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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. Coronary angioplasty for early postinfarction unstable angina

    NARCIS (Netherlands)

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

    1986-01-01

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

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

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    José Roberto Tavares

    2002-08-01

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

  4. 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.

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

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    Hanmant S Amane

    2011-01-01

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

  6. 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.

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

    Science.gov (United States)

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

    1980-08-01

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

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

    Science.gov (United States)

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

    1995-06-01

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

  9. Angiographic findings in patients with refractory unstable angina according to troponin T status

    NARCIS (Netherlands)

    C. Heeschen (Christopher); C.W. Hamm (Christian); M.L. Simoons (Maarten); M.J.B.M. van den Brand (Marcel)

    1999-01-01

    textabstractBACKGROUND: The CAPTURE (C7E3 fab AntiPlatelet Therapy in Unstable REfactory angina) trial enrolled patients with refractory unstable angina and documented a therapeutic benefit for abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, that was particularly e

  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. 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.

  12. 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)

  13. Plasma Levels of the Anti-inflammatory Cytokine IL-10 and Inflammatory Cytokine IL-6 in Patients with Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    HONG Mei; WEI Wenning; HU Yu; YANG Rui; YANG Yan

    2005-01-01

    The plasma levels of inflammatory cytokine interleukin-6 (IL-6) and anti-inflammatory cytokine interleukin-10 (IL-10) in the patients with unstable angina or stable angina were determined and compared. In 30 patients with unstable angina and 22 patients with stable angina, plasma levels of IL-10 and IL-6 were detected by ELISA and plasma lipid parameters by lipid research clinical methods respectively. The results showed plasma levels of IL-10 were significantly lower in unstable angina group than in stable angina group (P=0. 005), while those of IL-6 were significantly increased in unstable angina group as compared with those in stable angina group (P = 0. 039).There was a significantly negative correlation between IL-10 and IL-6 in patients with unstable angina (r=-0.41, P=0. 003). In the unstable angina group, IL-6 levels were obviously positively correlated with TC (r=0. 314, P=0. 023), but not with TG and HDL. There were no significant correlations between IL-10 and plasma lipid parameters. It was suggested that the decreased IL-10and increased IL-6 might be associated with the atheromatous plaque stability and progression of coronary heart diseases. IL-10 may play an important role in preventing coronary vascular lesions.

  14. 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...

  15. 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.

  16. 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.

  17. 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...

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

    OpenAIRE

    A. I. Kondratiev

    2014-01-01

    Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2).Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina) and acute left ventricular failure(Killip class I–III) during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical...

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

    Science.gov (United States)

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

    1990-12-01

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

  20. Unstable 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 ...

  1. Association of the 894G>T polymorphism of the endothelial constitutive nitric oxide synthase gene with unstable angina

    Directory of Open Access Journals (Sweden)

    G.R. Iturry-Yamamoto

    2007-04-01

    Full Text Available The 894G>T polymorphism of the endothelial constitutive nitric oxide synthase gene consists of the substitution of a guanine base by a thymine at the 894th nucleotide of the gene. An association of this polymorphism with acute coronary syndromes has been described, only when in combination with other polymorphisms of this gene. The aim of the present study was to search for an association between this polymorphism and unstable angina in a southern Brazilian population. In a case-control study, 156 patients (group 1 (N = 83: unstable angina, group 2 (N = 73: stable angina were genotyped by PCR and digestion of the product. Univariate analysis demonstrated that the minimal luminal diameter and the degree of stenosis of the culprit lesion differed between groups (P = 0.006 and 0.005, respectively. In addition, the frequencies of the T allele and of the T allele carriers (combined TT and TG genotypes were significantly higher in the group with unstable angina (41.6 vs 28.8%; P = 0.025, Pearson chi-square test, and 73.5 vs 45.2%; P = 0.001, Pearson chi-square test, respectively. Multivariate logistic regression showed that the frequency of the T allele carriers was the only variable with a predictive value for unstable angina, when controlled for the other variables (6.1 (95% CI = 2.55-14.43; P T polymorphism was associated with unstable angina. We suggest that this polymorphism may be a genetic risk factor for unstable angina.

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

    Science.gov (United States)

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

    2003-01-01

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

  3. 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 ...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  5. 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

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

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    Xiaoxia Zhang

    2015-01-01

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

  7. 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.

  8. 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

  9. Risk stratification in unstable angina and non-Q wave myocardial infarction using soluble cell adhesion molecules

    Science.gov (United States)

    Mulvihill, N; Foley, J; Murphy, R; Curtin, R; Crean, P; Walsh, M

    2001-01-01

    OBJECTIVE—To assess prospectively the prognostic value of soluble cellular adhesion molecules (CAMs) in patients with unstable angina and non-Q wave myocardial infarction and to compare their prognostic accuracy with that of C reactive protein (CRP).
DESIGN AND SETTING—Prospective observational study of patients presenting acutely with unstable angina and non-Q wave myocardial infarction to a single south Dublin hospital.
METHODS—Patients with Braunwald IIIA unstable angina and non-Q wave myocardial infarction had serum samples taken at presentation before initiation of antithrombotic treatment and were followed for six months. The primary end point was the occurrence of major adverse cardiovascular events (recurrent unstable angina, non-fatal myocardial infarction, and cardiovascular death) at six months. Concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble endothelial selectin, and soluble platelet selectin were measured using an enzyme linked immunosorbent assay technique. CRP was measured with an immunophelometric assay.
RESULTS—91 patients (73 men and 18 women, mean (SD) age 61 (11) years) were studied; 27 patients (30%) had major adverse cardiac events during the six months of follow up. Concentration of CRP were significantly raised in patients who had an ischaemic event (mean (SEM) 11.5 (6.4) mg/l v 5.4 (2.5) mg/l, p  3 mg/l and sVCAM-1 > 780 ng/ml for predicting future events was > 90%. There was no difference in concentrations of sICAM-1, soluble endothelin selectin, or soluble platelet selectin between event and non-event groups.
CONCLUSION—Raised concentrations of sVCAM-1 and CRP are predictive of an increased risk of major adverse cardiovascular events six months after presentation with unstable angina and non-Q wave myocardial infarction. These findings suggest that the intensity of the vascular inflammatory process at the time of

  10. 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.

  11. 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

  12. Screening and identification of microRNA involved in unstable angina using gene-chip analysis

    Science.gov (United States)

    Li, Si; Sun, Ya-Nan; Zhou, Yun-Tao; Zhang, Chun-Lai; Lu, Feng; Liu, Jia; Shang, Xiao-Ming

    2016-01-01

    Increasing evidence has suggested that microRNA (miRNA) may play a role in the pathogenesis of cardiovascular disease, which has led to a greater understanding of the complex pathophysiological processes underlying unstable angina (UA). The present study aimed to investigate changes in the miRNA expression profiles of patients with UA using gene-chip analysis, in order to further elucidate the pathogenesis of UA. Total RNA was extracted and purified from plasma samples collected from patients with UA and healthy controls. The samples underwent microarray analysis using an Exiqon miRCURY LNA™ microRNA Array. Differentially expressed miRNAs were identified by volcano plot filtering, and were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In addition, functional annotation of the differentially expressed miRNAs involved gene ontology analyses. Among the 212 miRNAs differentially expressed between the two groups, 82 were upregulated and 130 were downregulated. Notably, the results of the RT-qPCR were consistent with the gene-chip results. The miRNAs identified in the present study may be potential novel biomarkers for the prevention and early diagnosis of UA. Furthermore, the results of the present study suggested that UA occurs as a result of complex and dynamic processes regulated by numerous factors, including multiple miRNAs.

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

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    A. I. Kondratiev

    2014-07-01

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

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

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    A. I. Kondratiev

    2011-01-01

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

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

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    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

  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.

  17. 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

  18. 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.

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

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    Savovic Zorica

    2016-06-01

    Full Text Available Given Taking that the TIMI score is a major predictor of MACE, this study aimed to determine the value of the TIMI risk score in predicting poor outcomes (death, myocardial infarction, recurrent pain in patients presenting with unstable angina pectoris in short-term observation. A total of 107 patients with APns were examined at the Clinical Centre Kragujevac and were included in the investigation. The TIMI score was determined on the first day of hospitalization. During hospitalization, the following factors were also observed: troponin, ECG evolution, further therapy (pharmacologic therapy and/or emergency PCI or CABG, age, hypertension and hyperlipidaemia. The low-risk group (TIMI 0 - 2 included 30.8% of patients, whereas 47.6% of patients were in the intermediate-risk group (TIMI 3 - 4, and 21.5% of patients were in the high-risk group (TIMI 5 - 7. Good outcomes (without adverse event and poor outcomes (death, myocardial infarction, and recurring chest pain were dependent on the TIMI risk score. The increase in TIMI risk score per one unit increased the risk of a poor outcome by 54%. Troponin and TIMI risk score were positively correlated. Our results suggest that the TIMI risk score may be a reliable predictor of a poor outcome (MACE during the short-term observation of patients with APns. Moreover, patients identified as high-risk benefit from early invasive PCI, enoxaparin and Gp IIb/IIIa inhibitors. Th us, routine use of the TIMI risk score at admission may reduce the number of patients not recognized as high-risk.

  1. Ranolazine Therapy Reduces Non-ST-Segment-Elevation Myocardial Infarction and Unstable Angina in Coronary Disease Patients with Angina.

    Science.gov (United States)

    Murray, Gary L; Colombo, Joseph

    2016-09-01

    High sympathetic tone and cardiac autonomic neuropathy (CAN) are associated with major adverse cardiac events (MACE). We have shown ranolazine (RAN) improves autonomic function. RAN was introduced to 51 successive anginal CD patients (RANCD). A control group of 54 successive nonanginal CD patients (NORANCD) continued baseline therapy. Mean study duration was 6.1 years, which included semi-annual autonomic function measures (ANX 3.0, ANSAR Medical Technologies, Inc., Philadelphia, PA) and yearly myocardial perfusion SPECT studies (MPI). MACE were experienced by 29% RANCD patients versus 46% NORANCD patients (p = 0.0105). The patients from both groups with abnormal parasympathetic and sympathetic (P&S) measures and MACE totaled 52 of those patients with MACE versus 17% of those patients without MACE (p = 0.0274). Abnormal MPI was demonstrated in 35% of those with abnormal (P&S) measures and MACE versus 12% without MACE. Sympathovagal balance (SB) was lower, indicating higher, relative parasympathetic tone (known to be cardioprotective) in the RANCD group. Acute coronary syndromes occurred 4.5 times as often in NORANCD patients. High SB occur more frequently than abnormal MPI in CD patients experiencing MACE. In addition to increased myocardial blood flow as its proposed mechanism of angina relief, RAN improves P&S measures, a potentially new mechanism whereby RAN improves outcomes.

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

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    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

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    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

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

    Institute of Scientific and Technical Information of China (English)

    董红晶

    2014-01-01

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

  5. 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.

  6. 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.

  7. 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.

  8. Effect of the platelet membrane GP Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Yonghui Zhao; Changcong Cui; Yanni Wang; Jiaqing Zhu

    2005-01-01

    Objective: To investigate the effect of platelet membrane glycoprotein(GP) Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris (UAP) in Chinese people. Methods: Collagen type Ⅰ -induced platelet aggregation was measured in 33healthy subjects in vitro. Plasma level of α-granule membrane protein (GMP-140) was measured in both the above 33 healthy subjects during fasting and 35 patients with recent onset effort anina during rest onset within 24 h after hospitalization. Furthermore, the platelet membrane GP Ⅰ a gene 807C/T polymorphism was checked in all subjects with polymerase chain reaction-sequence specific primers(PCR-SSP)technique. Results: The lag time before 30% platelet aggregation was significantly longer in healthy subjects with CC genotype than with TC genotype ( P <0.01). However, there was no significant difference in the maximal platelet aggregation between healthy subjects with the above two genotypes. Plasma level of GMP-140 was significantly higher in TC genotypic patients with recent onset effort angina than in CC genotypic patients with the same type of UAP( P < 0.05) and healthy subjects ( P < 0.01), furthermore, there was also significant difference between the latter two groups( P < 0.05). Conclusion: The rapid initiation of collagen-induced platelet aggregation may be associated with platelet membrane GP Ⅰ a T807 allele, which may play an important role in the pathogenesis of UAP.

  9. 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

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

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    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.

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

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    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.

  12. 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.

  13. 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

  14. 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)

  15. 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.

  16. 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.

  17. Unstable angina pectoris prognosis clinical analysis%不稳定性心绞痛预后临床分析

    Institute of Scientific and Technical Information of China (English)

    闵晓梅; 宁渝

    2008-01-01

    目的 探讨不稳定性心绞痛患者远期预后的影响因素.方法 采用回顾性分析总结我院2001-2007年间92例不稳定性心绞痛患者的临床资料,依据患者静息心电图,连续24 h动态心电图,超声心动图及冠状动脉造影检查结果及患者的年龄、性别、吸烟、饮酒与否、室性心律失常的发生、危险度分层对远期预后的影响关系进行分析.结果 左室射血分数(LVEF)低于45%的患者较高于45%的患者病死率高(P0.05),入院时心率大于90次/min的患者较心率小于90次/min的患者病死率高(P<0.05),发生复杂型室性期前收缩患者病死率较无复杂型室性期前收缩患者病死率有明显意义(P<0.01),高危组患者死亡率较低危组患者死亡率明显增加(P<0.05).结论 左心室功能,冠状动脉病变部位和范围、年龄、性别、吸烟、复杂型心律失常、危险度分层均是影响不稳定性心绞痛的远期预后因素.%Objective Discussion influence unstable angina pectoris patients forward prognosis factor.Methods Uses the review analysis to summarize my courtyard during for 2001-2007 year 92 example unstable angina pectoris patients' clinical material,ceases activity the electrocardiogram based on the patients,the con-tinual 24 hours dynamic electrocardiograms,the eehoeardiogram and the coronary artery radiography inspection result and patients' age, the sex, smoking, drink wine or not, the room arrythmia occurrence, the risk factor lami-nation carry on the analysis to the forward prognosis influence relations. Results The left room shoots the men-struation number(LVEF) , Being lower than 45% the patient to compare higher than 45% The patient case fatali-ty rate is high(P<0.01) ,the left coronary artery branch pathological change patient case fatality rate far is big-ger than the patient who left front falls a pathological change (P<0.01) , the age 60 year old of above patient compares 60 year old of following patient case

  18. 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.

  19. Dual left anterior descending coronary artery from right aortic sinus: report of a case of recurrent unstable angina after CABG.

    Science.gov (United States)

    Formica, Francesco; Corti, Fabrizio; Colombo, Virgilio; Monica, Gionali; Paolini, Giovanni

    2005-01-01

    Anomalies of the left coronary artery are very rare, with an incidence range between .3% and 1.64%. The diagnosis is generally incidental during coronary angiogram, coronary artery bypass operation, or autopsy. However, sometimes this anomaly is not recognized during CABG operation and can be responsible for the recurrence of angina after CABG operation and even compromise the outcome. We presented a case in which the dual left anterior coronary artery from the right aortic sinus occasionally was shown in a coronary angiogram after CABG operation; the angiogram was performed because of the recurrence of angina.

  20. Study on Effect of Zhixinkang Capsule(脂欣康胶囊)in Treating Unstable Effort Angina and Hyperlipidemia and Lts Function in Vascular Endothelium Protection

    Institute of Scientific and Technical Information of China (English)

    ZHANGWen-gao; MENG-Xian-zhongtffu

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endotelium of Zhixin-kang Capsule(ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia.Methods:Sixty-five patients with unstable effort angina were randomly divided into ZXKC group(34 ca-ses)and control group(31 cases).Conventional western medical therapy was given to both groups,with ZXKC group receiving additional ZXKC treatment.Data of 20 healthy persons were taken as normal group.Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 ca-ses) and control group treated with Yixintong(17 cases).The changes of clinical symptoms and laborato-ry indexes in all the patients were observed before and after treatment.Results:In patients with unstable effort angina,the efficacy of treatment of ZXKC,the withdrawal rate of nitroglycerin,the relieving of symptoms,the improvement of the electrocardiogram,the counts of circulating endothelial cells,the con-tent of platelet P-selectin,the content of plasma endothelin(ET),the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde(MDA) were all better than those in the control group.In patients with hyperlipidemia,there was no significant difference in lipids reduction between ZXKC group and the control group.In both groups,the total cholesterol(TC),triglyceride(TG),low density lipo-protein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],ET, oxidized low density lipoprotein,MDA,arte-riosclerotic index(AI)all lowered obviously,while the SOD,HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly.In the ZXKC group,the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly.The total effective rate in symptom relieving,the markedly effective rate,the reduction of TC,ET and ET/CGRP,and the elevation of SOD in ZXKC group were all superior to those in the control group.Conclusion:ZXKC could effectively resist myocardial ische

  1. 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

  2. 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...... 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 NSTEMI, the CAG examination probability at 3 days leaped from 20% in 2007 to 32% in 2008 and 39% in 2009, and for PCI the same was true with a leap in treatment probability from 19% to 28% from 2008 to 2009. CONCLUSIONS: In Denmark the use of CAG and PCI in treatment of NSTEMI and unstable angina has...

  3. 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.

  4. Simvastation Treatment of Unstable Angina pector Clinical Analysis%辛伐他汀治疗不稳定性心绞痛的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈哲

    2012-01-01

      目的:探讨辛伐他汀治疗不稳定性心绞痛的临床效果.方法:将我院自2010年1月~2012年1月收治的不稳定型心绞痛患者50例随机分为治疗组和对照组各25例,对照组仅给予常规药物治疗,治疗组在常规药物治疗的基础上给予辛伐他汀治疗,比较2组患者的临床疗效.结果:治疗组的总有效率为100%,对照组的总有效率为76%,治疗组的总有效率显著高于对照组,2组对比发现,差异具有统计学意义(P0.05).结论:辛伐他汀治疗不稳定性心绞痛,能显著控制炎症反应,减少新病灶及全堵塞的形成,改善血糖和血脂,延长运动导致的心绞痛发作时间,疗效确切、安全可靠,值得临床推广应用.%  Objective:Discussion simvastation Unstable angina pector treatment of the clinical effect. Methods: Will our hospital from January 2010 to January 2012 were Unstable angina pector 50 patients were randomly divided into the treatment group and control group every 25 cases and control only give regular drug therapy, the treatment group on the basis of routine therapy to give simvastation treatment, compared with two groups of patients with clinical curative effect. Results: The total effective rate of the treatment group were 100%and the total effective rate is 76%and the total effective rate of the treatment group was significantly higher than the control group, the two groups s found that a statistically significant difference (P 0.05). Conclusions: Simvastation treatment of Unstable angina pector can significantly control inflammation, reduce new lesions and the formation of the jam, improve blood sugar and blood fat, extend the movement of heart attacks in time, definite effect, safe and reliable, and clinical application.

  5. Different edge effects of paclitaxel-and sirolimus-eluting stents on proximal and distal edges in patients with unstable angina:serial intravascular ultrasound analysis

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; YE Fei; ZHANG Jun-jie; LIU Zhi-zhong; SHAN Shou-jie; SUN Xue-wen; ZHANG Ai-ping; CHEN Jing-guo; XU Ya-wei; YANG Song; CHEN Feng; LUO Weng-ping

    2009-01-01

    Background It is unclear whether edge segments have different responses to paclitaxel eluting stent (PES) and sirolimus eluting stent (SES) implantation in patients with unstable angina. This study aimed to compare the different vascular edge responses in patients with unstable angina and single de novo coronary lesion treated with SES and PES. Methods Two hundred and fifty-five patients with unstable angina and single de novo lesion were randomly assigned to PES and SES groups. Serial volumetric intravascular ultrasound (IVUS) images were taken immediately after stenting and at an eight-month follow-up. Five-mm edge segments proximal and distal to the stents were analyzed. Results Baseline characteristics were comparable between the two groups. At proximal-edge segment, the vessel area decreased and the plaque area increased significantly in the PES group as compared with the SES group. A significant net loss of lumen area was found in the PES group (from (11.10±3.12) mm2 at baseline to (9.92+3.59) mm2 at the follow-up, P <0.001). At the distal-edge segment, the net loss of lumen area in the PES group (from (7.71±2.81) mm2 at baseline to (6.66±2.29) mm2 at the follow-up, P <0.001) was attributed to a significant increase of plaque area. Proximal-edge stenosis was commonly seen in the PES group (20.0%) as compared with the SES group (5.0%, P=0.001). This correlated with the higher incidence of target lesion revascularization in the PES group (P=-0.03). Subsegmentally, the smallest A lumen area was located at 2 mm proximally in both groups, at 0 mm distally in the PES group, and at 1 mm distally in the SES group. Conclusions The two groups demonstrated negative remodeling of edge segments. PES was less effective than SES in inhibiting the growth of plaque within the first 1-mm length proximal to the stent.

  6. Comparison of signs and symptoms of myocardial infarction and unstable angina in male and female hospitalizedpatients in coronary care units of Kerman Medical University hospital, 2004-2005

    Directory of Open Access Journals (Sweden)

    S. Sabzevari

    2007-01-01

    Full Text Available Abstract Background and purpose: Coronary Artery Disease (CAD is one of the most common causes of mortality and disability in the world. The results of some studies show that there are differences in signs and symptoms of CAD between male and female.Materials and Methods: This research was done to compare males and females for these signs and symptoms in 600 hospitalized patients in coronary care units of Kerman Medical University from December 2004 to July 2005. For data collection a questionnaire was used which was designed in five sections: demographic characteristics, disease variables, pictures for determining the points of chest pain, Visual Analog Scale for determining the intensity of pain and measures taken by patients after the beginning the signs and symptoms. This questionnaire was completed by two nurses in different shifts by interviewing the patients. For data analysis T test, χ2, Fisher exact and Man-Whitney U were used.Results: The results showed that the women were older than men (p<0.001. Most women had unstable angina and men had myocardial infarction (P<0.05. There were no significant differences between the chest pain in both genders but neck pain, back pain, fatigue, decrease of appetite, flushing, dizziness, tiredness, visual disturbances, suffocation feeling, palpitation and restlessness were experienced in women more than men (p<0.05. Also dyspenea during the heart attack was seen in most women (44.7% vs 29.4% but there was no significant difference between two genders for intensity of pain.Conclusion: This study showed that atypical signs and symptoms of unstable angina and myocardial infarction were seen in female more than male. Furthermore this may be followed by some problems in diagnosis and then delay in referring the patients to medical centers. On the other hand, health care workers may not pay enough attention to these atypical signs and symptoms, in women with normal ECG so they might not receive nessaceery

  7. Understanding factors that influence the use of risk scoring instruments in the management of patients with unstable angina or non-ST-elevation myocardial infarction in the Netherlands: a qualitative study of health care practitioners’ perceptions.

