dominate over burning. Eventually, the pulsations of the flame become quite complex and the interaction between the flame front and the vortices can't be simply described. We have measured the subsequent wrinkling of the flame front by computing its fractal dimension and the energy spectra behind the flame front. Measurements of the fractal dimension suggest that it saturates, implying that any additional speed up of the flame must be due to large-scale stretching or disruption of the flame front. Our simulations were performed at NERSC which is supported by the Department of Energy.

  17. Unstable gravitino dark matter prospects for indirect and direct detection

    Energy Technology Data Exchange (ETDEWEB)

    Grefe, Michael

    2011-11-15

    We confront the signals expected from unstable gravitino dark matter with observations of indirect dark matter detection experiments in all possible cosmic-ray channels. For this purpose we calculate in detail the gravitino decay widths in theories with bilinear violation of R parity, particularly focusing on decay channels with three particles in the final state. Based on these calculations we predict the fluxes of gamma rays, charged cosmic rays and neutrinos expected from decays of gravitino dark matter. Although the predicted spectra could in principal explain the anomalies observed in the cosmic ray positron and electron fluxes as measured by PAMELA and Fermi LAT, we find that this possibility is ruled out by strong constraints from gamma-ray and antiproton observations. Therefore, we employ current data of indirect detection experiments to place strong constraints on the gravitino lifetime and the strength of R-parity violation. In addition, we discuss the prospects of forthcoming searches for a gravitino signal in the spectrum of cosmic-ray antideuterons, finding that they are in particular sensitive to rather low gravitino masses. Finally, we discuss in detail the prospects for detecting a neutrino signal from gravitino dark matter decays, finding that the sensitivity of neutrino telescopes like IceCube is competitive to observations in other cosmic ray channels, especially for rather heavy gravitinos. Moreover, we discuss the prospects for a direct detection of gravitino dark matter via R-parity violating inelastic scatterings off nucleons. We find that, although the scattering cross section is considerably enhanced compared to the case of elastic gravitino scattering, the expected signal is many orders of magnitude too small in order to hope for a detection in underground detectors. (orig.)

  18. Unstable gravitino dark matter prospects for indirect and direct detection

    International Nuclear Information System (INIS)

    We confront the signals expected from unstable gravitino dark matter with observations of indirect dark matter detection experiments in all possible cosmic-ray channels. For this purpose we calculate in detail the gravitino decay widths in theories with bilinear violation of R parity, particularly focusing on decay channels with three particles in the final state. Based on these calculations we predict the fluxes of gamma rays, charged cosmic rays and neutrinos expected from decays of gravitino dark matter. Although the predicted spectra could in principal explain the anomalies observed in the cosmic ray positron and electron fluxes as measured by PAMELA and Fermi LAT, we find that this possibility is ruled out by strong constraints from gamma-ray and antiproton observations. Therefore, we employ current data of indirect detection experiments to place strong constraints on the gravitino lifetime and the strength of R-parity violation. In addition, we discuss the prospects of forthcoming searches for a gravitino signal in the spectrum of cosmic-ray antideuterons, finding that they are in particular sensitive to rather low gravitino masses. Finally, we discuss in detail the prospects for detecting a neutrino signal from gravitino dark matter decays, finding that the sensitivity of neutrino telescopes like IceCube is competitive to observations in other cosmic ray channels, especially for rather heavy gravitinos. Moreover, we discuss the prospects for a direct detection of gravitino dark matter via R-parity violating inelastic scatterings off nucleons. We find that, although the scattering cross section is considerably enhanced compared to the case of elastic gravitino scattering, the expected signal is many orders of magnitude too small in order to hope for a detection in underground detectors. (orig.)

  19. Effects of an unstable shoe construction on balance in women aged over 50 years

    DEFF Research Database (Denmark)

    Ramstrand, Nerrolyn; Thuesen, Anna Helena; Nielsen, Dennis Brandborg;

    2010-01-01

    BACKGROUND: Shoes with an unstable sole construction are commonly used as a therapeutic tool by physiotherapists and are widely available from shoe and sporting goods retailers. The aim of this study was to investigate the effects of using an unstable shoe (Masai Barefoot Technology) on standing...

  20. A controlled comparison of oxyfedrine, isosorbide dinitrate and placebo in the treatment of patients suffering attacks of angina pectoris.

    Science.gov (United States)

    Whittington, J; Raftery, E B

    1980-09-01

    1 In a group of 23 patients with documented ischaemic heart disease who experienced angina pectoris, oral oxyfedrine (24 mg three times daily) was compared with isosorbide dinitrate (10 mg three times daily) and placebo in a double-blind double-crossover clinical trial. 2 Isosorbide dinitrate appeared no better than placebo, either in terms of symptomatic relief or ECG responses to exercise. Thirty eight per cent of patients complained of headaches and 28% had to cease taking the drug for this reason. 3 Oxyfedrine produced statistically significant improvements in both symptom level (P exercise (P effect noted was a reversible loss of taste sensation by one patient. 4 Neither drug produced any adverse changes in any haematological or biochemical parameters. 5 Oxyfedrine is, therefore, to be preferred to isosorbide dinitrate, being both much better tolerated and more efficacious. PMID:7002181