    NARCIS (Netherlands)

    Engels, J.; Heeren, M.J.; Wulp, I. van der; Bruijne, M.C. de; Wagner, C.

    2014-01-01

    Background Cardiac risk scores estimate a patient’s risk of future cardiac events or death. They are developed to inform treatment decisions of patients diagnosed with unstable angina or non-ST-elevation myocardial infarction. Despite recommending their use in guidelines and evidenc

  8. Study of relationship between the levels of serum bilirubin ,uric acid and unstable angina pectoris%不稳定型心绞痛患者血清胆红素及尿酸水平的分析

    Institute of Scientific and Technical Information of China (English)

    梁启权; 曾胜宏

    2009-01-01

    目的 探讨冠心病不稳定型心绞痛与胆红素及尿酸的关系.方法 将入选202例冠心病不稳定型心绞痛患者,采集空腹静脉血测定总胆红素、直接胆红素、间接胆红素及尿酸,比较其心绞痛发作时、3个月、6个月及1年内未再发作时胆红素及尿酸的变化情况.结果 心绞痛发作时胆红素降低,尿酸偏高.结论 胆红素和尿酸水平可间接反映不稳定型心绞痛机体氧化、抗氧化情况,胆红素对评估病情有一定帮助.%Objective To investigate the relationship between the levels of serum bilirubin,uric acid(UA) and coronary heart disease unstable angina pectoris.Methods The leves of total bilirubin (TBIL),direct bilirubin (DBIL),indirect bilirubin(IBIL) and UA in venous blood by limosis were determind in 202 patients with unstable angina pectoris.We determine the different levels of TBIL,DBIL,IBIL and UA when they were suffering from angina pectoris.Then we respectively determine the levels of TBIL,DBIL,IBIL and UA in 3 months,6 months and 12 months after they had been suffered from angina pectoris.Results The levels of serum bilirubin were lower and UA were higher,when the patients were suffering from angina pectoris.Conclusion We can indirectly assess the oxidative and antioxidative activities by testing bilirubin and UA in unstable angina pectoris.

  9. 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.

  10. 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....

  11. 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...

  12. 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.

  13. 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...

  14. 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

  15. 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

  16. Evaluation of coronary plaque and stent deployment by intravascular optical coherence tomography in elderly patients with unstable angina and non-ST-elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Caiyi LU; Jinyue ZHAI; Shiwen WANG; Wei YAN; Xingli WU; Yuxiao ZHANG; Qiao XUE; Muyang YAN; Peng LIU; Rui CHEN

    2007-01-01

    Objective To evaluate the feasibility and efficacy of intravascular optical coherence tomography (OCT) in the assessment of plaque characteristics and drug eluting stent deployment quality in the elderly patients with unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI). Methods OCT was used in elderly patients undergoing percutaneous coronary interventions.Fifteen patients, 9 males and 6 females with mean age of 72.6±5.3 years (range 67-92 years) were enrolled in the study. Images were obtained before initial balloon dilatation and following stent deployment. The plaque characteristics before dilation, vessel dissection,tissue prolapse, stent apposition and strut distribution after stent implantation were evaluated. Results Fifteen lesions were selected from 32 angiographic lesions as study lesions for OCT imaging after diagnostic coronary angiography. There were 7 lesions in the left anterior descending artery, 5 lesions in the right coronary artery and 3 lesions in the left circumflex coronary artery. Among them,12 (80.0%) were lipid-rich plaques, and 10 (66.7%) were vulnerable plaques with fibrous cap thickness 54.2±7.3 μm. Seven ruptured culprit plaques (46.7%) were found; 4 in UA patients and 3 in NSTEMI patients. Tissue prolapse was observed in 11 lesions (73.3%).Irregular stent strut distribution was detected in 8 lesions (53.3%). Vessel dissections were found in 5 lesions (33.3%). Incomplete stent apposition was observed in 3 stents (20%) with mean spacing between the struts and the vessel wall 172±96 mm (range 117-436 mm).Conclusions 1) It is safe and feasible to perform intravascular OCT to differentiate vulnerable coronary plaque and monitor stent deployment in elderly patients with UA and USTEMI. 2) Coronary plaques in elderly patients with UA and USTEMI could be divided into acute ruptured plaque, vulnerable plaque, lipid-rich plaque, and stable plaque. 3) Minor or critical plaque rupture is one of the mechanisms of UA

  17. 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

  18. 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

  19. Systematic Review of Associated Prescriptions of Gualou and Xiebai on Unstable Angina Pectoris%《金匮要略》瓜蒌薤白类方治疗不稳定型心绞痛的系统评价

    Institute of Scientific and Technical Information of China (English)

    庄严

    2014-01-01

    Objective:To systematically assess the efficacy of the associated prescriptions of Gualou and Xiebai on unstable angina pectoris. Methods:Randomized controlled trials of associated prescriptions of Gualou and Xiebai on unstable angina pectoris were retrieved from the Cochrane library,PubMed,CNKI, Wanfang database and CBM. The risk of bias of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of interventions. Such statistical analyses as heterogeneity analysis,meta-analysis,sensitivity analysis and funnel plot analysis were performed using the Review Manager 5.2.6 software. Results:Fourteen qualified trials were included. The risk of bias was generally high and clinical heterogeneity exists among them. Meta-analysis shows that the associated pre scriptions of Gualou and Xiebai can improve angina pectoris(RR=1.24,95%CI[1.18,1.31]) and ECG manifestations(RR=1.29,95%CI[1.19,1.39]),funnel plot is asymmetry. Conclusion:Current evidence indicates that treating un-stable angina pectoris with the associated prescriptions of Gualou and Xiebai can improve the efficacy on unstable angina pectoris. Due to the low quality of included studies ,clinical trials with adequate samples , rational design and strict execution should be carried out to provide more reliable evidence.%目的:系统评价《金匮要略》瓜蒌薤白类方治疗不稳定型心绞痛的临床疗效。方法:检索中国学术文献总库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、The Cochrane Library、PubMed等数据库,搜集瓜蒌薤白类方治疗不稳定型心绞痛的随机对照试验,按照Cochrane协作网推荐的方法评估纳入研究的偏倚风险,运用RevMan 5.2.6软件完成异质性检验、Meta-分析、敏感性分析、倒漏斗图分析等相关统计分析。结果:共纳入14项合格研究,均存在较高的方法学偏倚风险,Meta-分析显示瓜蒌薤白类方在

  20. 益气活血法对不稳定型心绞痛心肌能量代谢的影响%Supplementing Qi and Activating Blood Circulation Method for Unstable Angina Myocardial Energy Metabolism

    Institute of Scientific and Technical Information of China (English)

    杨佳瑞; 刘东方

    2014-01-01

    Objective:To observe supplementing Qi and activating blood circulation method for unstable angina myocardial energy metabolism .Methods:80 patients with unstable angina patients were randomly divided into treatment group and control group .Compare two groups before and after medication weekly frequency of angina attack, nitroglycerin stopped reduction rate , resting electrocardiogram changes and changes in serum free fatty acid (FFA) contents.Results:After treatment in both groups after treatment nitroglycerin stopped reduction rate and weekly frequency of angina attack , resting electrocardiogram changes and changes in serum free fatty acid (FFA) contents had no significant difference (P>0.05).Conclusion:Supplementing Qi and activating blood circulation method may take use of influencing the myocardial energy metabolism to play the role in the protection of ischemic myocardium and to reduce the occurrence of clinical cardiovascular events .%目的:观察益气活血法对不稳定型心绞痛心肌能量代谢的影响。方法:80例符合纳入标准的不稳定型心绞痛患者随机分为治疗组和对照组,在常规治疗的基础上,治疗组给予益气活血中药汤剂,对照组口服万爽力,比较两组用药前后每周心绞痛发作频率、硝酸甘油减停率、静息心电图变化及血清中游离脂肪酸( FFA)含量变化。结果:两组患者治疗后硝酸甘油减停率、每周心绞痛发作频率、静息心电图变化及血清中游离脂肪酸(FFA)含量变化无显著差异(P>0.05)。结论:益气活血法可能通过影响心肌能量代谢达到保护缺血心肌的作用,以减少临床心血管事件的发生。

  1. 护理干预在不稳定型心绞痛中的应用研究%Analysis of Nursing Intervention Application in Treatment of Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    尹贞顺

    2015-01-01

    目的:探究不稳型性心绞痛患者采用护理措施的效果。方法选取2013年4月~2014年8月收治的35例不稳定型心绞痛患者进行护理,随机分组,实验组19例患者采用综合护理,对照组16例患者选择常规护理,对比患者的护理效果。结果实验组患者护理有效率为94.74%,对照组患者护理有效率为75.0%,差异具有统计学意义(P<0.05)。结论不稳定型心绞痛患者在治疗中采用综合护理,可提高治疗效果,减轻病痛,保持良好心态,效果显著。%ObjectiveTo explore nursing intervention effect in treatment of unstable angina.Methods Choose 35 patients with unstable angina that were treated in hospital from April 2014 to August 2014 and separated them into two groups at random,19 patients in study group were given comprehensive nursing,while 16 patients in control group were given conventional nursing and then compared nursing effects between two groups.ResultsPatients’ nursing efficacy in study group was 94.74%,while patients’ nursing efficacy in control group was 75.0%,there was a great differential of nursing effects between two groups and such a differential had statistic value(P< 0.05).Conclusion Comprehensive nursing is of efficacy in treatment of unstable angina,it is conducive to increasing treatment efficacy,relieving patients’ pain and assisting patients to be in a mood.

  2. 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

  3. 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,

  4. Clinical Research about Different Antiplatelet Scheme forTreatment of Unstable Angina Pectoris%不同抗血小板方案治疗不稳定性心绞痛疗效临床研究

    Institute of Scientific and Technical Information of China (English)

    邓应忠; 曹晨; 郑兴萍

    2011-01-01

    Objective:To compare unstable angina pectoris curative effect of single,double, double dual antiplatelet therapy.Methods:325 cases of unstable angina patients were divided into dual antiplatelet group of 120 patients,single-agent antiplatelet group 114 cases,the first two group therapy invalid cases into double dual antiplatelet therapy.Observe clinical treatment effect of unstable angina pectoris.Results:Dual antiplatelet therapy was significantly effective in 71 cases(59.17%),effective in 23 cases(19.17%)and invalid in 26 cases(21.67%).Single-agent antiplatelet therapy was significantly effective in 56 cases (49.12%),effective in 19 cases(16.67%)and invalid in 39 cases (34.12%).P<0.05,the difference was statistically significant.Double dual antiplatelet therapy was significantly effective in 21 cases(65.63%),effective in 5 cases(15.63%)and invalid in 6 cases(28.6%).Conclusions:Dual antiplatelet therapy is more effective than single-agent antiplatelet therapy in treatment of unstable angina,double dual antiplatelet therapy can further enhance the curative effect.%目的:比较单重、双重、加倍双重抗血小板治疗不稳定性心绞痛(UAP)的疗效,探讨UAP更好的治疗方案.方法:234例不稳定型心绞痛患者分为双重抗血小板组120例、单重抗血小板组114例,前两组治疗无效病例进入加倍双重抗血小板治疗组32例.观察UAP临床治疗效果.结果:双重抗血小板治疗组显效71例(59.17%),有效23例(19.17%),无效26例(21.67%).单重抗血小板治疗组:显效56例(49.12%),有效19例(16.67%),无效39例(34.21%);差异有统计学意义(P<0.05).加倍双重抗血小板治疗组:显效21例(65.63%),有效5例(15.63%),无效6例(28.6%).结论:双重抗血小板治疗较单重抗血小板治疗有UAP治疗更好的疗效,加倍双重抗血小板治疗可以进一步提高疗效.

  5. Observation of the Therapeutic Effect of Ferulic Acid Sodium Treating Unstable Angina Pectoris in 86 Cases%阿魏酸钠治疗不稳定型心绞痛86例疗效观察

    Institute of Scientific and Technical Information of China (English)

    裘健

    2011-01-01

    目的 观察阿魏酸钠治疗不稳定型心绞痛(UAP)的疗效及安全性.方法 164例UAP患者随机分为两组:阿魏酸钠组(治疗组)和丹参组(对照组),观察两组患者的临床症状疗效、心电图改善情况,治疗前后高敏C反应蛋白(hs-CRP)变化及不良反应发生情况.结果 治疗组临床症状及心电图改善情况均显著优于对照组(P<0.05);两组患者治疗前后hs-CRP均无显著变化(P>0.05);两组患者在治疗过程中均未出现明显不良反应.结论 阿魏酸钠治疗UAP疗效明显,安全性佳,值得临床推广应用.%Objective To observe the clinical effect and safety of ferulic acid sodium for patients with unstable angina pectoris( UAP ). Methods 164 UAP patients were randomly divided into ferulic acid sodi-um group( treatment group )and the salvia miltiorrhiza group( control group ). Clinical symptoms, electrocardi-ogram,high sensitive C-reactive protein( hs-CRP)and adverse effect were observed. Results Clinical symp-toms and electrocardiogram,amelioration in treatment group were better than control group( P 0.05 ); there was no obvious adverse effects during the treatment course in bothgroups. Conclusion Ferulic acid sodium is an efficient and safe therapeutic tool for unstable angina pectoris, worthy of clinical applica-tion.

  6. Analysis of Curative Effect of Simvastatin in the Treatment of Unstable Angina Pectoris%辛伐他汀治疗不稳定型心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    王亚新

    2014-01-01

    Objective Simvastatin treatment of unstable angina clinical results were evaluated. Methods 120 patients were randomly divided into a control group and the observation group. Changes in two groups of patients before and after treatment LDL cholesterol, ECG and angina time for comparison. Results Efficacy results after treatment showed that patients in the observation group reached 96% of the total efficiency of the control group patients achieved a total ef iciency of 80%, a significant difference was statistical y significant ( <0.05), after treatment LDL cholesterol was observed between the groups compared with the control group, significant dif erence was statistical y significant ( <0.05).Conclusion In the treatment of unstable angina when using simvastatin with ten male significant effect, worthy of promotion and application in clinical practice.%目的对辛伐他汀治疗不稳定型心绞痛的临床效果进行评价。方法随机的将120例患者分为对照组以及观察组。对两组患者在治疗前后的各项指标进行比较。结果经过治疗后的疗效比较结果显示,观察组患者达到了96%的总有效率,而对照组患者达到了80%的总有效率,差异显著具有统计学意义(<0.05),在治疗之后,观察组与对照组之间的低密度脂蛋白胆固醇相比较,差异显著具有统计学意义(<0.05)。结论在对不稳定型心绞痛进行治疗的时候采用辛伐他汀具有十分显著的疗效。

  7. Clinical analysis of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris%盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的效果

    Institute of Scientific and Technical Information of China (English)

    柳青; 李慧芳; 刘丽凤; 董瓅瑾

    2012-01-01

    Objective To observe the efficacy of injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris. Methods 101 patients with unstable angina pectoris in our hospital were randomly divided into test group (re =51) and control group (re = 50) . The test group was administered with diltiazem hydrochloride in combination with nitroglycerin while the control group was given nitroglycerin alone. After 48 hours, the two groups of patients were observed and compared in terms of anginal attacks, heart rate, Prt, Qrto, 01 interval time, blood pressure, myocardial oxygen consumption index, blood routine, blood biochemical index. JvesultS Ihere was no death, no complications or significant arrhythmias and hemodynamic changes. After treatment, the heart rate and myocardial oxygen consumption index of the test group decreased more significantly ( P < 0. 05 ) than in the control group. PR interval and QT interval of the test group were slightly longer than those of the control group, but without significant difference. Conclusion Injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris patients induces no serious adverse rectons and can effectively relieve angina,significantly reduce myocardial oxygen con- sumption and provide better myocardial protection.%目的 观察注射用盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的临床疗效.方法 选择我院住院的101例不稳定型心绞痛患者,随机分为实验组(n=51) 和对照组( n=50),对照组单用硝酸甘油,实验组应用硝酸甘油和盐酸地尔硫联合治疗.观察并比较两组患者用药48 h对心绞痛发作次数、心率、PR间期、QRS时限、QT间期、血压、心肌耗氧指标、血常规、血生化等指标.结果 两组均无并发症,无死亡,并且血流动力学的改变及心律失常的发生率差别均无统计学意义.实验组治疗后心率

  8. 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 ...

  9. Meta-analysis of Dengzhanxixin injection treatment for unstable angina pectoris%灯盏细辛注射液联用西药治疗不稳定心绞痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    聂晓璐; 申浩; 谢雁鸣; 胡晶; 张越伦; 黎元元

    2012-01-01

    Objective: To assess the efficacy and safety of Dengzhanxixin injection for unstable angina pectoris. Method: All clinical studies of Dengzhanxixin injection for unstable angina pectoris ( UAP) were searched from Cochrane library,Medline,EM-base,CBM,CNKI,Wanfang and VIP. Quality assessment and information extraction were done by two independent screening . The quality of the included documents was evaluated by the Cochrane Collaboration's tool for assessing risk of bias and allocation concealment . Revman 5. 1. 4 software was used for data analysis. Result: A total of 17 randomized controlled trials were included (1 644 patients ) ,in which,only 2 studies were true RCT,1 study used single blind method,while other studies did not mention allocation concealment ,blind and loss-up information. Meta-analysis showed that the Dengzhanxixin injection group was better than the conventional treatment group in efficiency ( OR = 3. 54,95% CI [ 2. 604. 82 ] ) and ECG ( OR = 2. 36,95% CI [ 1. 88-2. 96 ] ) . Researches with ADR/AE information of Dengzhanxixin injection showed that the symptoms of ADR/AE were slight. This study may exist publication bias. Conclusion: Dengzhanxixin injection on the basis of conventional treatment can improve the efficacy of the treatment of unstable angina pectoris. However,due to the sample size of included studies were small and of lower quality,conclusions above still need high-qualitied randomized,double-blind,controlled trials be confirmed.%目的:评价灯盏细辛联合西药常规治疗不稳定型心绞痛临床疗效和安全性.方法:计算机检索Cochrane图书馆,Medline,EMbase,CBM,CNKI,VIP和万方数据库,由2位研究者独立筛选和提取资料,根据Cochrane Reviewer's Handbook 5.0评价标准和工具评价纳入文献质量,用RevMan 5.1软件进行数据分析.结果:共纳入17个随机对照试验,共计1644名患者.仅2个研究采用恰当的随机分配方法,1个研究提及采用单盲,其余所有研究均未提

  10. 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。

  11. [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

  12. 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.

  13. 256层ICT探测冠状动脉钙化在不稳定心绞痛与稳定心绞痛患者中的对比%Detection of Coronary Artery Calcification Score and Compare it in Patients Diagnosed Clinically as Stable and Unstable Angina by 256 ICT

    Institute of Scientific and Technical Information of China (English)

    朱大光

    2013-01-01

    目的:探讨256层ICT在探测冠状动脉钙化积分中的意义。方法:采用256层ICT对2组患者进行冠状动脉钙化积分扫描,钙化积分由工作站软件自动获得,132例患者分为2组,55例稳定心绞痛,77不例稳定心绞痛。结果:不稳定心绞痛患者的钙化积分要显著大于稳定心绞痛患者(p<0.05),不稳定心绞痛患者的血管钙化数目要明显多于稳定心绞痛组。结论:不稳定心绞痛患者的钙化更明显,因此预测冠状动脉情况冠状动脉钙化积分可以作为重要指标。%Objective:To detect Coronary calcification score and compare it in patients diagnosed clinically of having stable and unsta -ble angina and they being more prone for cardiovascular risk .Methods:Coronary artery calcification was scanned and its scores ( CACS) were measured through 256-slice ICT in 132 patients diagnosed of having stable and unstable angina .(55 stable and 77 unstable angi-na).the result were analyzed statistically by 2-grouped test.Also some associated risk factors were also taken into concideraton (HTN, total cholesterol ,Triglycerides etc ) .Results:The calcification scores in patients with unstable angina were comparatively more than those with patients having stable angina (p<0.05).Also it found that 3-vesssel calcification was more significant with unstable angina ,where as 1-vesssel calcification was more significant with stable angina cases .Conclusion:Coronary artery calcification scores is of great value in predicting cardiovascular enets .

  14. 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。

  15. Characteristics of urine metabonomics in patients with blood stasis syndrome of CHD unstable angina%冠心病不稳定心绞痛血瘀证患者尿液代谢组学特征的研究

    Institute of Scientific and Technical Information of China (English)

    王娟; 李中峰; 赵慧辉; 陈建新; 陈婵; 柴欣楼; 王伟

    2012-01-01

    目的 利用磁共振波谱代谢学方法研究冠心病不稳定心绞痛血瘀证患者和健康志愿者尿液代谢物的变化.方法 通过临床横断面调查研究,收集冠心病不稳定心绞痛血瘀证患者和健康志愿者的一般资料和尿液样品,采用磁共振(NMR)和模式识别技术对磁共振氢谱进行分析,对谱图去水峰后采用0.01化学位移分段积分和归一化处理.所得数据输入SIMCA-P软件,采用偏最小二乘-判别分析法(PLS-DA)对结果进行分析.结果 冠心病不稳定心绞痛血瘀证患者尿液中脯氨酸、丙氨酸、异亮氨酸、葡萄糖、缬氨酸、组氨酸、马尿酸等物质的含量升高;柠檬酸、肌酸酐、牛磺酸等物质的含量下降.结合PLS-DA对尿液样品的分析结果显示冠心病患者与健康人在代谢组学方面存在差异,且化合物分布在性别方面也有差异.结论 研究表明尿液样品中柠檬酸、脯氨酸、异亮氨酸、牛磺酸等代谢物的改变构成了冠心病不稳定性心绞痛血瘀证患者的代谢组学特征,从而为疾病的诊断和治疗以及中医证候研究提供了新思路和新方法.%Objective To study the changes of urine metabolites in patients with blood stasis syndrome of unstable angina of coronary heart disease ( CHD) and health volunteers by applying metabonomics method of nuclear magnetic resonance ( NMR). Methods The general materials and urine samples were collected from the patients (CHD group) and health volunteers (health group) through clinical cross-section survey, and then magnetic resonance spectrogram (MRS) was analyzed with techniques of NMR and pattern recognition technique. The spectrogram after removing water peak was treated with 0. 01ppm segmented integral and normalization. All data were imputed into SIMCA-P + software (v11. 5 , Umetrics, Sweden) and the results were analyzed by using partial least square-discriminant analysis (PLS-DA). Results The content of proline, alanine

  16. 不稳定型心绞痛患者血清细胞因子与基质金属蛋白酶-2的关系%Relation between inflammatory cytokines and matrix metalloproteinase-2 in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    何亚菲; 夏大胜; 魏民新; 刘清华

    2011-01-01

    Objective: To elucidate the relationship among pro-inflammatory cytokine (IL-1, IL-6, TNF-a), anti-inflammatory cytokine (IL-10) and MMP-2 and their effects on the stability of plaque in unstable angina. Methods-. The concentrations of IL-1, IL-6, TNF-a, IL-10, MMP-2 and TIMP-2 were analyzed using ELISA in 170 patients and 30 healthy control subjects. Patients were divided into two groups, stable angina (n = 35) and unstable angina (n = 135). Results; The serum levels of IL-1, IL-6, TNF-a, IL-10, MMP-2 and TIMP-2 were significantly higher in UAP group and SAP group compared with the healthy control group ( P < 0. 05 ) , and so were the ratio of MMP-2/TIMP-2 and( IL-1 + IL-6 + TNF-a)/IL-10 (P < 0. 05). The levels of above mentioned cyto-kines and ratios in patients with unstable angina were significantly higher than those with stable angina (P < 0. 05). Correlation analysis revealed the level of MMP-2 was positively related to the levels of IL-1, IL-6, IL-10 and TNF-a. In multiple linear regression analysis, significant positive correlations were found between MMP-2 and IL-10, (IL-1 +IL-6 + TNF-a) /IL-10 and fasting blood glucose separately in patients with unstable angina. Conclusion; The imbalance of proinflammation/anti-inflammation could lead to unstability of the plaque through the regulation of MMP-2, which could trigger unstable angina.%目的:探讨不稳定型心绞痛(UAP)患者血清致炎因子(IL-1、IL-6、TNF-α)、抗炎因子(IL-10)水平与基质金属蛋白酶-2(MMP-2)及其抑制剂(TIMP-2)的关系.方法:选择UAP患者135例(UAP组)、稳定型心绞痛(SAP)患者35例(SAP组)、对照组30例,应用ELISA法检测血清IL-1、IL-6、TNF-α、IL-10、MMP-2、TIMP-2水平.结果:UAP组患者血清IL-1、IL-6、TNF-α、IL-10、(IL-1 +IL-6+TNF-a)/IL-10、MMP-2、TIMP-2、MMP-2/TIMP-2水平高于对照组及SAP组(P均<0.05);Spearson相关分析显示,UAP患者血清MMP-2活性与IL-1、IL-6、IL-10、TNF-α水平正相关(P<0.05);多元

  17. 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.

  18. Clinical efficacy of Low-molecular-weight Heparin Sodium combined Aspirin in the treatment of unstable angina pectoris%低分子肝素钠联合阿司匹林治疗不稳定型心绞痛疗效分析

    Institute of Scientific and Technical Information of China (English)

    谢平

    2011-01-01

    目的:观察低分子肝素钠联合阿司匹林治疗不稳定型心绞痛(UA)的临床疗效.方法:将67例住院的UA患者随机分为对照组(34例)和治疗组(33例),治疗组使用低分子肝素钠加阿司匹林,对照组单用阿司匹林,疗程为1周,结果:治疗组总有效嘈<为96.96%,对照组为76.47%.两组疗效比较,差异有统计学意义(P<0.05).结论:低分子肝素钠联合阿司匹林治疗UA能明显减少心绞痛的发作,改善临床症状,具有安全有效的特点.%Objective: To observe the clinical efficacy of Low-molecular-weight Heparin Sodium combined Aspirin in the treatment of unstable angina pectoris. Methods: 67 cases of patients with unstable angina pectoris were randomly divided into control group (34 cases) and treatment group (33 cases). The control group was received Aspirin for 1 week. The treatment group was received Low-molecular-weight Heparin Sodium for 1 week based on the control group. Results: The total effective rate of treatment group was 96.96% and was significantly higher than that of control group (76.47%) (ρ<0.05). Conclusion: Low-molecular-weight Heparin Sodium combined with Aspirin is effective and safe in the treatment of unstable angina pectoris.

  19. 低分子肝素钠联用丹红治疗不稳定型心绞痛的临床疗效分析%Clinical observation on low molecular weight heparin sodium combined with Danhong injection in the treatment of unstable angina

    Institute of Scientific and Technical Information of China (English)

    樊晓洋

    2014-01-01

    Objective To analyze the clinical efficacy of low molecular weight heparin combined with Danhong injection in the treatment of unstable angina. Methods The study group were treated with low molecular weight heparin combined with Danhong treated control group were given low molecular weight heparin. Results The total effective rate was significantly higher, the difference was statistically significant (P<0.05). Conclusion The effect of low molecular weight heparin combined with Danhong injection in the treatment of unstable angina was significantly better than with low molecular weight heparin with less adverse reaction, so it is worthy of clinical application.%目的:分析研究低分子肝素钠联用丹红治疗不稳定型心绞痛的临床疗效。方法观察组患者给予低分子肝素钠联用丹红治疗,对照组仅给予低分子肝素钠治疗。结果观察组总有效率显著高于对照组,两组比较差异有统计学意义(P<0.05)。结论低分子肝素钠联用丹红治疗不稳定型心绞痛的疗效明显优于单用低分子肝素钠,且不良反应少,值得临床应用。

  20. 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

  1. 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

  2. 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

  3. 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

  4. 阿托伐他汀对不稳定型心绞痛患者血浆C-反应蛋白和血脂的影响%Effects of atorvastatin on C-reactive protein and blood lipid levels in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    王莉

    2014-01-01

    目的 分析阿托伐他汀对不稳定型心绞痛(UA)患者血浆C-反应蛋白和血脂的影响.方法 将200例UA患者随机分为治疗组和对照组,每组100例,两组均采用常规治疗,治疗组在此基础上给予阿托伐他汀20 mg/d,疗程12周,观察两组研究对象血脂以及炎症因子C-反应蛋白的差异,并比较两组治疗前后血脂和血浆C-反应蛋白的变化.结果 与对照组比较,治疗组可明显降低血脂及C-反应蛋白水平,差异有统计学意义(P<0.01).结论 UA患者早期应用阿托伐他汀治疗可以降低患者血浆CRP的浓度,降低胆固醇、甘油三酯和低密度脂蛋白,减轻炎症反应,稳定动脉粥样硬化斑块.%Objective To analyze the effect of atorvastatin on C-reactive protein and blood lipid levels in patients with unstable angina(UA).Methods Two hundred patients with unstable angina were randomly divided into treatment group and control group.The patients in the two groups were all given conventional treatment,and the patients in treatment group were given atorvastatin 20 mg/d,the course was 12 weeks.The levels of blood fat and C-reactive protein before and after treatment in the two groups were observed.Results Compared with control group,the levels of blood fat and C-reactive protein reduced significantly in treatment group (P < 0.01).Conclusions Early administration of atorvastatin can decrease the plasma concetration of hs-CRP,TC,TG and LDL-C significantly in patients with unstable angina,relieve the inflammatory reaction and stablize the atherosclerotic plaque.

  5. Sodium Tanshinone ⅡA Sulfonate Combined with Low Molecular Weight Heparin in Treating Unstable Angina: A Meta-analysis%丹参酮ⅡA磺酸钠联合低分子肝素治疗不稳定型心绞痛Meta分析

    Institute of Scientific and Technical Information of China (English)

    赵劲波; 李元红; 江洪

    2012-01-01

    目的 评价丹参酮ⅡA磺酸钠联合低分子肝素治疗不稳定型心绞痛的效果.方法 计算机检索中国学术期刊网络出版总库、CNKI( 1994-2011)、万方医学数据库(1999-2011)、维普中文科技期刊全文数据库(1989-2011年)中关于丹参酮ⅡA磺酸钠联合低分子肝素治疗不稳定型心绞痛的随机对照试验,对符合标准的随机对照试验进行Meta分析.结果 共命中7篇符合条件文献.Meta分析结果显示,治疗2周后试验组疗效优于对照组,总效应Z=6.12(P <0.00001),OR及其95%可信区间4.48(2.77,7.24),其中3项研究对心电图进行评价,治疗2周后心电图改善情况试验组亦显著优于对照组,总效应Z =3.80(P =0.0001),OR及其95%可信区间2.83(1.65,4.84).结论 不稳定型心绞痛患者在常规治疗基础上联合应用丹参酮ⅡA磺酸钠和低分子肝素可明显改善心绞痛症状,有效控制心绞痛发作.%Objective To evaluate the effectiveness of Sodium Tanshinone DA Sulfonate combined with Low Molecular Weight Heparin in treating unstable angina (UA). Methods We conducted Meta-analysis by the randomized controlled trails (RCT) for patients with Sodium Tanshinone DA Sulfonate combined with l>ow Molecular Weight Heparin in treating unstable angina ( UA) from CNKI database (1994—2012) , Wan Fang medicine database (1999—2012), VIP full-text data base (1989—2012) and Medline. Results There were 7 trials. After two weeks treatment Meta-analysis indicated that the rurative effect of combination therapy was better than that of regular group in treating angina pectoris. The total effect was Z =6. 12 (P <0.00001), and the total effect of therapy group was better than that of control group [OR =4.48, 95% CI (2.77, 7.24), P <0.00001 ]. Three items showed that the curative efficiency and significant efficiency in the improvement of electrocardiogram were dramatically better than that of control group, and the total effect was Z = 3.80 [OR = 2. 83

  6. 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

  7. Comparison Between Elective PCI and Simple Optimal Drug Therapy for Senile Unstable Angina Pectoris%经择期PCI和单纯优化药物治疗老年不稳定性心绞痛的比较研究

    Institute of Scientific and Technical Information of China (English)

    郝翠平

    2015-01-01

    目的:探究经择期PCI和单纯优化药物治疗老年不稳定性心绞痛的临床效果。方法整群选取自2012年1月-2014年3月该院收治的老年不稳定性心绞痛患者134例为该次研究对象,将其随机分成实验组与对照组,分别予以择期PCI、单纯优化药物治疗,观察两组左心室功能改善情况及并发症发生情况。结果实验组出院90 d时LVEF (63.23±8.72)%vs(51.23±9.43)%、心输血量(6.97±2.82)vs (5.72±1.72)mL较对照组明显增加,LVEDD(50.23±10.64)mm vs (53.24±11.72)mm较对照组显著下降,再发心绞痛发生率10.44%vs 26.86%低于对照组,差异有统计学意义(P<0.05)。造影剂肾病、出血发生率11.94%vs 0;17.91%vs 4.47%高于对照组,但经过及时对症治疗,均可得到治愈。结论经择期PCI治疗老年不稳定性心绞痛临床疗效优于单纯优化药物治疗,安全指数高,能有效调节患者左心室功能,改善患者预后,临床上应引起足够重视。%Objective To explore the effect of elective PCI and simple optimal drug therapy in the treatment of senile unstable angina pectoris. Methods Based on the completely randomized digital table method, 134 patients with senile unstable angina pec-toris in our hospital from January 2012 to March 2014 were selected as the study objects and divided into experimental group and control group. Elective PCI and simple optimal drug therapy were performed in the two groups respectively. The improvement of left ventricle function and occurrence of complications of the two groups were observed, respectively. Results For experimental group, when they left hospital after 90days, the LVEF was (%63.23±8.72 vs 51.23±9.43), the heart blood transfusion volume was (ml:6.97±2.82 vs 5.72±1.72) which was obviously increased compared to control group. The LVEDD (mm:50.23±10.64 vs 53.24±11.72) was obviously decreased compared to control group. Recurrence of angina morbidity (%:10.44 vs 26

  8. 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...

  9. 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.

  10. 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

    Full Text Available FUNDAMENTO: Poucos estudos compararam a atividade inflamatória entre pacientes diabéticos e não-diabéticos com síndrome coronariana aguda, e ainda não foi publicado nenhum somente com portadores de angina instável (AI. OBJETIVO: Este estudo teve dois objetivos. Em primeiro lugar, comparar os níveis séricos de proteína C reativa (PCR e interleucina - 6 (IL-6 em pacientes diabéticos e não-diabéticos com angina instável (AI para determinar se a diferença na atividade inflamatória justifica o pior prognóstico nos pacientes diabéticos. Em segundo, avaliar a correlação entre os marcadores inflamatórios e o perfil metabólico em pacientes diabéticos e entre a resposta inflamatória e os desfechos hospitalares, como morte, infarto agudo do miocárdio, insuficiência cardíaca congestiva e tempo de hospitalização. MÉTODOS: Estudo de coorte prospectivo de 90 pacientes consecutivos admitidos na Unidade de Dor Torácica com angina instável. Os pacientes foram divididos em dois grupos: diabéticos e não-diabéticos. Os níveis séricos de PCR e IL-6, o perfil metabólico e a contagem de leucócitos foram obtidos na chegada ao hospital. RESULTADOS: Dos pacientes analisados, 42 (47% eram diabéticos (idade 62 ± 9 e 48 (53% não eram diabéticos (idade 63 ± 12. Não foram encontradas diferenças entre a mediana da PCR (1,78 vs. 2,23 mg/l, p = 0,74 e da IL-6 (0 vs. 0 pg/ml, p = 0,31 entre os dois grupos. Houve uma correlação positiva entre PCR e colesterol total (rs = 0, 21, p = 0, 05, PCR e colesterol LDL (r s = 0,22, p = 0,04 e PCR e contagem de leucócitos (r s = 0,32, p = 0,02 nos dois grupos. Nenhuma associação foi encontrada entre os marcadores inflamatórios e os desfechos hospitalares. CONCLUSÃO: Não encontramos diferença na atividade inflamatória entre os pacientes diabéticos e não-diabéticos com AI, o que indica que esse quadro clínico pode equilibrar a atividade inflamatória entre os dois grupos e aumentar a

  11. Influence factors of success rate of serum LDL-C in patients with unstability angina pectoris taking atorvastatin%服用阿托伐他汀的不稳定型心绞痛患者血清LDL-C达标率的影响因素

    Institute of Scientific and Technical Information of China (English)

    于薇; 孟存良; 容春莉; 曹东平; 吕军娥; 彭应心

    2011-01-01

    目的 分析使用阿托伐他汀的不稳定型心绞痛患者低密度脂蛋白胆固醇(LDL-C)达标率的临床影响因素.方法 选择血清LDL-C水平未达标的不稳定型心绞痛患者146例,阿托伐他汀20 mg口服,1次/d,疗程8周.分析年龄、性别、体质量指数(BMI)、膳食控制、糖基化血红蛋白A1c(HbA1c)等因素对服用阿托伐他汀后LDL-C达标率的影响.结果服用阿托伐他汀8周后,LDL-C总达标率为49.3%;经逐步多元Logistic回归分析,年龄与LDL-C达标率无显著相关性;BMI正常组、超体质量组和肥胖组的组间比较,LDL-C达标率差异无统计学意义(P>0.05);膳食控制组较无膳食控制组患者LDL-C达标率高;血糖控制良好的患者LDL-C达标率高.结论 膳食及血糖控制水平为服用阿托伐他汀的不稳定型心绞痛患者LDL-C达标率的独立影响因素.%Objective To analyze the clinical influence factors of success rate of serum low density lipoprotein-cholesterol(LDL-C) in patients with unstability angina pectoris taking aorvastatin. Methods 146 patients with unstability angina pectoris and unsuccessful level of serum LDL-C were collected. 20 mg atorvastatin were taken orally once a day with treatment course of 8 weeks.Effects of clinical factors such as age, gender, body mass index(BMI), diet control and glycosylated hemoglobin Alc (HbAlc) on success rate of serum LDL-C after aorvastatin administration were analyzed. Results The overall success rate of serum LDL-C was 49.3 % after 8 weeks of aorvastatin administration;Age had no significant correlation with the success rate of LDL-C according to stepwise multivariate Logistic regression analysis;Comparison of the success rates of LDL-C among BMI normal group,overweight group and obesity group,there were no statistically significant(P>0.05) ;Success rates of LDL-C of patients in diet control group were higher than that in non-diet control group;Patients with well-controlled blood glucose showed

  12. 奥扎格雷钠注射液与低分子肝素钙治疗不稳定型心绞痛的疗效观察%Observation on the curative effect of Ozagrel Sodium Injection and low molecular weight heparin calcium on unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    周雷

    2014-01-01

    目的:探讨奥扎格雷钠注射液与低分子肝素钙联合应用在不稳定型心绞痛中的治疗效果。方法选择本院82例不稳定型心绞痛患者,上述患者随机分为观察组和对照组,两组均给予常规治疗,对照组同时给予奥扎格雷钠注射液,观察组给予奥扎格雷钠注射液联合低分子肝素。评定两组疗效,观察血液流变学指标改变情况。结果观察组总有效率为95.0%,对照组总有效率为75.6%,观察组总有效率高于对照组(P<0.05)。观察组治疗后全血粘度高切、全血粘度低切和血液粘度分别与对照组治疗后比较,差异有统计学意义(P<0.05)。结论奥扎格雷钠注射液与低分子肝素钙治疗不稳定型心绞痛效果显著,有助于改善患者血液流变学指标,值得借鉴。%Objective To explore the effect of combined application of Ozagrel Sodium Injection and low molecular weight heparin on unstable angina pectoris. Methods 82 cases with unstable angina patients, the patients were randomly divided into observation group and control group, two groups were given conventional treatment, the control group was treated ozagrel sodium Injection, the observation group was given ozagrel sodium Injection combined with low molecular weight heparin. the efficacy of two groups was evaluated, the changes of blood rheology was observed. Results The total effective rate in the observation group, was 95%, the total effective rate in the control group was 75.6%, the total effective rate in observation groupwas higher than that in the control group (P<0.05). The whole blood high shear viscosity, whole blood low shear viscosity and blood viscosity in the observation group after treatment compared with those in the control group after treatment, the difference was statistically significant (P<0.05). Conclusion Ozagrel sodium Injection combined with low molecular weight heparin calcium on unstable angina pectoris has significant effect

  13. Retraction of a paper containing plagiarized material: the prognostic value of serum troponin T in unstable angina. Gökhan Cin V, Gök H, Kaptanoğlu B. Int J Cardiol. 1996 Mar;53(3):237-44.

    Science.gov (United States)

    Coats, Andrew J S

    2010-12-01

    On the 6th December 2008, in my role as Editor-in-Chief of the International Journal of Cardiology, I received an email from Professor Harold Garner of UT Southwestern Medical Center, Dallas. Professor Garner told me that using a new search engine methodology (eTBLAST) he and colleagues had identified a paper in the International Journal of Cardiology published in 1996 which had remarkable text and data similarity to an earlier paper published in 1992 in the New England Journal of Medicine. They had detected this similarity after randomly selecting citations from Medline and submitting them to the tool to find other highly similar citations as part of their NIH/R01 funded research on the ethics of publication. We have been notified that all such cases are reported in a database, Déjà Vu (http://spore.swmed.edu/dejavu/). We investigated the text of the two papers and we agreed that there was such a similarity that the later paper must have plagiarized the earlier paper, and in doing so infringed the copyright. In accordance with our previously published standards on ethical publishing in the Journal we hereby retract the paper "The prognostic value of serum troponin T in unstable angina. Gökhan Cin V, Gök H, Kaptanoğlu B. Int J Cardiol. 1996 Mar;53(3):237-44.".

  14. 小剂量替罗非班在老年不稳定型心绞痛患者择期冠脉介入治疗中的应用%Application of small dose tirofiban in elderly patients with unstable angina underwent elective coronary interven-tion treatment

    Institute of Scientific and Technical Information of China (English)

    刘国楼; 赵国安

    2015-01-01

    Objective To study the efficacy and safety of small dose of tirofiban in elderly patients with unstable angina who underwent primary percutaneous coronary intervention. Methods Sixty-four elderly patients with unstable an-gina underwent elective PCI were randomly divided into treatment group(35 cases)and normal group(29 cases). The pa-tients of two groups were given routine drug therapy,in treatment group,on the basis of conventional treatment,tirofiban was used for PCI:5 μg/ kg bolus then 0. 05 μg/(kg·min)infusion for 24 h. The postoperative coronary TIMI flow,tropo-nin levels,and the incidence of cardiovascular events and bleeding events during hospitalization and discharge for 30 days were compared between the two groups. Results The incidence of slow blood flow in treatment group was lower than that in the normal group after PCI(P ﹤0. 05). TnI after 24 hours increased in both groups,that in the normal group rised more prom-inent(P ﹤0. 05). Hospitalization and follow-up in 30 days,discharge angina symptom recurrence rate in treatment group was less than that in the normal group(P ﹤0. 05). There was no significant difference in the incidence of bleeding events between the two groups(P ﹤0. 05). Conclusions Small doses of tirofiban in elderly patients with unstable angina underwent elective PCI can effectively improve myocardial perfusion,reduce myocardial injury,reduce the occurrence of adverse cardiovascular events,without increasing the risk of bleeding.%目的:探讨小剂量替罗非班在老年不稳定型心绞痛患者行冠脉介入治疗中的有效性及安全性。方法选取64例老年不稳定型心绞痛择期行 PCI 患者,随机将其分为治疗组(35例)和常规组(29例),两组患者均给予常规药物治疗,治疗组在常规治疗的基础上行 PCI 术中加用替罗非班,术中冠脉内0.5μg/ kg,术后0.05μg/(kg·min)静脉滴注维持24 h;比较两组术后冠脉 TIMI 血流、肌钙蛋白(TnI

  15. Pharmacological approaches of refractory angina.

    Science.gov (United States)

    Giannopoulos, Andreas A; Giannoglou, George D; Chatzizisis, Yiannis S

    2016-07-01

    Refractory angina refers to a group of patients with stable coronary atherosclerotic disease and angina symptoms, unresponsive to traditional medical management, while considered to be suboptimal candidates for revascularization procedures. Up to 15% of angina patients are considered to have refractory angina and, taking into account the aging population and the improvements in the treatment of stable coronary artery disease, the incidence of this entity is expected to increase. This review describes traditional and novel pharmacotherapies for symptoms relief and for long-term management of refractory angina. Mechanisms of action and relevant clinical trials are discussed and current recommendations from major European and US cardiovascular societies are reported.

  16. 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

  17. The optimal timing of early invasive therapy in patients with unstable angina and non-ST-elevation myocardial infarction:a Meta-analysis%非ST段抬高急性冠脉综合征不同介入时间窗的Meta分析

    Institute of Scientific and Technical Information of China (English)

    贾林·阿布扎力汗; 于子翔; 马依彤; 杨毅宁; 李晓梅; 谢翔; 刘芬; 陈铀

    2016-01-01

    ObjectiveThis meta-analysis aims to determine the optimal timing of invasive therapy in patients with unstable angina and non-ST-elevation myocardial infarction.Methods The following databases are searched,PubMed(1985 to October 2015),The Cochrane Library (January 1975 to October 2015),MEDLINE (January 1980 to September 2015),EMbase (January 1978 to September 2015),CBM (January 1994 to September 2015),CNKI (January 1990 to November 2015),and Wanfang (January 1993 to October 2015).The evaluation of the included studies and data extraction were done by two independent reviewers.Data analyses were performed by using the Cochrane Collaboration's RevMan 5.3 software.Results According to including criteria,seven trials were included finally,of which six were RCTs including 7568 patients,and one was observational study.Meta-analyses showed that the incidence of all-cause death,fatal or non-fatal myocardial infarction at 1 month or long-term follow-up and rehospitalisation related to angina between two groups(24 h group were not significant statistically(OR=0.99,P=0.96 andOR=0.87,P=0.27,respectively). There was no publication bias among the included studies in terms of all-cause mortality.The incidence of fatal or non-fatal myocardial infarction at 1 month was non-significant(OR=0.71,P=0.20);During the long-term follow-up,the 12~24 h group had a significantly lower incidence of fatal or non-fatal myocardial infarction compared to >24 h group.There was also a reduction in rehospitalization related to angina in the 12~24 h group(OR=0.76,P=0.01).Conclusion For patients with UA/NSTEMI,the potential timing of intervention would be 12~24 h.More studies will be needed to determine the optimal timing for patients with unstable angina or non-ST-elevation myocardial infarction.%目的:系统评价非ST段抬高急性冠脉综合征早期介入治疗的最适时间窗。方法计算机检索PubMed(1985.1~2015.10)、Cochrane图书馆(1975.1~2015.10)、MEDLINE(1980.1

  18. 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

  19. D型人格不稳定心绞痛患者治疗前后抑郁情绪躯体疲劳状况及生活质量的变化%The healty status and quality of life of unstable angina patients with type D personality

    Institute of Scientific and Technical Information of China (English)

    欧薇; 孙月吉; 孙玉兰; 孙喜琢; 姜一农; 曲鹏

    2008-01-01

    目的 探讨D型人格不稳定心绞痛患者治疗前后抑郁情绪躯体疲劳状况及生活质量的变化.方法 依据D型人格量表(DS14)评分情况,将109名患者分为D型人格组(n=32)和非D型人格组(n=77).在治疗前和治疗后1个月,采用抑郁自评量表(SDS)、疲劳评定量表(FIA)和生活质量综合评定问卷(GQOL-74)进行评估.结果 1)D型人格在冠心病患者中约占29%.2)治疗前后D型人格组疲劳改善不明显;D型人格组较非D型人格组抑郁情绪改善的程度差,2组治疗前后SDS评分差值分别为(0.85±1.04)分,(-2.31±0.809)分,差异有显著性(P<0.05);生活质量方面D型人格组改善更差.3)治疗前后GQOL-74项分值差为因变量,进入回归方程的是D型人格和疲劳评定因子1得分差值.结论 影响冠心患者治疗结果和生活质量的因素主要是D型人格和FIA-1得分差值.%Objective To find out the relation of type D personality and unstable angina.Methods 109 patients with unstable angina(UA)were drawn out in the gome hospital in Dalian.All patients were divided into two groups according to DSl4 diagnostic criterion(Type D Personality Scale),one group had 32 patients with D type personality(type D group)and the other group had 77 patienm without D type personality(non-type D group).All of them were investigated with the General Health Questionnaire.the Zung' Self-Rating Depression scale(SDS),Fatigue Assessment Instrument(FIA)and General Quality of Life Inventory-74(GQOL-74)before receiving medication and after one month.SPSS11.0 software was used.Results 1)29%patients with UA were type D patients.After 1 month,when the patients have recovered from the stress.A significant difference were found in FIA-14,SDS(0.85±1.049,-2.31±0.809,t=2.311,P=0.027)and GQOL between the D type group and non-type D group.The GQOL-74 difference serve as a dependence value.and other psychologic factors as independent value.results enter the regression equation are D type

  20. Observation on curative effects of low molecular weight heparin of prolongable curative course on treating unstable angina pectoris%低分子肝素延长疗程治疗不稳定型心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡亚力; 苏珍; 白洪雁; 苏晓燕; 刘怡

    2001-01-01

    目的:观察低分子肝素延长疗程治疗不稳定型心绞痛的疗效。方法:同期入院的不稳定型心绞痛患者168例,随机分为2组,均在常规治疗基础上应用低分子肝素(立迈青)皮下注射,每日2次。A组应用1周,B组应用3周,第1周用量2组均为每次120 IU/kg,第2~3周B组用量每次100 IU/kg。结果:早期(第7日)观察2组总有效率分别为75.9%、77.4%,疗效无显著差异(P>0.05);心血管意外事件(急性心肌梗死、心脏性或非心脏性死亡、药物无法控制病情需行急性血运重建术)及出血,在2组的发生率无显著差异(P>0.05) 。晚期(第8~30日)观察2组总有效率分别为87.2%、97.5%,有显著性差异(P0.05) 。结论:低分子肝素延长疗程治疗不稳定型心绞痛疗效较短程应用疗效为好,且不增加出血发生率。%Objective:To observe the curative effect of low molecular weight heparin of prolongable curative course on treating unstable angina pectoris.Methods:One hundred and sixtyeight cases with unstable angina pectoris who were admitted into hospital at the same period were randomly divided into two groups.Both groups were subcutaneously injected by low molecular weight heparin combined with conventional therapy,two times a day for one week in group A and three weeks in group B respectively.In the first week,the dosage of heparin in group A and B was 120 IU/kg every time,from second to third week,the dosage of heparin in group B was 100 IU/kg every time.Results:The total effective rates in group A and group B were 75.9% and 77.4% respectively in early stage (seventh day),and the difference was not significant (P>0.05).The incidences of cardiovascular accidental events (acute myocardial infarction,cardiac death,uncardiac death,the illness which could not be controlled by the medicine and should be treated with acute reconstruction of blood circulation) and haemorrhage in both groups had not significantly different

  1. Gene Polymorphism and Serum Lipid Levels Correlation of Unstable Angina Angiotensin Converting Enzyme%不稳定性心绞痛患者血管紧张素转换酶基因多态性与血脂水平的相关性研究

    Institute of Scientific and Technical Information of China (English)

    邵静; 贾景香; 陈璐

    2014-01-01

    Objective:Discussion the correlation of ACE gene polymorphism and serum lipid levels on the elderly unstable angina( UA), as the traditional Chinese medicine treatment of the disease to provide reference. Methods:Choose 60 cases of elderly patients with un-stable angina,with 30 cases of healthy people as a control. Through the restriction fragment length polymorphism by polymerase chain reaction( PCR-RFLP)to determine the insertions and deletions included 16 sub-polymorphism and serum lipid levels of ACE gene and compare the different genotypes. Results:The intron of ACE gene in UA group carrying DD genotype and D allele was higher than that of control group. The control group carrying II genotype and I allele was higher than that of old UA group(P<0. 05). The TG and LDL-C blood concentrations of Elderly UA group were higher than that of control group. The TG and LDL-C levels of disease group were sig-nificantly higher(P<0. 05),whereas HDL-C levels were significantly lower than that of control group(P<0. 05). Compared the ACE DD and ID genotype of disease groups with II genotype,the difference had statistical significance(P<0. 05). ACE gene polymorphism and TG,LDL-C had significantly positively correlated(P<0. 01)but negative correlation with HDL-C concentrations(P<0. 001). Con-clusion:ACE DD genotype and D allele have relation with abnormal lipid metabolism,but have nothing to do with I allele.%目的:探讨老年不稳定性心绞痛( UA)患者ACE基因多态性与血脂水平的相关性,为中医药治疗本病提供参考。方法:选取老年不稳定性心绞痛患者60例,同期选择老年健康人群30例作为对照,通过限制性片段长度多态性聚合酶链反应( PCR-RFLP)技术测定ACE基因内含子16的插入和缺失多态性,并比较不同基因型的血脂水平差异。结果:老年UA组ACE基因内含子16携带DD基因型和 D等位基因较对照组增高,对照组携带 II基因型及 I

  2. 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。

  3. 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...

  4. Characteristics of Coronary Lesions in Patients Older than 80 Years with Unstable Angina and Efficacy & Safety of Percutaneous Coronary Intervention%80岁以上高龄心绞痛患者冠状动脉病变特点和经皮冠状动脉介入治疗的效果及安全性

    Institute of Scientific and Technical Information of China (English)

    刘同库; 万凤伟; 丁福祥; 顾明

    2012-01-01

    Objective To study the characteristics of coronary lesions in patients older than 80 years with unstable angina and to evaluate the efficacy and safety of percutaneous coronary intervention ( PCI ). Methods A total of 72 patients ( elderly group, over 80 years old ) and 187 patients ( middle - aged group, 40 to 60 years old ) with unstable angina admitted to the cardiovascular center of the affiliated hospital of Beihua university from October 2008 to October 2011 were recruited in this study. All patients received PCI. The risk factors, Syntax scores of coronary lesions, distribution of coronary lesions segments, number and length of stent, short - term effectiveness, and complications were compared between the two groups. Results The prevalence of high blood pressure, diabetes, hyperlidemia, and smoking showed significant differences between the elderly group and middle - aged group ( all P <0. 01 ). The coronary lesions of RCA and LCA took place in the 2nd - 3rd segments and the 5th, 11th, 12th - 13th segments respectively in the two groups. The differences in constituent ratio of coronary artery disease ( CAD ) counts, Syntax scores of coronary lesions, number and length of stent, hemorrhagic complications, incident rate of MACE were all significant ( all P <0. 05 ). The significant differences were also found in the blood stream of target vessel TIMI 3 level, acute or sub - acute thrombosis, the incident rate of broke and mortality. Conclusion The coronary lesions in elderly patients had such characteristics as more numbers, more complex and more severity. The short - term efficacy and safety of PCI in treating elderly patients who had angina and pectoris but without severe brain, lung, kidney, valvular lesions were the same as those in middle - aged patients.%目的 探讨80岁以上高龄冠心病心绞痛患者的冠状动脉病变特点和经皮冠状动脉介入(PCI)治疗的疗效和安全性.方法 选择2008年10月-2011年10月在北华大学附属

  5. 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...

  6. 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

  7. 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

  8. 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 ...

  9. 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.

  10. 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

  11. Effect of Compound Danshen Dripping Pill Combined with Clopidogrel on Platelet Function in Patients with Unstable Angina%复方丹参滴丸联合氯吡格雷片对不稳定型心绞痛患者血小板功能的影响

    Institute of Scientific and Technical Information of China (English)

    蔡洪滨; 姚朱华; 高仪

    2013-01-01

    Objective To observe the effect of Compound Danshen Dripping Pill (CDDP) combined with clopidogrel for unstable angina (UA). Methods Totally 102 UA patients were randomized into the CDDP group (33 cases) , clopidogrel group (35 cases) and CDDP+clopidogrel group (34 cases). The patients in the CDDP group were orally taken 270mg CDDP twice daily on the basis of routine treatment. The patients in the clopidogrel group were orally taken 75 mg clopidogrel once daily. The CDDP+clopidogrel group was given the combo therapy of the CDDP group and clopidogrel group. After the treatments were given to each of groups for 3 weeks, the improvement of clinical symptoms and electrocardiogram (ECG) ST segment changes were evaluated. The platelet aggregation function and thromboxane B2(TXB2) levels were measured before and after treatment. Results There was no significant difference between groups in the total effective rate and ECG effective rate (P> 0. 05). The platelet aggregation rates and TXB2 levels were significantly decreased in all groups after treatment (P<0. 01) , especially in the CDDP+clopidogrel group (P<0. 05). Conclusion The combo therapy of clopidogrel and CDDP is more effective in inhibiting platelet aggregation than single treatment. It provides the basis for clinical integrative antithrombotic therapy.%目的 观察复方丹参滴丸联合氯吡格雷片对不稳定型心绞痛患者的作用.方法 将102例不稳定型心绞痛患者随机分为3组,在常规治疗的基础上,复方丹参滴丸组(33例)给予复方丹参滴丸每次270 mg,每日2次,口服.氯吡格雷片组(35例)给予氯吡格雷片每次75 mg,每日1次,口服.联合治疗组(34例)给予前两种治疗方案联合治疗.各组均治疗3周后观察患者的症状疗效及心电图疗效,测定血小板聚集率及血栓素B2(TXB2).结果 复方丹参滴丸组、氯吡格雷片组、联合治疗组症状疗效总有效率分别为90.9%、91.4%、94.1%,心电图

  12. Comparison between Transradial and Transfemoral Approaches for Coronary Rotational Atherectomy in Unstable Angina Patients%经桡动脉与经股动脉途径冠状动脉旋磨治疗不稳定型心绞痛的疗效对比研究

    Institute of Scientific and Technical Information of China (English)

    刘新林; 刘军翔; 梁国庆; 李玉明

    2013-01-01

    Objective To analyze the safety and effectiveness of transradial and transfemoral approaches for coronary rotational atherectomy ( CRA ) in treatment of unstable angina ( USA ). Methods Form January 2010 to February 2012, the clinical data of 67 USA patients undergoing CRA were analyzed retrospectively, the rotational parameters and effects of transradial and transfemoral approaches compared. Results There was no significant difference between 2 groups in damaged vessel number, rotational vessel, mean number of used rotary grinding heads, maximum diameter of rotary grinding heads, mean stent length, maximum stent diameter, mean number of pre - expanded balloons and that of post - expanded, temporary pacing rate, puncture site bleeding complications, average operation time, mean amount of radiation exposure and hospital major adverse cardiac events ( P >0. 05 ). The diameter of guiding catheter, utilization rate of intra - aortic balloon counterpulsation were lower, and mean stent number more in transradial group than in transfemoral group, the difference was significant ( P <0. 05 ). Conclusion In CRA treatment, transradial approach is an effective alternative method for transfemoral approach.%目的 对比分析经桡动脉和经股动脉途径行冠状动脉旋磨(CRA)治疗不稳定型心绞痛的安全性和有效性.方法 回顾性分析2010年1月-2012年2月我院67例行CRA治疗的不稳定型心绞痛患者的临床资料,比较经桡动脉与经股动脉途径完成CRA患者的临床资料、旋磨参数及手术效果.结果 两组患者病变血管支数、旋磨血管、平均使用旋磨头个数、最大旋磨头直径、平均支架长度、最大支架直径、平均预扩球囊数及平均后扩球囊数、临时起搏率、穿刺部位出血并发症、平均手术时间、平均射线曝光量及院内主要心脏不良事件比较,差异均无统计学意义(P>0.05).桡动脉组导引导管直径、主动脉内球囊反搏使用率小于

  13. 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, ...

  14. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... please enable JavaScript. Coronary artery disease - living with Heart Disease and Angina Coronary heart disease (CHD) is a ...

  15. Bradycardiac angina: haemodynamic aspects and treatment.

    Science.gov (United States)

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

    1969-01-11

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

  16. 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

  17. 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)

  18. 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

  19. 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. ...

  20. 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

  1. 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.

  2. 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

  3. 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...

  4. 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...

  5. 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.

  6. 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

  7. 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.

  8. Ectasia coronaria, angina inestable e insuficiencia aórtica

    Directory of Open Access Journals (Sweden)

    Róger A Lanzas Rodríguez

    2009-12-01

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

  9. Renal artery stenosis presenting as crescendo angina pectoris.

    Science.gov (United States)

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

    1995-07-01

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

  10. Controls for unstable structures

    Science.gov (United States)

    Guenther, Oliver; Hogg, Tad; Huberman, Bernardo A.

    1997-06-01

    We study the behavior of several organizations for a market based distributed control of unstable physical systems and show how a hierarchical organization is a reasonable compromise between rapid local responses with simple communication and the use of global knowledge. We also introduce a new control organization, the multihierarchy, and show that is uses less power than a hierarchy in achieving stability. The multihierarchy also has a position invariant response that can control disturbances at the appropriate scale and location.

  11. 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 ...

  12. Acute management of unstable angina and non-ST segment elevation myocardial infarction.

    Science.gov (United States)

    Silva, Fernando Morita Fernandes; Pesaro, Antonio Eduardo Pereira; Franken, Marcelo; Wajngarten, Mauricio

    2015-01-01

    Non-ST segment elevation coronary syndrome usually results from instability of an atherosclerotic plaque, with subsequent activation of platelets and several coagulation factors. Its treatment aims to reduce the ischemic pain, limiting myocardial damage and decreasing mortality. Several antiplatelet and anticoagulation agents have been proven useful, and new drugs have been added to the therapeutic armamentarium in the search for higher anti-ischemic efficacy and lower bleeding rates. Despite the advances, the mortality, infarction and readmission rates remain high. PMID:26466065

  13. First Diagonal Coronary Artery: Left Ventricular Fistula Presenting as Unstable Angina

    Directory of Open Access Journals (Sweden)

    Murat Sener

    2013-01-01

    Full Text Available Coronary artery fistulae are characterized by communications between a coronary artery and a cardiac chamber or another vascular structure. They are usually congenital, but acquired forms may occur. Most patients are usually asymptomatic. However, some studies have emphasized that the incidence of symptoms and complications increases with age, particularly after the age of 20 (Liberthson et al. 1979, Hong et al. 2004. We aimed to present a very rare form of fistula originating from the first diagonal artery and connecting into the left ventricle.

  14. First diagonal coronary artery: left ventricular fistula presenting as unstable angina.

    Science.gov (United States)

    Sener, Murat; Akkaya, Mehmet; Bilici, Muammer

    2013-01-01

    Coronary artery fistulae are characterized by communications between a coronary artery and a cardiac chamber or another vascular structure. They are usually congenital, but acquired forms may occur. Most patients are usually asymptomatic. However, some studies have emphasized that the incidence of symptoms and complications increases with age, particularly after the age of 20 (Liberthson et al. 1979, Hong et al. 2004). We aimed to present a very rare form of fistula originating from the first diagonal artery and connecting into the left ventricle.

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

    Science.gov (United States)

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

    2006-10-01

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

  16. 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.

  17. 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

  18. 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.

  19. 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.

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

    DEFF Research Database (Denmark)

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

    1993-01-01

    test with > or = 0.10 mV horizontal or down-sloping ST-segment depression and limited by angina pectoris, and at least 10 attacks of angina pectoris in the initial single-blind placebo period. During the placebo period, a total duration of transient myocardial ischemia > or = 0.10 mV during the 24-hour...

  1. Treatment with verapamil and trandolapril in patients with congestive heart failure and angina pectoris or myocardial infarction. The DAVIT Study Group. Danish Verapamil Infarction Trial

    DEFF Research Database (Denmark)

    Hansen, J F; Hagerup, L; Sigurd, B;

    1997-01-01

    In a double-blind, randomized trial in a consecutive group of postinfarct patients in treatment with diuretic agents for congestive heart failure, the 3 month rate of cardiac events (i.e., death, repeat infarction, unstable angina pectoris, or repeat admission because of heart failure) was 14....... These findings indicate that combined treatment with verapamil and trandolapril may be beneficial in patients with congestive heart failure....

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

    DEFF Research Database (Denmark)

    Andréll, P; Yu, W; Gersbach, P;

    2010-01-01

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

  3. The Black Ring is Unstable

    CERN Document Server

    Santos, Jorge E

    2015-01-01

    We study non-axisymmetric linearised gravitational perturbations of the Emparan-Reall black ring using numerical methods. We find an unstable mode whose onset lies within the "fat" branch of the black ring and continues into the "thin" branch. Together with previous results using Penrose inequalities that fat black rings are unstable, this provides numerical evidence that the entire black ring family is unstable.

  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. 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...

  7. Treatment of Unstable Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Yaniel Truffín Rodríguez

    2015-11-01

    Full Text Available Patients with unstable ankle fractures frequently attend the emergency rooms. It is estimated that there are 122 ankle fractures per 100 000 people a year. Surgical treatment of those that are unstable is inevitable since they can not be corrected in a conservative way. Several surgical procedures for repair of such lesions have been described and all of them constitute important tools for the orthopedic surgeon. Therefore, we conducted a literature review to discuss the current management of unstable ankle fractures based on the analysis of the published literature and the experiences in the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos.

  8. 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

  9. 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. 

  10. 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.

  11. 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.

  12. Angina de Ludwig. Reporte de 2 casos

    Directory of Open Access Journals (Sweden)

    Antonio Fabbio Gagliardi Lugo

    2014-10-01

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

  13. 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 circ...... in the circuit. The performance of the circuit is investigated by means of numerical integration of appropriate differential equations, PSPICE simulations, and hardware experiment.......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...

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

    Science.gov (United States)

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

    2016-08-01

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

  15. 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....

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

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

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

  18. 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...

  19. 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

  20. 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.

  1. 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.

  2. Management of Stable Angina - Current Guidelines: A Critical Appraisal.

    Science.gov (United States)

    Thadani, Udho

    2016-08-01

    Guidelines provide recommendations to improve patient outcomes, but many of the recommendations made for treating patients with stable angina are opinion based rather than evidence based. Risk stratification to predict patients at an increased risk of myocardial infarction (MI) and sudden ischemic death, and selection of patients for possible revascularization, is based on expert opinion. Randomized trials have compared optimal medical therapy to revascularization, after the coronary anatomy was known, and yet routine coronary angiography to exclude left main disease is not recommended. What exactly is optimal antianginal treatment varies considerably from one country's guideline recommendations to another. None of the antianginal drugs reduce mortality or MI and these drugs are equally effective in treating angina pectoris; and yet beta-blockers and calcium channel blockers are recommended as first line therapy. Double and triple therapy with different classes of antianginal drugs is also expert opinion based rather than evidence based. Recommendations to reduce the incidence of MI and sudden death are appropriate; however the use of a potent, high dose statin, is recommended by AHA/ACC and NICE guidelines for all patients with ischemic heart disease, while the European guidelines recommend a target LDL goal in patients with coronary artery disease (CAD). Management of patients with stable angina pectoris with normal coronary arteries remains ambiguous. This short review critically appraises the recommendations for managing patients with stable angina pectoris. PMID:27638354

  3. Effects of acupuncture in moderate, stable angina pectoris

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Pedersen, F; Pietersen, A;

    1990-01-01

    In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  5. 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...

  6. Insights into the pathophysiology of unstable coronary artery disease.

    Science.gov (United States)

    Kristensen, S D; Ravn, H B; Falk, E

    1997-09-01

    Coronary atherosclerosis without thrombosis is, in general, a benign disease. However, plaque disruption, or fissuring, with superimposed thrombosis, frequently complicates the course of coronary atherosclerosis. Small ruptures often remain clinically silent, whereas more extensive plaque rupture may cause the development of unstable angina, myocardial infarction, and sudden death. The risk of plaque disruption depends more on plaque type (composition) than on plaque size and stenosis severity. Major determinants of a plaque's vulnerability to rupture are: the size and consistency of the lipid-rich atheromatous core; the thickness of the fibrous cap covering the core; and ongoing inflammation and repair within the cap. Both plaque vulnerability (intrinsic disease) and rupture triggers (extrinsic forces) are important for plaque disruption. The former predisposes the plaque to rupture whereas the latter may precipitate it. The resultant thrombotic response, which is important for the clinical presentation and outcome, is portly determined by the reactivity of the circulating platelets and the balance between the fibrinolytic and coagulation systems. New ways of identification and treatment of the dangerous vulnerable plaques responsible for infarction and death, and optimization of antithrombotic treatment, are highly warranted in order to prevent and treat life-threatening coronary thrombosis.

  7. 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.

  8. Unstable Fields in Kerr Spacetimes

    CERN Document Server

    Dotti, Gustavo; Ranea-Sandoval, Ignacio F

    2011-01-01

    We present a generalization of previous results regarding the stability under gravitational perturbations of nakedly singular super extreme Kerr spacetime and Kerr black hole interior beyond the Cauchy horizon. To do so we study solutions to the radial and angular Teukolsky's equations with different spin weights, particulary $s=\\pm 1$ representing electromagnetic perturbations, $s=\\pm 1/2$ representing a perturbation by a Dirac field and $s=0$ representing perturbations by a scalar field. By analizing the properties of radial and angular eigenvalues we prove the existence of an infinite family of unstable modes.

  9. Is Quantum Spacetime Foam Unstable?

    CERN Document Server

    Redmount, I H; Redmount, Ian H.; Suen, Wai-Mo

    1993-01-01

    A very simple wormhole geometry is considered as a model of a mode of topological fluctutation in Planck-scale spacetime foam. Quantum dynamics of the hole reduces to quantum mechanics of one variable, throat radius, and admits a WKB analysis. The hole is quantum-mechanically unstable: It has no bound states. Wormhole wave functions must eventually leak to large radii. This suggests that stability considerations along these lines may place strong constraints on the nature and even the existence of spacetime foam.

  10. 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.

  11. 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.

  12. 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...

  13. Frequent sampling by clear venipuncture in unstable angina is a reliable method to assess haemostatic system activity

    NARCIS (Netherlands)

    Biasucci, L.M.; Liuzzo, G.; Caligiuri, G.; Monaco, C.; Quaranta, G.; Sperti, G.; Greef, W. van de; Maseri, A.; Kluft, C.

    1994-01-01

    Sudden limitations in coronary flow account for the majority of cases of UA. Measurement of TAT in peripheral blood represent a reliable marker of an ongoing thrombotic process. The aim of the study was to assess the reliability of frequent blood sampling (Phase A) and to correlate TAT fluctuation t

  14. 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 ...

  15. Prediction of clinical outcome by myocardial CT perfusion in patients with low-risk unstable angina pectoris

    DEFF Research Database (Denmark)

    Linde, Jesper J; Sørgaard, Mathias; Kühl, Jørgen T;

    2016-01-01

     %) suffered a MACE (cardiac death, non-fatal myocardial infarction and revascularizations). Accuracy for the prediction of MACE expressed as the area under curve (AUC) on receiver-operating characteristic curves was 0.88 (0.83-0.92) for visual assessment of a PD and 0.80 (0.73-0.85) for stress TPR (transmural...... perfusion ratio). After adjustment for the pretest probability of obstructive coronary artery disease, both detection of a PD and stress TPR were significantly associated with MACE with an adjusted hazard ratio of 39 (95 % confidence interval 11-134), p ....98-0.99) for stress TPR, p 10 % of the LV myocardium had a worse prognosis compared to patients with a PD covering

  16. 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...

  17. High probability of disease in angina pectoris patients

    DEFF Research Database (Denmark)

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

    2007-01-01

    BACKGROUND: According to most current guidelines, stable angina pectoris patients with a high probability of having coronary artery disease can be reliably identified clinically. OBJECTIVES: To examine the reliability of clinical evaluation with or without an at-rest electrocardiogram (ECG......) in patients with a high probability of coronary artery disease. PATIENTS AND METHODS: A prospective series of 357 patients referred for coronary angiography (CA) for suspected stable angina pectoris were examined by a trained physician who judged their type of pain and Canadian Cardiovascular Society grade...... on CA. Of the patients who had also an abnormal at-rest ECG, 14% to 21% of men and 42% to 57% of women had normal MPS. Sex-related differences were statistically significant. CONCLUSIONS: Clinical prediction appears to be unreliable. Addition of at-rest ECG data results in some improvement, particularly...

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

    CERN Document Server

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

    2001-01-01

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

  19. Management of angina pectoris: the role of spinal cord stimulation.

    Science.gov (United States)

    Eckert, Siegfried; Horstkotte, Dieter

    2009-01-01

    Progress in prevention as well as drug and interventional therapy has improved the prognosis of patients with cardiovascular disorders. Many patients at risk have advanced coronary artery disease (CAD), have had multiple coronary interventions, and present with significant co-morbidity. Despite adequate risk factor modulation and often several revascularization procedures, some of these patients still have refractory angina pectoris. Apart from advanced CAD and insufficient collateralization, the cause is often endothelial dysfunction. For this situation, one treatment option is neuromodulation. Controlled studies suggest that, in patients with chronic refractory angina pectoris, spinal cord stimulation (SCS) provides a relief from symptoms equivalent to that provided by surgical therapy, but with fewer complications and lower rehospitalization rates. SCS may result in significant long-term pain relief with improved quality of life. In patients with refractory angina undergoing SCS, some studies have shown not only a symptomatic improvement, but also a decrease in myocardial ischemia and an increase in coronary blood flow. Discussion is ongoing as to whether this is a direct effect on parasympathetic vascodilation or merely a secondary phenomenon resulting from increased physical activity following an improvement in clinical symptoms. Results from nuclear medical studies have sparked discussion about improved endothelial function and increased collateralization. SCS is a safe treatment option for patients with refractory angina pectoris, and its long-term effects are evident. It is a procedure without significant complications that is easy to tolerate. SCS does not interact with pacemakers, provided that strict bipolar right-ventricular sensing is used. Use in patients with implanted cardioverter defibrillators is under discussion. Individual testing is mandatory in order to assess optimal safety in each patient. PMID:19178129

  20. 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...

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2008-12-01

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

  3. 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.

  4. 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.

  5. Osteoporosis in unstable adult scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Velis, K.P.; Healey, J.H.; Schneider, R.

    1988-12-01

    New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.

  6. 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)

  7. 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....

  8. 40 CFR 258.15 - Unstable areas.

    Science.gov (United States)

    2010-07-01

    ... that engineering measures have been incorporated into the MSWLF unit's design to ensure that the...-made features or events (both surface and subsurface). (b) For purposes of this section: (1) Unstable... releases from a landfill. Unstable areas can include poor foundation conditions, areas susceptible to...

  9. 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.

  10. 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

  11. Ludwig’s Angina in Pregnancy Necessitating Pre Mature Delivery

    OpenAIRE

    Kamath, Abhay Taranath; Bhagania, Manish Kumar; Balakrishna, R.; Sevagur, Ganesh Kamath; Amar, R.

    2012-01-01

    Ludwig’s angina is a potentially life threatening disease that can arise from odontogenic infections if they are not attended well in advance. Its incidence in pregnancy is rare, but has been reported. Pregnancy is associated with complex physiological changes in the body which can make small dental infections assume grave proportions if not treated appropriately. This article presents a case of a 24 year old, 32 week pregnant lady who reported with swelling around the jaws and neck, difficul...

  12. 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

  13. 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...

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

    DEFF Research Database (Denmark)

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

    1991-01-01

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

  15. 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...

  16. 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.

  17. 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.

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

    Science.gov (United States)

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

    1986-09-01

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

  19. 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.

  20. 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.

  1. Angina crónica estable. Consideraciones actuales

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-03-01

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

  2. Testing the Equivalence Principle with Unstable Particles

    CERN Document Server

    Bonder, Y; Hernandez-Coronado, H; Krause, D E; Rohrbach, Z; Sudarsky, D

    2013-01-01

    We develop a framework to test the Equivalence Principle (EP) under conditions where the quantum aspects of nature cannot be neglected, specifically in the context of interference phenomena with unstable particles. We derive the nonrelativistic quantum equation that describes the evolution of the wavefunction of unstable particles under the assumption of the validity of the EP and when small deviations are assumed to occur. As an example, we study the propagation of unstable particles in a COW experiment, and we briefly discuss the experimental implications of our formalism.

  3. 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...

  4. Vasospastic angina with J waves formation in patients with sudden loss of consciousness

    Institute of Scientific and Technical Information of China (English)

    Dan ZHU; Yi-Ming LUO; Ke-Hu A; Ling-Yun ZU; Yan-Hui ZHANG; Li-Jun GUO; Wei GAO; Yuan ZHANG

    2015-01-01

    Vasospastic angina is caused by sudden occlusive vasoconstriction of a segment of an epicardial artery, which can present with a wide spectrum of clinical scenario. We report the cases of two patients diagnosed with vasospastic angina, with one of which presenting with sud-den cardiac arrest, while the other presenting with a relatively benign syncope. But both of them have J waves formation on ECG during active ischemia. The diagnosis and management of vasospastic angina, as well as the proposed clinical significance of J waves during coro-nary spasm are discussed.

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

  6. 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.

  7. 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...

  8. 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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  11. 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.

  12. 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

  13. 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...... of stable angina pectoris, which ceteris paribus would be associated with cost savings in the health care sector. However, these potentials should be examined in a larger- scale study....

  14. 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.

  15. 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...

  16. 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

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

    Science.gov (United States)

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

    1980-08-01

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

  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. 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...

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

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2011-01-01

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

  1. 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.)

  2. 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...

  3. 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.

  4. 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.

  5. The Fate of Unstable Gauge Flux Compactifications

    CERN Document Server

    Burgess, C P; Zavala, I

    2009-01-01

    Fluxes are widely used to stabilise extra dimensions, but if they arise within a non-abelian gauge sector they are often unstable. We seek the fate of this instability, focussing on the simplest examples: sphere-monopole compactifications in six dimensions. Without gravity most non-abelian monopoles 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 geometry adjusting accordingly: a Mink(d)xS2 geometry supported by an unstable monopole relaxes to an AdS(d)xS2. For 6D supergravity, the dilaton obstructs this simple evolution, acquiring a gradient and thus breaking some of the spacetime symmetries. We argue that it is the 4D symmetries that break, and examine several endpoint candidates. Oxidising the supergravity system into a higher-dimensional Einstein-YM monopole, we use the latter to guide us to the corresponding endpoint. The result is a singular Kasner-like geometry conformal to Mink(4)xS2. The solution has ...

  6. 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

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

    Science.gov (United States)

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

    2010-07-01

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

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

    DEFF Research Database (Denmark)

    Verheye, Stefan; Jolicœur, E Marc; Behan, Miles W;

    2015-01-01

    BACKGROUND: Many patients with coronary artery disease who are not candidates for revascularization have refractory angina despite standard medical therapy. The balloon-expandable, stainless steel, hourglass-shaped, coronary-sinus reducing device creates a focal narrowing and increases pressure...... ischemia, who were not candidates for revascularization, to implantation of the device (treatment group) or to a sham procedure (control group). The primary end point was the proportion of patients with an improvement of at least two CCS angina classes at 6 months. RESULTS: A total of 35% of the patients...... patient had died and 3 had had a myocardial infarction. CONCLUSIONS: In this small clinical trial, implantation of the coronary-sinus reducing device was associated with significant improvement in symptoms and quality of life in patients with refractory angina who were not candidates for revascularization...

  9. 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...

  10. Efficacy of Enhanced External Counterpulsation in Patients With Chronic Refractory Angina on Canadian Cardiovascular Society (CCS) Angina Class: An Updated Meta-Analysis.

    Science.gov (United States)

    Zhang, Chunmei; Liu, Xiangjuan; Wang, Xiaomeng; Wang, Qi; Zhang, Yun; Ge, Zhiming

    2015-11-01

    A growing number of patients with chronic artery disease suffer from angina, despite the optimal medical management (ie, β-blockers, calcium channel blockers, and long-acting nitrates) and revascularization. Currently, enhanced external counterpulsation (EECP) therapy has been verified as a noninvasive, safe therapy for refractory angina. The study was designed to evaluate the efficacy of EECP in patients with chronic refractory angina according to Canadian Cardiovascular Society (CCS) angina class.We identified systematic literature through MEDLINE, EMBASE, the Cochrane Clinical Trials Register Database, and the ClinicalTrials. gov Website from 1990 to 2015. Studies were considered eligible if they were prospective and reported data on CCS class before and after EECP treatment. Meta-analysis was performed to assess the efficacy of EECP therapy by at least 1 CCS angina class improvement, and proportion along with the 95% confidence interval (CI) was calculated. Statistical heterogeneity was calculated by I statistic and the Q statistic. Sensitivity analysis was addressed to test the influence of trials on the overall pooled results. Subgroup analysis was applied to explore potential reasons for heterogeneity.Eighteen studies were enrolled in our meta-analysis. Pooled analysis showed 85% of patients underwent EECP had a reduction by at least one CCS class (95%CI 0.81-0.88, I = 58.5%, P < 0.001). The proportion of patients enrolled at primarily different studies with chronic heart failure (CHF) improved by at least 1 CCS class was about 84% after EECP (95%CI 0.81-0.88, I = 32.7%, P = 0.1668). After 3 large studies were excluded, the pooled proportion was 82% (95%CI 0.79-0.86, I = 18%, P = 0.2528). Funnel plot indicated that some asymmetry while the Begg and Egger bias statistic showed no publication bias (P = 0.1495 and 0.2859, respectively).Our study confirmed that EECP provided an effective treatment for patients who were unresponsive to medical management and

  11. 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.

  12. 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.)

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

    DEFF Research Database (Denmark)

    Jespersen, C M

    1997-01-01

    BACKGROUND: Angina pectoris accompanied by transient ST-segment changes during the in-hospital phase of acute myocardial infarction (AMI) is a well established marker of subsequent cardiac death and reinfarction. HYPOTHESIS: This study was undertaken to record the prognostic significance of angina...... 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...

  14. Emergency management of hemodynamically unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang

    2011-01-01

    Pelvic fractures are serious injuries.Death within 24 hours is most often a result of acute blood loss.The emergency management of these patients is challenging and controversial.The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding.Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team.The issues addressed in this management algorithm are diagnostic evaluation,damage control resuscitation,indications for noninvasive pelvic stabilization,preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography.This review article focuses on the recent body of knowledge on those determinations.

  15. 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.

  16. 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....

  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. 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

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

    NARCIS (Netherlands)

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

    1995-01-01

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

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  1. Percutaneous Revascularization in a Case of Vasospastic Angina Associated with Polymorphic Ventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Roxana Rudzik

    2015-12-01

    Full Text Available Introduction: Coronary vasospasm is a possible cause of ventricular tachyarrhythmias and is frequently associated with atherosclerotic lesions. The revascularization of mild to moderate coronary artery stenosis which causes symptoms only due to associated vasospasm is still a matter of debate, as the standard treatment of Prinzmetal angina is represented by the long term administration of calcium-channel blockers.

  2. 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

  3. 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

  4. 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

  5. Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department.

    Science.gov (United States)

    Safdar, Basmah; D'Onofrio, Gail

    2016-06-01

    Emergency departments (ED) in the United States see over eight million cases of chest pain annually. While a cardinal symptom of acute coronary syndrome (ACS), multiple emergent and non-emergent causes can attribute to chest pain. This case-based perspective describes the different sex-specific causes of angina seen in ED patients. Once coronary artery disease (CAD) is ruled out with standard protocols, microvascular dysfunction is perhaps the most prevalent but under-diagnosed cause of non-CAD related angina in ED patients. Additional causes include coronary artery spasm, coronary artery dissection, coronary artery endothelial dysfunction and myocardial bridging. Non-CAD related angina is associated with persistent chest pain causing poor function, quality of life, and recidivism. Clinicians should consider additional diagnostics to routinely screen for non-CAD related causes of angina in patients with recurrent chest pain. Future work is needed to better define the epidemiological, clinical, biological, and genetic correlates of microvascular dysfunction in these patients. PMID:27354848

  6. 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.

  7. 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)

  8. 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.)

  9. 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

    : Compared with men, women were older, weighed less, were less likely to have prior myocardial infarction or revascularization, and had lower baseline creatinine clearance and hemoglobin level values. Rates of the composite of cardiovascular death/myocardial infarction/stroke (20.2% vs 19.1%; P = .56), all......BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We examined sex-specific differences in long......-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...

  10. 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.

  11. 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

  12. 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.

  13. 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

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

    Science.gov (United States)

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

    1993-02-01

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

  15. 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...

  16. 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.

  17. Unstable optical resonator loss calculations using the prony method.

    Science.gov (United States)

    Siegman, A E; Miller, H Y

    1970-12-01

    The eigenvalues for all the significant low-order resonant modes of an unstable optical resonator with circular mirrors are computed using an eigenvalue method called the Prony method. A general equivalence relation is also given, by means of which one can obtain the design parameters for a single-ended unstable resonator of the type usually employed in practical lasers, from the calculated or tabulated values for an equivalent symmetric or double-ended unstable resonator.

  18. 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.

  19. Unstable vicinal crystal growth from cellular automata

    Science.gov (United States)

    Krasteva, A.; Popova, H.; KrzyŻewski, F.; Załuska-Kotur, M.; Tonchev, V.

    2016-03-01

    In order to study the unstable step motion on vicinal crystal surfaces we devise vicinal Cellular Automata. Each cell from the colony has value equal to its height in the vicinal, initially the steps are regularly distributed. Another array keeps the adatoms, initially distributed randomly over the surface. The growth rule defines that each adatom at right nearest neighbor position to a (multi-) step attaches to it. The update of whole colony is performed at once and then time increases. This execution of the growth rule is followed by compensation of the consumed particles and by diffusional update(s) of the adatom population. Two principal sources of instability are employed - biased diffusion and infinite inverse Ehrlich-Schwoebel barrier (iiSE). Since these factors are not opposed by step-step repulsion the formation of multi-steps is observed but in general the step bunches preserve a finite width. We monitor the developing surface patterns and quantify the observations by scaling laws with focus on the eventual transition from diffusion-limited to kinetics-limited phenomenon. The time-scaling exponent of the bunch size N is 1/2 for the case of biased diffusion and 1/3 for the case of iiSE. Additional distinction is possible based on the time-scaling exponents of the sizes of multi-step Nmulti, these are 0.36÷0.4 (for biased diffusion) and 1/4 (iiSE).

  20. 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

  1. 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.)

  2. 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...

  3. 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.

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

  5. 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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    , advanced echocardiographic modalities at rest and during stress, and invasive measures of CFR and coronary vascular reactivity. The study will include 2000 women who will be followed for 5 years for cardiovascular outcomes. RESULTS: By May 2013, 1685 women have been screened, 759 eligible patients......BACKGROUND: The iPOWER study aims at determining whether routine assessment of coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease is feasible and identifies women at risk. METHODS: All women with angina referred to invasive angiographic...... assessment in Eastern Denmark are invited to join the study according to in- and exclusion criteria. Assessment includes demographic, clinical and psychosocial data, symptoms, electrocardiogram, blood- and urine samples and transthoracic echocardiography during rest and dipyridamol stress with measurement...

  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. 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

  9. 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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Chuan Wang

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

  12. 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...

  13. 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...

  14. 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

  15. 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

  16. 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

  17. THE UNSTABLE MODES OF NATURAL CONVECTION BOUNDARY LAYER

    Institute of Scientific and Technical Information of China (English)

    Tao Jianjun; Zhuang Fenggan; Yan Dachun

    2000-01-01

    The instability of natural convection boundary layer around a vertical heated flat plate is analyzed theoretically in this paper. The results illustrate that the “loop” in the neutral curve is not a real loop but a twist of the curve is the frequencywave number-Grashof number space, and there is only one unstable mode at small Prandtl numbers. Specially, when the Prandtl number is large enough two unstable modes will be found in the “loop” region. Along the amplifying surface intersection the two unstable modes have the same Grashof number, wave number and frequency but different amplifying rates. Their instability characteristics are analyzed and the criterion for determining the existence of the multi-unstable modes is also discussed.

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

    Directory of Open Access Journals (Sweden)

    Ali Bozorgi

    2015-10-01

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

  19. 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...

  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. Suppressing unstable deformation of nanocolloidal crystals with atomic layer deposition

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Di [Department of Mechanical Engineering, Villanova University, Villanova, PA 19085 (United States); Zhang, Lei; Lee, Daeyeon [Department of Chemical and Biomolecular Engineering, University of Pennsylvania, Philadelphia, PA 19104 (United States); Cheng, Xuemei [Department of Physics, Bryn Mawr College, Bryn Mawr, PA 19010 (United States); Feng, Gang, E-mail: gang.feng@villanova.edu [Department of Mechanical Engineering, Villanova University, Villanova, PA 19085 (United States)

    2015-07-15

    Despite their useful photonic properties, poor mechanical robustness hinders the application of nanocolloidal crystals (NCCs). Understanding the mechanical behavior of NCCs is critical to propose effective reinforcement techniques. We find that as-assembled NCCs exhibit unstable deformation, manifested as pop-ins upon nanoindentation. By deepening indentation, the unstable deformation mode transitions from NC dislodging to shear band (SB) formation. We find that alumina atomic layer deposition (ALD) significantly suppresses NC dislodging and SB formations in NCCs by increasing interparticle bonding.

  3. 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.

  4. 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

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

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2012-01-01

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

  6. 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.

  7. 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.

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

    Science.gov (United States)

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

    1977-01-01

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

  9. 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

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

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

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

  11. Cardiac arrest after sugammadex administration in a patient with variant angina: a case report

    Science.gov (United States)

    Kim, Yong Han; Kang, Eunsu; Lee, Byeong-Cheol; Lee, Sujung

    2016-01-01

    A 76-year-old man with no notable medical history was scheduled for a robot-assisted radical prostatectomy. After the operation, he was given sugammadex. Two minutes later, ventricular premature contraction bigeminy began, followed by cardiac arrest. Cardiac arrest occurred three times and cardiopulmonary resuscitation was done. The patient recovered after the third cardiopulmonary resuscitation and was transferred to the intensive care unit. Coronary angiography was done on postoperative day 1. The patient was diagnosed with variant angina and discharged uneventfully on postoperative day 8.

  12. 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

  13. 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......BACKGROUND: The majority of women with angina-like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary.......01), hypertension (P=0.02), current smoking (Pstress testing...

  14. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris

    OpenAIRE

    Vulink, NCC; Jessurun, GAJ; TenVaarwerk, IAM; Kropmans, TJB; van der Schans, CP; Middel, B; Staal, MJ; DeJongste, MJL; Hessurun, G.A.J.

    1999-01-01

    Objective. For patients with refractory angina pectoris, spinal cord stimulation (SCS) is a beneficial and safe adjuvant therapy. However, it has not yet been established whether SCS alters the quality of life (QoL) in these patients. Methods. In this study, 26 consecutive patients (age 61.3 +/- 7.0 years, 13 females, angina duration 12.7 +/- 6.0 years) were recruited. Social, mental, and physical aspects of QoL were determined by Nottingham Health Profile (NHP I), depression scale (CES-D), s...

  15. 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

  16. 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.

  17. Symmetry energy, unstable nuclei, and neutron star crusts

    CERN Document Server

    Iida, Kei

    2013-01-01

    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.

  18. 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.)

  19. 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.

  20. 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.

  1. Flame spectra of solid propellants during unstable combustion.

    Science.gov (United States)

    Eisel, J. L.; Ryan, N. W.; Baer, A. D.

    1972-01-01

    The spectral and temporal details of the flames of a series of ammonium perchlorate-polyurethane propellants during both unstable and stable combustion were observed experimentally. A 400-scan per second optical spectrometer operating in the middle infrared region was used. During unstable combustion at low ratios of chamber free volume to nozzle throat area, three different frequencies were observed simultaneously. These were attributable to at least two mechanisms. During stable combustion periodic fluctuations in flame temperature and composition were also observed. Some aspects of theory of bulk mode instability were confirmed, but the assumptions of constant flame temperature and constant composition were found to be inaccurate.

  2. Analysis the Clinical Curative Effect of Low Molecular Heparin Combine With Simvastatin in Treatment of Angina%低分子肝素钙联合辛伐他汀治疗心绞痛的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    夏东亚; 郭好战; 李红员

    2015-01-01

    Objective Analysis of low molecular weight heparin and simvastatin treatment of angina pectoris.MethodsRetrospective selected 89 cases with court of unstable angina from December 2012 to December 2014 clinical data, according to the different treatment options are divided into two groups, the control group of 43 case adopt routine conventional treatment, 46 cases of the study group at its base upward low molecular weight heparin and simvastatin combination therapy, compared the efifcacy of the two groups was observed parameters and cardiac function.Results The control group total efifciency was 76.7% lower than the study group 95.7%,P<0.05, had difference statistically signiifcance.Conclusion Angina to low molecular weight heparin and simvastatin combination therapy a signiifcant effect.%目的:分析低分子肝素钙和辛伐他汀联合治疗心绞痛疗效。方法回顾性分析2012年12月~2014年12月本院89例不稳定型的心绞痛患者临床资料,按不同治疗方案分为两组,对照组43例行常规治疗,研究组46例在其基础上行低分子肝素钙和辛伐他汀联合治疗,观察两组疗效及心功能的参数情况。结果对照组总有效率76.7%低于研究组95.7%,P<0.05,差异具有统计学意义。结论心绞痛给予低分子肝素钙和辛伐他汀联合治疗的疗效显著。

  3. 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-T,...

  4. 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.

  5. 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...

  6. 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

  7. 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

  8. Value of the addition of Amlodipine to atenolol in patients with angina pectoris despite adequate beta blockade

    NARCIS (Netherlands)

    Dunselman, PHJM; Bouwens, LHM; Herweijer, AH; Bernink, PJLM

    1998-01-01

    Anginal patients who remain symptomatic despite optimally dosed beta blockade may also be given dihydropyridine calcium antagonists. This treatment regimen was examined in a double-blind parallel, randomized, controlled study in 147 patients with angina and positive bicycle exercise tests despite op

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  10. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris

    NARCIS (Netherlands)

    Vulink, NCC; Jessurun, GAJ; TenVaarwerk, IAM; Kropmans, TJB; van der Schans, CP; Middel, B; Staal, MJ; DeJongste, MJL; Hessurun, G.A.J.

    1999-01-01

    Objective. For patients with refractory angina pectoris, spinal cord stimulation (SCS) is a beneficial and safe adjuvant therapy. However, it has not yet been established whether SCS alters the quality of life (QoL) in these patients. Methods. In this study, 26 consecutive patients (age 61.3 +/- 7.0

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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...

  15. 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.

  16. Beam shaping characteristics of an unstable-waveguide hybrid resonator.

    Science.gov (United States)

    Xiao, Longsheng; Qin, Yingxiong; Tang, Xiahui; Wan, Chenhao; Li, Gen; Zhong, Lijing

    2014-04-01

    The unstable-waveguide hybrid resonator emits a rectangular, simple astigmatic beam with a large number of high-spatial-frequency oscillations in the unstable direction. To equalize the beam quality, in this paper, a beam shaping system with a spatial filter for the hybrid resonator was investigated by numerical simulation and experimental method. The high-frequency components and fundamental mode of the output beam of the hybrid resonator in the unstable direction are separated by a focus lens. The high-frequency components of the beam are eliminated by the following spatial filter. A nearly Gaussian-shaped beam with approximately equal beam propagation factor M² in the two orthogonal directions was obtained. The effects of the width of the spatial filter on the beam quality, power loss, and intensity distribution of the shaped beam were investigated. The M² factor in the unstable direction is changed from 1.6 to 1.1 by optimum design. The power loss is only 9.5%. The simulation results are in good agreement with the experimental results.

  17. Shearing box simulations in the Rayleigh unstable regime

    DEFF Research Database (Denmark)

    Nauman, Farrukh; Blackman, Eric G.

    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...

  18. 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.

  19. 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

  20. 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

  1. Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

    Directory of Open Access Journals (Sweden)

    Jörn Reinders

    2014-01-01

    Full Text Available Background. Wear-related failures and instabilities are frequent failure mechanisms of total knee replacements. High-conforming designs may provide additional stability for the joint. This study analyzes the effects of a ligamentous insufficiency on the stability and the wear behavior of a high-conforming knee design. Methods. Two simulator wear tests were performed on a high-conforming total knee replacement design. In the first, a ligamentous-stable knee replacement with a sacrificed anterior cruciate ligament was simulated. In the second, a ligamentous-unstable knee with additionally insufficient posterior cruciate ligament and medial collateral ligament was simulated. Wear was determined gravimetrically and wear particles were analyzed. Implant kinematics was recorded during simulation. Results. Significantly higher wear rates (P≤0.001 were observed for the unstable knee (14.58±0.56 mg/106 cycles compared to the stable knee (7.97 ± 0.87 mg/106 cycles. A higher number of wear particles with only small differences in wear particle characteristics were observed. Under unstable knee conditions, kinematics increased significantly for translations and rotations (P≤0.01. This increase was mainly attributed to higher tibial posterior translation and internal rotations. Conclusion. Higher kinematics under unstable test conditions is a result of insufficient stabilization via implant design. Due to the higher kinematics, increased wear was observed in this study.

  2. 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...

  3. 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.

  4. 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...

  5. 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).

  6. 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 t...

  7. 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)

  8. 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.

  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. 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. 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.

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

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed. PMID:15036817

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  14. 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%.

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

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-01

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

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

    Directory of Open Access Journals (Sweden)

    N. P. Kutishenko

    2005-01-01

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

  19. External fixation in early treatment of unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    HU San-bao; XU Hong; GUO Heng-bing; SUN Tong; WANG Chang-jun

    2012-01-01

    Background Patients with pelvic fractures are often treated in hospitals without the capacity to implement an open reduction internal fixation (ORIF).This often leads to pelvic malunion in patients with unstable pelvic fracture,shock or even death due to uncontrollable pelvic hemorrhage and unstable hemodynamics.This study explored the role of early external fixation (within 7 days) for patients with unstable pelvic fractures.Methods A retrospective analysis was conducted on 32 patients with unstable pelvic fractures treated with early external fixation from January 2005 to January 2010 (file type B:18 cases; C:14 cases).The study comprised 28 males and 4 females,with a mean age of (32±8) years (range,21-56 years).Of these patients,22 were treated with emergency pelvic external fixation and 10 were treated with external fixation within 1-7 days.Fifteen cases suffered traumatic hemorrhagic shock.A statistical analysis was conducted to compare fluid infusion and blood transfusion volumes within the first 24 hours of these shock patients with another cohort of patients treated without early external fixation from January 1993 to January 1998.Results The average follow-up was (34.7±14.6) months (range,6-66 months).Six to eight weeks after external fixation,patients could walk with crutches; by 12 weeks,external fixation was removed and all fractures had healed.Seven patients presented with sequelae,including 3 patients with long-term lumbosacral pain,3 patients with erectile dysfunction and 1 patient with Morel-Lavallee lesion and other complications.The 15 shock patients in this study (2005-2010 group) required significantly lower volumes of fluid infusion and blood transfusion (Pfluid=0.000;Ptransfusion=0.000) as compared to the 1993-1998 cohort.Conclusions The early application of external fixation in unstable pelvic fracture patients positively affects hemodynamic stability,with outstanding efficacy as a final fixation option for unstable pelvic fractures.

  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. 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.

  2. 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...

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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...

  8. 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

  9. 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.

  10. 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

  11. 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...

  12. CP Violation in Correlated Production and Decay of Unstable Particles

    CERN Document Server

    Kittel, Olaf

    2012-01-01

    We study resonant CP-violating Einstein--Podolsky--Rosen correlations that may take place in the production and decay of unstable scalar particles at high-energy colliders. We show that as a consequence of unitarity and CPT invariance of the S-matrix, in 2 --> 2 scatterings mediated by mixed scalar particles, at least three linearly independent decay matrices associated with the unstable scalar states are needed to obtain non-zero CP-odd observables that are also odd under C-conjugation. Instead, for the correlated production and decay of two unstable particle systems in 2 --> 4 processes, we find that only two independent decay matrices are sufficient to induce a net non-vanishing CP-violating phenomenon. As an application of this theorem, we present numerical estimates of CP asymmetries for the correlated production and decay of supersymmetric scalar top--anti-top pairs at the LHC, and demonstrate that these could reach values of order one. As a byproduct of our analysis, we develop a novel spinorial trace ...

  13. 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....

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

    Science.gov (United States)

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

    1990-12-01

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

  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. 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...

  18. 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...

  19. 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.

  20. 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...

  1. 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...

  2. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris.

    Science.gov (United States)

    Vulink, N C; Overgaauw, D M; Jessurun, G A; Tenvaarwerk, I A; Kropmans, T J; van der Schans, C P; Middel, B; Staal, M J; Dejongste, M J

    1999-01-01

    Objective. For patients with refractory angina pectoris, spinal cord stimulation (SCS) is a beneficial and safe adjuvant therapy. However, it has not yet been established whether SCS alters the quality of life (QoL) in these patients. Methods. In this study, 26 consecutive patients (age 61.3 ± 7.0 years, 13 females, angina duration 12.7 ± 6.0 years) were recruited. Social, mental, and physical aspects of QoL were determined by Nottingham Health Profile (NHP I), depression scale (CES-D), scoring of angina pectoris attacks and short-acting nitroglycerine intake, pain score on the Visual Analog Scale (VAS), perceived health percentage, Satisfaction With Life scale (SWLS), and one-aspect Linear Analog Self Assessment scale (LASA). QoL outcomes at baseline were compared with reference values from healthy subjects. Within-group changes and magnitude of changes (effect size, ES) were assessed after 3 months and 1 year of SCS. Results. Compared to healthy subjects, the patients had significantly worse scores at baseline on NHP, SWLS, and LASA. After 3 months of SCS, NHP I aspect pain (ES = 1.39), AP-score (ES = 0.85), perceived health percentage (ES =- 0.80), NTG-use (ES = 1.08) and VAS-score (ES = 1.13) were all significantly improved (p pain, energy, emotional reactions, social isolation, sleep, and physical mobility (p 0.80). Conclusion. QoL in patients with refractory angina pectoris is poor. Both pain and health aspects of QoL improved significantly after 3 months of SCS. Social, mental, and physical aspects of QoL were found improved after 1 year of SCS. PMID:22151060

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

    Science.gov (United States)

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

    2007-01-01

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

  4. 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. ...

  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. 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.

  7. 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.

  8. Unstable shoe construction: influence on gait and posture

    Directory of Open Access Journals (Sweden)

    Masood T

    2011-01-01

    Full Text Available Footwear, in one form or another, have been around for millennia. The advancements in the technology have made possible the transformation of animal skin and fur wrapped around feet by our ancestors into modern-day marvels of athletic shoes. Arguably one of the most pronounced innovations in the field of footwear design is the introduction of unstable shoe construction (USC, over the last few decades. Most widely investigated shoes are the Masai Barefoot Technology (MBT shoes. Numerous scientific studies conducted on these shoes have revealed their effects on human gait and posture in healthy and morbid populations.

  9. 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.

  10. 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)

  11. 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.

  12. Unstable behavior of anodic arc discharge for synthesis of nanomaterials

    Science.gov (United States)

    Gershman, Sophia; Raitses, Yevgeny

    2016-09-01

    A short carbon arc operating with a high ablation rate of the graphite anode exhibits a combined motion of the arc and the arc attachment to the anode. A characteristic time scale of this motion is in a 10‑3 s range. The arc exhibits a negative differential resistance before the arc motion occurs. Thermal processes in the arc plasma region interacting with the ablating anode are considered as possible causes of this unstable arc behavior. It is also hypothesized that the arc motion could potentially cause mixing of the various nanoparticles synthesized in the arc in the high ablation regime.

  13. 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

  14. Stabilizing unstable steady states using multiple delay feedback control.

    Science.gov (United States)

    Ahlborn, Alexander; Parlitz, Ulrich

    2004-12-31

    Feedback control with different and independent delay times is introduced and shown to be an efficient method for stabilizing fixed points (equilibria) of dynamical systems. In comparison to other delay based chaos control methods multiple delay feedback control is superior for controlling steady states and works also for relatively large delay times (sometimes unavoidable in experiments due to system dead times). To demonstrate this approach for stabilizing unstable fixed points we present numerical simulations of Chua's circuit and a successful experimental application for stabilizing a chaotic frequency doubled Nd-doped yttrium aluminum garnet laser.

  15. 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.

  16. 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.

  17. 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.

  18. Tender Endothelium Syndrome: Combination of Hypotension, Bradycardia, Contrast Induced Chest Pain, and Microvascular Angina.

    Science.gov (United States)

    Goberdhan, Shivesh; Chiew, Soon Kwang; Syed, Jaffer

    2016-01-01

    Hypotension, bradycardia, and contrast induced chest pain are potential complications of cardiac catheterization and coronary angiography. Catheter-induced coronary spasm has been occasionally demonstrated, but its relationship to spontaneous coronary spasm is unclear. We describe a 64-year-old female who underwent coronary artery bypass surgery in 1998 on the basis of an angiographic diagnosis of severe left main disease, who recently presented with increasingly frequent typical angina. Repeat coronary angiography was immediately complicated by severe chest pain, hypotension, and bradycardia but demonstrated only mild disease of the left main artery and entire coronary tree with complete occlusion of her prior grafts. This reaction was almost identical to that observed during her original coronary angiogram. We now believe her original angiogram was complicated by severe catheter-induced left main spasm, with the accompanying contrast reaction attributed to left main disease, and the occlusion of coronary grafts explained by the absence of significant left main disease. The combination of these symptoms has not been documented in the literature. In this instance, these manifestations erroneously led to coronary bypass surgery. It is unknown whether routine, systematic injection of intracoronary nitroglycerin prior to angiography might blunt the severity of such reactions. PMID:26981290

  19. 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.

  20. 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.

  1. Prevalence of linked angina and gastroesophageal reflux disease in general practice

    Institute of Scientific and Technical Information of China (English)

    Hirohito Kato; Takamasa Ishii; Tatsuo Akimoto; Yoshihisa Urita; Motonobu Sugimoto

    2009-01-01

    AIM: To evaluate the association between gastroesophageal reflux diseases (GERD) and coronary heart diseases. METHODS: One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as Stsegment depression based on the Minnesota code. RESULTS: Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients). CONCLUSION: The present study suggested that ischemic heart disease might be found although apatient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.

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

    Directory of Open Access Journals (Sweden)

    Alan Nurden

    2012-01-01

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

  3. 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.

  4. 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...

  5. 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.

  6. 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.

  7. A Zoology of unstable modes in a stratified cylinder wake

    Science.gov (United States)

    Bosco, Mickael; Meunier, Patrice

    2013-11-01

    Although the dynamics of a cylinder wake is well known and extremely rich for a homogeneous fluid, very few studies have been focused on stratified wakes despite the obvious extensive number of applications for geophysical flows and submarine wakes. The presence of the stratification may largely modify the dynamics of the wake. The study is devoted to understand the effect of the tilt and also of a strong stratification. So extensive experimental and numerical results have been investigated to describe the full dynamics of a tilted cylinder wake. For weak stratification and small tilt angle, the classical mode A found for a homogeneous fluid is still present, but for a large tilt angle, an instability appearing far from the cylinder is created. The case of a cylinder towed a very stratified fluid has been finally investigated. The dynamics is strongly modified and for moderate tilt angles, a new unstable mode appears with a structure similar to the Kelvin-Helmholtz billows (observed in the critical layer of a tilted stratified vortex), whereas for large tilt angles, another unstable mode characterized by a strong shear appears generated without a 2D von Karman structure. This reveals the rich dynamics of the cylinder wake in the presence of a stable stratification.

  8. 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

  9. Eigenmodes of misaligned unstable optical resonators with circular mirrors.

    Science.gov (United States)

    Bowers, M S

    1992-03-20

    It is shown numerically that the diffractive transverse (Fox-Li) eigenmodes supported by an unstable cavity with tilted end mirrors can be computed by expanding these modes in terms of the fully aligned (aberration-free) eigenmodes of the same cavity. Circular mirror resonators are considered in which the aligned cavity eigenmodes can be decomposed into different azimuthal components. The biorthogonality property of the aligned cavity eigenmodes is used to obtain the coefficients in the modal expansion of the misaligned modes. Results are given for two different resonators: a conventional hard-edge unstable cavity with a small tilt of the output coupler and one that uses a graded reflectivity output mirror with a small tilt of the primary mirror. It is shown that the series expansion of the misaligned modes in terms of the aligned modes converges, and the converged eigenvalues are virtually identical to those computed by using the Prony method. Symmetry considerations and other new insights into the effects of a mirror tilt on the modes of a resonator are also discussed.

  10. 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

  11. 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...

  12. 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)

  13. Some cases of terrain unstability from the Dolenjska karst area

    Directory of Open Access Journals (Sweden)

    Magda Čarman

    2010-12-01

    Full Text Available The paper presents some cases of terrain unstability from the Dolenjska karst area formed in the last yearsaround Žužemberk and Dolenjske Toplice. The Dolenjska karst has its own characteristic way of development. Themain features are thick soil top, mainly composed of clay, and high and strongly fluctuating water table. Presentedare a landslide, two rockfalls and a sinkhole collapse. A landslide nearby Žužemberk was initiated in soil top. Bothrockfalls appeared in tectonically highly disturbed carbonate rocks along the Žužemberk fault. The sinkhole collapsein the area around Dolenjske Toplice developed in tectonically damaged rocks inside the Dolenjska - Notranjskahorst and during a period of heavy rain.

  14. Neutron capture measurements on unstable nuclei at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J.L.; Haight, R.C. [LANSCE-3, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Fowler, M.M.; Miller, G.G.; Rundberg, R.S.; Wilhelmy, J.B. [CST-11, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    1999-06-01

    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. {copyright} {ital 1999 American Institute of Physics.}

  15. 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.

  16. Antisocial personality disorder--stable and unstable subtypes.

    Science.gov (United States)

    Ullrich, Simone; Coid, Jeremy

    2010-04-01

    There have been criticisms that the criteria for antisocial personality disorder (ASPD) are over-dependent on criminal behavior. This study aimed to identify unrelated criteria of social and behavioral problems and instability, and to investigate their associations in a representative household sample of adults in the UK. Approximately one third of adults with ASPD did not fulfill any of the criteria for instability. They were less aggressive and involved in illegal activities but expressed less remorse for their behaviors. Instability in ASPD was mediated primarily through comorbid anxiety disorders and borderline personality disorder. The concept of Secondary Psychopathy, which has not generally been applied to ASPD, demonstrated many similarities to the unstable subtype.

  17. 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...

  18. Breit-Wigner approximation for propagators of mixed unstable states

    CERN Document Server

    Fuchs, Elina

    2016-01-01

    For systems of unstable particles that mix with each other, an approximation of the fully momentum-dependent propagator matrix is presented in terms of a sum of simple Breit-Wigner propagators that are multiplied with finite on-shell wave function normalisation factors. The latter are evaluated at the complex poles of the propagators. The pole structure of general propagator matrices is carefully analysed, and it is demonstrated that in the proposed approximation imaginary parts arising from absorptive parts of loop integrals are properly taken into account. Applying the formalism to the neutral MSSM Higgs sector with complex parameters, very good numerical agreement is found between cross sections based on the full propagators and the corresponding cross sections based on the described approximation. The proposed approach does not only technically simplify the treatment of propagators with non-vanishing off-diagonal contributions, it is shown that it can also facilitate an improved theoretical prediction of ...

  19. 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...

  20. 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

  1. Unstable fronts and stable "critters" formed by microrollers

    CERN Document Server

    Driscoll, Michelle; Youssef, Mena; Sacanna, Stefano; Donev, Aleksandar; Chaikin, Paul

    2016-01-01

    Condensation of objects into stable clusters occurs naturally in equilibrium and driven systems. It is commonly held that potential interactions, depletion forces, or sensing are the only mechanisms which can create long-lived compact structures. Here we show that persistent motile structures can form spontaneously from hydrodynamic interactions alone with no sensing or potential interactions. We study this structure formation in a system of colloidal rollers suspended and translating above a floor, using both experiments and large-scale 3D simulations. In this system, clusters originate from a previously unreported fingering instability, where fingers pinch off from an unstable front to form autonomous "critters", whose size is selected by the height of the particles above the floor. These critters are a stable state of the system, move much faster than individual particles, and quickly respond to a changing drive. With speed and direction set by a rotating magnetic field, these active structures offer inter...

  2. Postural control responses sitting on unstable board during visual stimulation

    Science.gov (United States)

    Mizuno, Y.; Shindo, M.; Kuno, S.; Kawakita, T.; Watanabe, S.

    2001-08-01

    Concerning with the relation of vection induced by the optokinetic stimulation and the body movement, especially we attended to the neck joint movement, which counteracted to the shoulder movement. Then, we analyzed the mechanisms of the sitting postural control by using the seesaw board. By the optokinetic stimulation through the head mounted display (H.M.D.), the vection was leaded, and it affected to the sway of the body on the seesaw board. In this experiment, we found that the movement of upper part of body except for the head was the same direction to the seesaw board but the head moved out of phase to the seesaw board. This phenomenon will be suggested that the unstable condition of sway is balanced by the counter swing of head and the neck muscle tonus is controlled by acting of the vestiburo-collic reflex.

  3. 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.

  4. 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.

  5. Intervention effects of atorvastatin calcium tablets on soluble CD40 ligand and C-reactive protein in patients with cardiac angina%阿托伐他汀钙片对心绞痛患者血清可溶性CD40配体与C反应蛋白的干预研究

    Institute of Scientific and Technical Information of China (English)

    王庆玲; 杨永全

    2011-01-01

    Objective To investigate the intervention of level of atorvastatin calcium tablets (lipitor) on soluble CD40 (CD40L) and high sensitivity C-reactive protein (hs-CRP) in patients with angina.Methods 65 patients with coronary heart disease were divided into stable angina (SA group,n= 30) and unstable angina (UA group,n= 35).The vein blood was collected in the hospitalized morning,2,4,6 weeks after treatment and serum levels of hs-CRP and CD40L were measured and compared between the two groups.Results The levels of soluable CD40L [(20.52± 2.91)μg/L] and CRP [(7.96±1.69) mg/L] in UA group were higher than SA group [(7.96±-1.35) tg/L and ( 1.58 ± 0.91 ) mg/L] (t = 21.705、18.493,both P< 0.05) before treatment,and after treatment,their levels in the two groups were significantly lower than pre-treatment (P<0.01).Conclusions CD40L and hs-CRP may involved in the pathophysiology of unstable angina process and can be used as an indicator reflecting vulnerable plaque.Lipitor might enhance stability of atherosclerotic plaque and prevent acute coronary events by reducing levels of CD40L and hs-CRP.%目的 探讨阿托伐他汀钙片对心绞痛患者血清可溶性CD40配体(CD40L)与高敏C反应蛋白(hs-CRP)的干预作用.方法 65例冠心病患者,其中稳定型心绞痛患者30例(SA组),不稳定型心绞痛患者35例(UA组),所有患者于入院当天清晨、治疗后2、4、6周静脉血,测定血清hsCRP、血清可溶性CD40L水平,并对两组结果进行比较.结果 治疗前UA组血清可溶性CD40L、hs-CRP浓度分别为(20.52±2.91)μg/L、(7.96±1.69) mg/L,明显高于SA组(7.96±1.35)μg/L、(1.58±0.91) mg/L(t=21.705、18.493,均P<0.05),而两组治疗后血清可溶性CD40L、hs-CRP浓度均较治疗前明显降低(均P<0.01).结论 血清可溶性CD40L、hs-CRP参与了不稳定型心绞痛的病理生理过程,可以作为反映易损斑块的指标,阿托伐他汀钙片可通过降低血清可溶性CD40L、hs-CRP而加强粥样硬化斑块的稳定性.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Aims: In patients with stable coronary artery disease (CAD) and refractory angina we performed direct intra-myocardial injections of autologous mesenchymal stromal cells (MSCs) and followed the safety and efficacy of the treatment for 12 months. Methods and Results: A total of 31 patients with st...... follow-up demonstrated, that it was safe to culture expand MSCs and use the cells for clinical treatment. The patients maximal metabolic equivalent (MET) during exercise increased from 4.23 MET at baseline to 4.72 MET at 12 months follow-up (p...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD) and repeat coronary angiography (CAG) in stable angina pectoris (SAP) with no obstructive coronary artery disease (CAD) versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11......-, and 3-vessel disease, respectively (all Prepeat CAG with multivariable adjusted hazard ratios for patients with angiographically normal coronary arteries being 2.3(1.9-2.9), for angiographically diffuse non-obstructive CAD 5.5(4.4-6.8) and for obstructive CAD...... 6.6-9.4(range)(all Prepeat CAG compared with asymptomatic reference...

  8. 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.)

  9. 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...

  10. 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.

  11. 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

  12. Complex-Mass Definition and the Structure of Unstable Particle’s Propagator

    Directory of Open Access Journals (Sweden)

    Vladimir Kuksa

    2015-01-01

    Full Text Available The propagators of unstable particles are considered in framework of the convolution representation. Spectral function is found for a special case when the propagator of scalar unstable particle has Breit-Wigner form. The expressions for the dressed propagators of unstable vector and spinor fields are derived in an analytical way for this case. We obtain the propagators in modified Breit-Wigner forms which correspond to the complex-mass definition.

  13. Relationship Between Unstable Angina Pectoris and Biorhythm in the Aged%老年不稳定型心绞痛与生物节律相关性的探讨

    Institute of Scientific and Technical Information of China (English)

    王丽君; 宋莉明; 计惠民; 田淑芬; 王学民

    1998-01-01

    对200例老年不稳定型心绞痛(UA)病人,进行了发病时间与生物节律相关性的探讨.结果显示:200例在体力低潮期UA日平均发作人数最高,与体力高潮期和临界期日平均发生数相比,差异均有显著性(P<0.01);200例UA病人在情绪低潮期UA日平均发作人数最高,与情绪高潮期和临界期UA日平均发作人数相比,差异均有显著性(P<0.01).提示:应予针对性的护理.

  14. 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.

  15. C-Reactive Protein and Troponin T Change in Unstable Angina%不稳定性心绞痛患者C-反应蛋白与肌钙蛋白T的变化

    Institute of Scientific and Technical Information of China (English)

    张峻; 陈纪林

    2001-01-01

    目的:探讨不稳定性心绞痛患者血清C-反应蛋白(CRP)及肌钙蛋白T(TnT)的变化.方法:选择92例不稳定性心绞痛患者(实验组),28例稳定性心绞痛患者(对照组),分别取血测定CRP和TnT.结果:实验组中TnT为阳性30例(32.6%),TnT为阴性62例(67.4%);对照组则均为阴性.实验组TnT阳性患者的CRP显著高于TnT阴性患者及对照组,有非常显著性差异(P<0.001).结论:实验组约1/3可出现TnT升高,其CRP亦显著高于TnT阴性的患者,且CRP与TnT呈正的直线相关(γ=0.489,P<0.01).

  16. 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.

  17. 不稳定性心绞痛GRACE积分与冠脉造影SYNTAX积分的相关性观察%Study of the relationship between GRACE score and SYNTAX score of unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    张富; 熊尚全

    2012-01-01

    目的 探讨不稳定性心绞痛(UAP)危险分层与GRACE积分及冠脉造影SYNTAX积分的关系.方法 选取符合病例组纳入标准并经冠脉造影确诊的UAP患者122例,进行危险度分层,并记录冠脉病变情况,计算SYNTAX积分和GRACE积分.结果 UAP患者危险分层不同组间的GRACE积分与SYNTAX积分有显著性差异 (P中危组(126.77±34.46)>低危组(88.16±43.01);SYNTAX积分:高危组(25.48±7.30)>中危组(20.75±5.56)>低危组(9.45±4.02).经Pearson直线相关分析,GRACE积分与SYNTAX积分有正相关性(r=0.644,P<0.01).结论 ①UAP患者GRACE积分与SYNTAX积分在不同的危险分层组间存在统计学差异,其值均随UAP危险程度增高而升高,可一定程度上反映病情轻重.②UAP患者GRACE积分与SYNTAX积分存在一定相关性.

  18. Clinical and therapeutic profile of patients presenting with acute coronary syndromes who do not have significant coronary artery disease.The Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) Trial Investigators

    NARCIS (Netherlands)

    M.T. Roe (Matthew); A. Vahanian (Alec); R.A. Harrington (Robert Alex); D.M. Prosper; K.S. Pieper (Karen); E.J. Topol (Eric); D.L. Bhatt (Deepak); A.M. Lincoff (Michael); M.L. Simoons (Maarten); R.M. Califf (Robert); E.M. Ohman (Magnus); K. Karsch (Karl); M.M. Kitt (Michael); W. Ruzyllo (Witold); K.M. Akkerhuis (Martijn)

    2000-01-01

    textabstractBACKGROUND: A proportion of patients who present with suspected acute coronary syndrome (ACS) are found to have insignificant coronary artery disease (CAD) during coronary angiography, but these patients have not been well characterized. METHODS AND RESULTS: Of the 5767

  19. 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.

  20. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hui Zhao; Hong Liu; Lin Chai; Ping Xu; Lu Hua; Xiao-Yuan Guan; Bing Duan

    2015-01-01

    Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P < 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P < 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95% confidence interval [CO:1.020-1.054,P < 0.001) and a high GS (OR =1.087,95% CI:1.051-1.124,P < 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95% CI:0.788-0.929,P < 0.001) than that of hsCRP (AUC =0.665,95% CI:0.557-0.773,P =0.006; Z =2.9363,P < 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3%,specificity:68.2%).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  1. A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (CHD-AP) with Xin-blood stagnation syndrome (XBSS).Methods: Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine(TCM) symptoms as well as the safety of the treatment. Results: The significantly effective rate and total effective rate in the tested group were 60.06% (194/323) and 91.02% (294/323) respectively; those in improvement of TCM symptoms were 40.18% (129/321) and 75.23% (243/323) respectively, which were better than those in the control group (P<0.01). Conclusion: SYI Injection is effective and safe in treating CHD-AP-XBSS.

  2. 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

  3. Disabilities caused by unstable mutations in Costa Rica.

    Science.gov (United States)

    Cuenca, Patricia; Morales, Fernando; Castro, Isabel

    2004-09-01

    Motonic dystrophy and fragile X syndrome are two genetically determined relatively common disabilities. Both are examples of a new type of mutation mechanism called unstable or dynamic mutations, triple repeats expansions or DNA amplification. Fragile X syndrome is recognized as the main cause of hereditary mental retardation and myotonic dystrophy is considered the most common muscular dystrophy of adults. This is a prospective non randomized study of clinically affected people, in order to confirm the diagnosis with molecular techniques (Southern blot and PCR) and to perform cascade screening of the rest of the family to offer them adequate genetic counseling. We were able to corroborate the initial diagnosis in most clinical cases of myotonic dystrophy, but in the cases of mental retardation more than half studies were negative for fragile X syndrome, stressing the difficulties encountered by medical practitioners to diagnose this syndrome. The reasons for this are several; probable the main culprit is the subtle and unspecific clinical picture affected individuals exhibit, particularly children before puberty. Cascade screening, genetic counseling and selective abortion are the only tools available to prevent these disabling diseases for the moment. PMID:17361543

  4. 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...

  5. 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.

  6. 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...

  7. Survival of habitable planets in unstable planetary systems

    Science.gov (United States)

    Carrera, Daniel; Davies, Melvyn B.; Johansen, Anders

    2016-09-01

    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 these scatterings may also cause habitable planets in interior orbits to become ejected, destroyed, or be transported out of the habitable zone. 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. Equal-mass planetary systems are far more destructive than systems with giant planets of unequal masses. We also establish a link with observation; we find that giant planets with present-day eccentricities higher than 0.4 almost never have a habitable interior planet. For a giant planet with an present-day eccentricity of 0.2 and semimajor axis of 5 AU orbiting a Sun-like star, 50% of the orbits in the habitable zone are resilient to the instability. As semimajor axis increases and eccentricity decreases, a higher fraction of habitable planets survive and remain habitable. However, if the habitable planet has rocky siblings, there is a significant risk of rocky planet collisions that would sterilize the planet.

  8. 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.

  9. 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.

  10. Dead discs, unstable discs and the stars they surround

    Directory of Open Access Journals (Sweden)

    D’Angelo Caroline

    2014-01-01

    Full Text Available Strong stellar magnetic fields significantly alter the behaviour of surrounding accretion discs. Recent work has demonstrated that at low accretion rates a large amount of mass can remain confined in the disc, contrary to the standard assumption that the magnetic field will expel the disc in an outflow (the “propeller regime”. These “dead discs” often become unstable, causing cycles of accretion onto the central star. Here I present the main predictions of this model, and argue that it provides a good explanation for the peculiar behaviour seen in several accreting sources with strong magnetic fields. I will focus in particular on three accreting millisecond X-ray pulsars: SAX J1808.4-3658, NGC 6440 X-2 and IGR J00291+5934. These sources all show low-frequency quasi-periodic oscillations consistent with a variable accretion rate, as well as unusual outburst patterns that suggest gas is confined in the inner disc regions during quiescence.

  11. 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.

  12. 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.

  13. Quantitative comparison of cellular patterns of stable and unstable mixtures

    Science.gov (United States)

    Zhao, H.; Lee, J. H. S.; Lee, J.; Zhang, Y.

    2016-09-01

    This study describes a comparison of smoked foils from five different mixtures ({{C}}2{{H}}2+2.5{{O}}2+85 %{{Ar}}, 2{{H}}2+{{O}}2+50 %{{Ar}}, {{C}}2{{H}}2+2.5{{O}}2+70 %{{Ar}}, {C}2{{H}}2+5{{N}}2{{O}}, and {{CH}}4+2{{O}}2) that produced transverse waves of regular and irregular spacing. Histograms, variance, and the autocorrelation function (ACF) were used to quantify the spacing irregularity. Each smoked foil was first digitized then separated into left-running and right-running waves for subsequent analysis. The five mixtures showed different degrees of irregularity in the analysis of the histograms and the ACF of the spacing of the transverse waves. The dominant mode was readily found from the peak in the histogram and the first peak in the ACF result. The spacing of the main transverse waves provided by the histogram and the first peak of the ACF were much closer to the spacing of the transverse waves measured by eye for stable mixtures than for unstable ones due to their stronger dominant mode. In certain cases, other modes besides the dominant one were observed, such as two peaks in the histogram and other large peaks in the ACF result. Variance was used as a quantitative measurement of the cellular pattern irregularity level.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. Predictive value of local and core laboratory echocardiographic assessment of cardiac function in patients with chronic stable angina: The ACTION study

    NARCIS (Netherlands)

    A.M. Dart (Anthony); J.E. Otterstad (Jan Erik); B.A. Kirwan (Bridget Anne); J.D. Parker (John); S. de Brouwer (Sophie); P. Poole-Wilson (Philip); J. Lubsen (Jacobus)

    2007-01-01

    textabstractAims: To evaluate the relationship between echocardiographic cardiac function and outcome in patients with stable symptomatic angina. Methods: Baseline echo left ventricular ejection fraction and volume data measured in a central laboratory was available for 7016 patients (92% of the tot

  19. 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

  20. 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...

  1. [Dengzhan Xixin injection as an adjuvant treatment for angina pectoris: a systematic review and Meta-analysis of randomized controlled trials].

    Science.gov (United States)

    Wang, Feng-jiao; Xie, Yan-ming; Liao, Xing; Jia, Min

    2015-08-01

    The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P < 0.000 010 and electrocardiogram curative effect (OR = 2.21; 95% CI; [1.83, 2.68]; P < 0.000 010. Funnel figure seemed that there was publication bias. The current limited evidence showed that when compared with the control group, treatment group was superior in improving patients with angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.

  2. Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery

    NARCIS (Netherlands)

    Jessurun, GAJ; Tio, RA; De Jongste, MJL; Hautvast, RWM; Den Heijer, P; Crijns, HJGM

    1998-01-01

    To study the effect of transcutaneous electrical nerve stimulation (TENS) on coronary vasomotion, patients with New York Heart Association class III angina pectoris and significant single-vessel left coronary artery disease and who were also scheduled for elective percutaneous transluminal coronary

  3. beta-blocker Therapy is Not Associated with Reductions in Angina or Cardiovascular Events After Coronary Artery Bypass Graft Surgery : Insights from the IMAGINE Trial

    NARCIS (Netherlands)

    Booij, Harmen G.; Damman, Kevin; Warnica, J. Wayne; Rouleau, Jean L.; van Gilst, Wiek H.; Westenbrink, B. Daan

    2015-01-01

    To evaluate whether beta-blockers were associated with a reduction in cardiovascular events or angina after Coronary Artery Bypass Graft (CABG) surgery, in otherwise stable low-risk patients during a mid-term follow-up. We performed a post-hoc analysis of the IMAGINE (Ischemia Management with Accupr

  4. 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

    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...... associated with angina pectoris among 4573 middle-aged Danish men and women free of heart disease at baseline in 2000. Results Nine per cent experienced onset of symptoms of angina pectoris. A higher degree of excessive demands or worries from the social relations was associated with increased risk of angina...... 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...

  5. 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.)

  6. 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.)

  7. Possible Emission of Cosmic $X$-- and $\\gamma$--rays by Unstable Particles at Late Times

    CERN Document Server

    Urbanowski, K

    2014-01-01

    Not all astrophysical mechanisms of the emission of electromagnetic radiation including $X$-- and $\\gamma$-- rays coming from the space are clear. We find that charged unstable particles as well as neutral unstable particles with non--zero magnetic moment which live sufficiently long may emit electromagnetic radiation. This new mechanism is connected with the properties of unstable particles at the post exponential time region. Analyzing the transition time region between exponential and non-exponential form of the survival amplitude it is found that the instantaneous energy of the unstable particle can take very large values, much larger than the energy of this state for times from the exponential time region. Basing on the results obtained for the model considered, it is shown that this purely quantum mechanical effect may be responsible for causing unstable particles to emit electromagnetic--, $X$-- or $\\gamma$--rays at some time intervals from the transition time regions.

  8. Understanding the Role of Autoimmune Disorders on the Initial Presentation of Cardiovascular Disease

    Science.gov (United States)

    2015-04-20

    Myocardial Infarction; Ischemic Stroke; Stroke; Subarachnoid Haemorrhage; Venous Thrombosis; Transient Ischemic Attack; Stable Angina Pectoris; Unstable Angina; Heart Failure; Peripheral Arterial Disease; Abdominal Aortic Aneurysm

  9. The clinical observation of the effect of music therapy combined with routine western medicine on unstable%常规西医配合音乐疗法治疗不稳定型心绞痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    王雪艳; 王志永; 杜清茂

    2011-01-01

    Objective To explore the effect of music therapy combined with routine westem medicine on unstable angina. Methods One hundred twenty - two patients with unstable angina were randomly divided into music treatment group and control group, 61 patients in each group. Treatment group was given music therapy on the basis of routine western medicine. The two groups were compared with clinical symptoms, ECG performance, heart rate variability and biochemical indicators after two weeks. Results The improvements of angina pectoris and ECG in treatment group were better than those in the control group ( P < 0.05 ). There were significant differences between two groups on references indexes of heart rate variability among SDNN, SDANN, RMSSD and pNN50 within 24 h ( P <0.01 ). There was obvious difference between two groups on the standard deviation of the average among continuously 5min segment oardiac within 24 h ( P < 0.05 ). There were significant differences between two groups on the clinical and biochemical indicators of fibrinogen, plasma viscosity and serum creatinine after treatment ( P < 0. 01 ). Total exercise time and ST segment depression rate of Treadmill test in the treatment group were significantly changed in comparison with those in control group after treatment ( P < 0. 05 ). Conclusion The music therapy can improve the symptoms and related supplementary tests of the patients with unstable angina.%目的 观察常规西医配合音乐疗法治疗不稳定型心绞痛的临床疗效.方法 将122例不稳定型心绞痛患者随机分为干预组和对照组,各61例.对照组子常规西医治疗,干预组在对照组治疗基础上予播放音乐.2组均7 d为1个疗程,2个疗程后观察心绞痛疗效、心电图疗效、心率变异性、生化指标及临床运动平板试验检查结果.结果 干预组心绞痛疗效、心电图疗效均优于对照组(P50 ms的个数所占该时间总心搏数的百分比(pNN50)及24 h内连续5 min节段

  10. Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.

    Science.gov (United States)

    Stillman, Arthur E; Gatsonis, Constantine; Lima, João A C; Black, William C; Cormack, Jean; Gareen, Ilana; Hoffmann, Udo; Liu, Tao; Mavromatis, Kreton; Schnall, Mitchell D; Udelson, James E; Woodard, Pamela K

    2016-09-01

    RESCUE is a phase III, randomized, controlled, multicenter, comparative efficacy study, designed to compare two diagnostic imaging/treatment paradigms that use coronary computed tomography angiography (CCTA) or single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) for assisting in the diagnosis of ischemic heart disease in patients with stable angina symptoms, and guiding subsequent treatment. The study is based on the hypothesis that CCTA as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with SPECT MPI. The RESCUE trial was funded by the Agency for Healthcare Research and Quality (AHRQ) and the American College of Radiology Imaging Network (ACRIN) Fund for Imaging Innovation, began in 2011, and completed in 2014. PMID:27595676

  11. The pro- and anti-inflammatory markers in patients with acute myocardial infarction and chronic stable angina.

    Science.gov (United States)

    Wojakowski, Wojciech; Maslankiewicz, Katarzyna; Ochala, Andrzej; Wyderka, Rafal; Zuk-Popiolek, Izabela; Flak, Zbigniew; Mroz, Iwona; Tendera, Michal

    2004-08-01

    The aim of this study was to assess the plasma levels of VEGF and interleukin-10 in patients with acute myocardial infarction (AMI) and stable chronic angina (SA) and correlate the values with traditional CHD risk factors, left ventricular ejection fraction (LVEF) and established inflammatory marker hsCRP. Fifty patients with AMI and 30 with SA were enrolled. IL-10 levels in AMI patients were lower than in SA patients (9.81 +/- 5.0 versus 22.63 +/- 8.38 pg/ml, p 40% and Killip class I-II (338.8 +/- 51.59 versus 271.8 +/- 50.51 pg/ml; p 6 h versus inflamatory markers and CHD risk factors and the function of the left ventricle on admission.

  12. [Results of combined therapy of stable 2-3 FC angina of effort with metabolic syndrome including metformin].

    Science.gov (United States)

    Dashdamirov, R L

    2014-01-01

    The aim of the study was to evaluate results of combined therapy of stable 2-3 FC angina of effort with metabolic syndrome including metformin. Group 1 was comprised of 71 patients (38 (53.3%) men and 33 (46.5%) women), group 2 consisted of 57 patients treated with isosorbid-5 mononitrate (40 mg/d + amlodipin (5 mg/d) + eprosartan (600 mg/d) + thrombo ASS (100 mg/d) + carvedilol (25 mg/d) + atorvastatin (20 mg/d). Effects of the treatment were assessed 3, 6, and 12 months after its onset. At the end of the study, fasting blood glucose, total cholesterol, triglyceride, and low density lipoproteide levels decreased by 12.8, 10.9, 12.9 and 13.6% respectively compared with the initial values (p physical load increased by 22.7%. PMID:25980297

  13. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  14. A literature review to evaluate the economic value of ranolazine for the symptomatic treatment of chronic angina pectoris.

    Science.gov (United States)

    Vellopoulou, Katerina; Kourlaba, Georgia; Maniadakis, Nikos; Vardas, Panagiotis

    2016-05-15

    To conduct a systematic review of the evidence regarding the economic value of ranolazine relative to standard-of-care (SOC) for the treatment of symptomatic chronic stable angina (CSA). Electronic databases were searched using relevant keywords. The identified studies were independently reviewed by two investigators against pre-determined inclusion and exclusion criteria. Their data were extracted using a relevant form and consequently were synthesized. Studies were also evaluated using the Quality of Health Economic Studies scale. The main outcomes considered were the cost and effectiveness for each comparator and the incremental cost per quality-adjusted-life year (QALY) gained. Six studies were included in the review. Five of these assessed the cost-utility of ranolazine added to SOC, compared to SOC alone, using decision trees or Markov models whereas one was a retrospective cost evaluation study. The analysis was conducted from a payer perspective in five studies and from a societal perspective in one study with the time horizon varying between six months and a year. The incremental cost-effectiveness ratio (ICER), ranged from €4000 to €15,000 per QALY gained. Ranolazine appears to be dominant or cost-effective, mainly due to its ability to decrease angina-related hospitalizations and also due to a marginal improvement in quality of life. The acquisition cost of ranolazine was the variable with the greatest impact upon the ICER. The existing evidence, although limited, indicates that ranolazine may be a dominant or cost-effective therapy option, for the treatment of patients with symptomatic CSA. Further research is required to evaluate the cost-effectiveness of ranolazine. PMID:26994453

  15. Evaluation of pharmacokinetics and pharmacodynamics relationships for Salvianolic Acid B micro-porous osmotic pump pellets in angina pectoris rabbit

    Directory of Open Access Journals (Sweden)

    Shu-Ling Kan

    2014-06-01

    Full Text Available The work aims to investigate the in vitro release, pharmacokinetics (PK, pharmacodynamics (PD and PK–PD relationships of Salvianolic Acid B micro-porous osmotic pump pellets (SalB-MPOPs in angina pectoris New Zealand White (NZW rabbits, compared with those of SalB immediate-release pellets (SalB-IRPs. The SalB plasma concentrations and Superoxide dismutase levels (PD index were recorded continuously at predetermined time interval after administration, and the related parameters were calculated by using WinNonlin software. The release profile of MPOPs was more sustained than that of IRPs. PK results indicated that the mean Cmax was significantly lower, the SalB plasma concentrations were steadier, both area under concentration-time curve from 0 to 24 h (AUC0–24 h and from 0 to infinity (AUC0–∞ were presented larger, and both the peak concentration time (Tmax and mean residence time (MRT were prolonged for MPOPs, as compared with those of IRPs. PD results suggested that peak drug effect (Emax was lower and the equilibration rate constant (ke0 between the central compartment and the effect compartment was higher of MPOPs vs. those of IRPs. PK–PD relationships demonstrated that the effect-concentration-time (ECT course of MPOPs was clockwise hysteresis loop, and that of IRPs was counter-clockwise hysteresis loop. Collectively, those results demonstrated that MPOPs were potential formulations in treating angina pectoris induced by atherosclerosis.

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

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez Sotelo

    2002-12-01

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

  17. Recent advances in the management of chronic stable angina I: Approach to the patient, diagnosis, pathophysiology, risk stratification, and gender disparities

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-07-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas 77054 USAAbstract: The potential importance of both prevention and personal responsibility in ­controlling heart disease, the leading cause of death in the USA and elsewhere, has attracted renewed ­attention. Coronary artery disease is preventable, using relatively simple and inexpensive lifestyle changes. The inexorable rise in the prevalence of obesity, diabetes, dyslipidemia, and ­hypertension, often in the risk cluster known as the metabolic syndrome, drives the ­ever-increasing incidence of heart disease. Population-wide improvements in personal health habits appear to be a fundamental, evidence based public health measure, yet numerous barriers prevent implementation. A common symptom in patients with coronary artery disease, classical angina refers to the typical chest pressure or discomfort that results when myocardial oxygen demand rises and coronary blood flow is reduced by fixed, atherosclerotic, obstructive lesions. Different forms of angina and diagnosis, with a short description of the significance of pain and silent ischemia, are discussed in this review. The well accepted concept of myocardial oxygen imbalance in the genesis of angina is presented with new data about clinical pathology of stable angina and acute coronary syndromes. The roles of stress electrocardiography and stress myocardial perfusion scintigraphic imaging are reviewed, along with the information these tests provide about risk and prognosis. Finally, the current status of gender disparities in heart disease is summarized. Enhanced risk stratification and identification of patients in whom procedures will meaningfully change management is an ongoing quest. Current guidelines emphasize efficient triage of patients with suspected coronary artery disease. Many experts believe the predictive value of current decision protocols for coronary artery disease still needs improvement in order to

  18. 催眠针法治疗心绞痛的疗效及血浆ET、NO改变的研究%A Study on Hypnotic Acupuncture Therapy for Angina Pectoris and Its Effects on Plasma ET and NO

    Institute of Scientific and Technical Information of China (English)

    李献; 郑强荪; 宋胜云; 高军军; 尼珍; 袁秀兰; 张录兴

    2002-01-01

    Objective: To evaluate the treatment effects of hypnotic acupuncture therapy on angina pectoris. Methods: 40 cases of angina pectoris treated by hypnotic acupuncture therapy were compared with 31 cases of angina pectoris treated by pure acupuncture. Results: Symptom relief rate and change of ECG were found to be more desirable in the Hypnotic acupuncture therapy group than in the pure acupuncture group (P<0.01,P<0.05). Pre-post treatment comparisons on levels of anxiety, depression, ET and NO also showed that hypnotic acupuncture therapy was superior to the pure acupuncture group (P<0.05).Conclusion:The present study provides strong support for hypnotic acupuncture therapy for angina pectoris, in terms of its treatment effects on both mental and physical improvement.

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

    Directory of Open Access Journals (Sweden)

    Luís Alberto Oliveira Dallan

    2008-03-01

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

  20. Percutaneous pedicle screw for unstable spine fractures in polytraumatized patients: A report of two cases

    Directory of Open Access Journals (Sweden)

    Boon Beng Tan

    2012-01-01

    Full Text Available Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS. We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.

  1. Influences of basic flow on unstable excitation of intraseasonal oscillation in mid-high latitudes

    Institute of Scientific and Technical Information of China (English)

    李崇银; 曹文忠; 李桂龙

    1995-01-01

    The influences of basic flow fields on the unstable excitation of the intraseasonal atmosphericoscillation in the mid-high latitudes are studied by using a simple nonlinear dynamical model.The results showthat the westerly profile has an important effect on unstable modes in the atmosphere;the growth rates andspectrum distributions of the excited unstable modes are different for the different profiles.For the usualwesterly profile patterns in the real atmosphere,the most unstable mode is in the intraseasonal(30—60 d)frequency band.The local intensity and meridional gradient of the westerlies also clearly affect unstablemodes.The consistency of the results in observational data analyses with that in dynamical theory proved thecorrectness and rationalization of the above-mentioned results.

  2. Two degree of freedom control scheme for unstable processes with small time delay.

    Science.gov (United States)

    Ajmeri, Moina; Ali, Ahmad

    2015-05-01

    In this work, a recently reported two degree of freedom control structure namely the Parallel Control Structure (PCS) is modified to achieve improved control performance for unstable processes. New tuning rules are proposed using a direct synthesis approach for unstable first order plus time delay (UFOPTD), unstable second order plus time delay (USOPTD) and integrating and unstable plus time delay (IUPTD) process models. The proposed method has two tuning parameters whose suitable values are recommended after studying their effect on the system performance and robustness. This is an advantage of the present work over the other reported control schemes where the authors provide suitable ranges of the tuning parameters values. Simulation examples show that the present scheme results in improved nominal and perturbed responses as compared to the recently reported methods. Also it is observed that satisfactory performance is achieved when the proposed tuning rules are applied on an isothermal chemical reactor which exhibits multiple steady state solutions. PMID:25617941

  3. Asymptotic behavior of CLS estimator of autoregressive parameter for nonprimitive unstable INAR(2) models

    CERN Document Server

    Barczy, Matyas; Pap, Gyula

    2010-01-01

    In this paper the asymptotic behavior of conditional least squares estimators of the autoregressive parameter for nonprimitive unstable integer-valued autoregressive models of order 2 (INAR(2)) is described.

  4. Circumferential wires as a supplement to intramedullary nailing in unstable trochanteric hip fractures

    DEFF Research Database (Denmark)

    Ban, Ilija; Birkelund, Lasse; Palm, Henrik;

    2012-01-01

    Fixation of unstable trochanteric fractures is challenging. Application of a circumferential wire may facilitate bone contact and avoid postoperative fracture displacement. However, the use of circumferential wires remains controversial due to possible disturbance of the blood supply to the under...

  5. Monitoring cardiac output during hyperbaric oxygen treatment of haemodynamically unstable patients

    DEFF Research Database (Denmark)

    Hansen, Marco Bo; Treschow, Frederik; Skielboe, Martin;

    2013-01-01

    Patients suffering from necrotizing fasciitis (NF) are often haemodynamically unstable and require extended monitoring of cardiovascular parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring...

  6. Experiments in nonlinear dynamics using control-based continuation: Tracking stable and unstable response curves

    DEFF Research Database (Denmark)

    Bureau, Emil; Schilder, Frank; Santos, Ilmar;

    2014-01-01

    We show how to implement control-based continuation in a nonlinear experiment using existing and freely available software. We demonstrate that it is possible to track the complete frequency response, including the unstable branches, for a harmonically forced impact oscillator.......We show how to implement control-based continuation in a nonlinear experiment using existing and freely available software. We demonstrate that it is possible to track the complete frequency response, including the unstable branches, for a harmonically forced impact oscillator....

  7. Control of unstable steady states by time-delayed feedback methods

    OpenAIRE

    Hoevel, P.; Schoell, E.

    2005-01-01

    We show that time-delayed feedback methods, which have successfully been used to control unstable periodic ortbits, provide a tool to stabilize unstable steady states. We present an analytical investigation of the feedback scheme using the Lambert function and discuss effects of both a low-pass filter included in the control loop and non-zero latency times associated with the generation and injection of the feedback signal.

  8. Role of proximal femur locking plate fixation in certain unstable trochanteric fractures

    OpenAIRE

    Jambu Nageswaran; Senthil Loganathan; Ganesan Ganesan Ram; Sumesh S; Samuel Chittaranjan

    2015-01-01

    Background: Comminution of the lateral trochanteric wall, postero-medial communition, reverse oblique fractures, fractures involving communition of greater trochanter are unstable fractures which had poor results with the regular methods of fixation. Our aim in this study is to evaluate radiological and functional outcome at the end of one year following proximal femur locking plate fixation for certain group of unstable intertrochanteric fractures. Methods: 20 patients (14 male and 6 fema...

  9. Is there a difference in the positioning of sliding screws between stable and unstable extracapsular fractures?

    OpenAIRE

    Pedro José Labronici; Rodrigo Freitas da Silva; Ana Maria Santos Viana; Saulo Santos Blunck; José Sergio Franco; Sergio Ricardo Neto; Robinson Esteves Santos Pires; Roberto Canto

    2015-01-01

    OBJECTIVE: To analyze the tip-apex distance (TAD), cervicodiaphyseal angle and Garden angle in stable and unstable extracapsular fractures of the femur treated with a plate and sliding screw.METHOD: Hip radiographs in anteroposterior (AP) and lateral view on 117 patients were evaluated. The fractures were classified as stable or unstable, using the AO classification, and the reduction achieved was assessed in accordance with the following criteria: TAD > 3 cm; Garden alignment index (AP) < 16...

  10. Effects of core strength training using stable versus unstable surfaces on physical fitness in adolescents

    OpenAIRE

    Granacher, Urs; Schellbach, Jörg; Klein, Katja; Prieske, Olaf; Baeyens, Jean-Pierre; Muehlbauer, Thomas

    2014-01-01

    Background It has been demonstrated that core strength training is an effective means to enhance trunk muscle strength (TMS) and proxies of physical fitness in youth. Of note, cross-sectional studies revealed that the inclusion of unstable elements in core strengthening exercises produced increases in trunk muscle activity and thus provide potential extra training stimuli for performance enhancement. Thus, utilizing unstable surfaces during core strength training may even produce larger pe...

  11. Geometry and kinematics of the fault systems controlling the unstable flank of Etna volcano (Sicily)

    OpenAIRE

    Azzaro, R.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Catania, Catania, Italia; Bonforte, A.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Catania, Catania, Italia; Branca, S.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Catania, Catania, Italia; Guglielmino, F.; Istituto Nazionale di Geofisica e Vulcanologia, Sezione Catania, Catania, Italia

    2013-01-01

    An updated tectonic framework of Etna's unstable flank has been defined as a result of multidisciplinary analyses carried out by integrating geological and geophysical data. The different typologies of datasets have been analyzed and correlated in order to constrain the geometry and kinematics of the fault systems controlling the unstable flank of Etna volcano and to better understand their complex relationship with the offshore morphostructures of the continental margin. In particular, we ha...

  12. UNSTABLE FEMORAL FRACTURES TREATED WITH TITANIUM ELASTIC INTRAMEDULLARY NAILS, IN CHILDREN

    OpenAIRE

    Soni, Jamil Faissal; Schelle, Gisele; Valenza, Weverley; Pavelec, Anna Carolina; Souza, Camila Deneka Arantes

    2015-01-01

    Objective: To evaluate the indications, epidemiology, associated lesions, complications and prognosis among children with unstable femoral diaphysis fractures who were treated with titanium elastic intramedullary nails. Method: This was a retrospective analysis on 24 patients aged 5-12 years with unstable femoral diaphysis fractures who underwent surgical treatment with elastic titanium intramedullary nails at the Cajuru University Hospital, Curitiba-PR, between April 2002 and March 2008, wit...

  13. Second mode unstable disturbance measurement of hypersonic boundary layer on cone by wavelet transform

    Institute of Scientific and Technical Information of China (English)

    Jian Han; Nan Jiang; Yan Tian

    2011-01-01

    Experimental investigation of hypersonic boundary layer instability on a cone is performed at Mach number 6 in a hypersonic wind tunnel. Time series signals of instantaneous fluctuating surface-thermal-flux are measured by Pt-thin-film thermocouple temperature sensors mounted at 28 stations on the cone surface in the streamwise direction to investigate the development of the unstable disturbance.Wavelet transform is employed as a mathematical tool to obtain the multi-scale characteristics of fluctuating surfacethermal-flux both in the temporal and spectrum space. The conditional sampling algorithm using wavelet coefficient as an index is put forward to extract the unstable disturbance waveform from the fluctuating surface-thermal-flux signals.The generic waveform for the second mode unstable disturbance is obtained by a phase-averaging technique. The development of the unstable disturbance in the streamwise direction is assessed both in the temporal and spectrum space.Our study shows that the local unstable disturbance detection method based on wavelet transformation offers an alternative powerful tool in studying the hypersonic unstable mode of laminar-turbulent transition. It is demonstrated that, at hypersonic speeds, the dominant flow instability is the second mode, which governs the course of laminar-turbulent transition of sharp cone boundary layer.

  14. Unstable infiltration fronts in porous media on laboratory scale

    Science.gov (United States)

    Schuetz, Cindi; Neuweiler, Insa

    2014-05-01

    Water flow and transport of substances in the unsaturated zone are important processes for the quality and quantity of water in the hydrologic cycle. The water movement through preferential paths is often much faster than standard models (e. g. Richards equation in homogeneous porous media) predict. One type/phenomenon of preferential flow can occur during water infiltration into coarse and/or dry porous media: the so-called gravity-driven fingering flow. To upscale the water content and to describe the averaged water fluxes in order to couple models of different spheres it is necessary to understand and to quantify the behavior of flow instabilities. We present different experiments of unstable infiltration in homogeneous and heterogeneous structures to analyze development and morphology of gravity-driven fingering flow on the laboratory scale. Experiments were carried out in two-dimensional and three-dimensional sand tanks as well as in larger two-dimensional sand tanks with homogeneous and heterogeneous filling of sand and glass beads. In the small systems, water content in the medium was measured at different times. We compare the experiments to prediction of theoretical approaches (e.g. Saffman and Taylor, 1958; Chuoke et al., 1959; Philip 1975a; White et al., 1976; Parlange and Hill, 1976a; Glass et al., 1989a; Glass et al., 1991; Wang et al., 1998c) that quantify properties of the gravity-driven fingers. We use hydraulic parameters needed for the theoretical predictions (the water-entry value (hwe), van Genuchten parameter (Wang et al., 1997, Wang et al., 2000) and saturated conductivity (Ks), van Genuchten parameter (Guarracino, 2007) to simplify the prediction of the finger properties and if necessary to identify a constant correction factor. We find in general that the finger properties correspond well to theoretical predictions. In heterogeneous settings, where fine inclusions are embedded into a coarse material, the finger properties do not change much

  15. [Relations of the duration of pre-existing angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction].

    Science.gov (United States)

    Juillière, Y; Danchin, N; Grentzinger, A; Suty-Selton, C; Perrin, O; Guenoun, P; Pernot, C; Cherrier, F

    1990-10-01

    The aim of this retrospective study was to determine the relationship between the duration of preceding angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction. Coronary angiography of 138 consecutive patients showed isolated and complete occlusions of the left anterior descending (58 patients) or right coronary artery (80 patients). One hundred and four patients had myocardial infarction with (Group A, n = 21) or without (Group B, n = 83) preceding angina pectoris and 34 had angina without myocardial infarction (Group C). The left ventricular ejection fraction was measured by ventriculography in the 30 degrees right anterior oblique projection. The collateral circulation was assessed by coronary angiography and evaluated as follows: no flow or flow limited to collateral branches (subgroup 1) and partial or complete filling of the epicardial arterial segment (subgroup 2). In the global population the left ventricular ejection fraction was higher and the duration of preceding angina pectoris was longer in the subgroups with a well developed collateral circulation. There was no difference in ejection fraction between Groups A and B (presence of myocardial infarction), on the other hand, within each of the groups, a good collateral circulation (subgroup 2) was associated with a significantly higher ejection fraction. Group C (without infarction) patients had better ejection fractions than Groups A or B, especially when the collateral circulation was poorly developed. Within Group C, the quality of the collateral circulation did not seem to affect the ejection fraction. The left ventricular ejection fraction is lower in patients with isolated coronary occlusion and myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation

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    Ivanović Miloš

    2013-01-01

    Full Text Available Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS. Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability. Objective. Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound - Virtual Histology in patients with stable angina and subjects in acute phase of ACS without ST segment elevation. Methods. The study comprised of 40 patients who underwent preintervention IVUS examination. Tissue maps were reconstructed from radio frequency data using IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions, while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions. In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs. 0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05 respectively. Conclusion. IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.

  17. Comparative study between patients with infarction and angina about the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility

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    Bakella P.

    2010-10-01

    Full Text Available Background: To examine the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility between patients with infarction and angina. Method: Subjects were 104 patients with infarction or angina, who completed the Hostility and Direction of Hostility Questionnaire, the Symptom Checklist-90-R, Cardiac Anxiety Questionnaire, the Pain Anxiety Symptoms Scale-20 and the Fear of Pain Questionnaire – III. Results: For all patients higher levels of fear and anxiety of pain, heart-focused anxiety psychopathology, and a tendency to develop a hostile attitude were observed. For angina group higher levels of fearfull thinking and total PASS-20, avoidance CAQ, somatization and anxiety (SCL-90. In addition, all patients were found to be significantly correlated (P< .005 with sex, fearfull PASS-20, physiological responses PASS-20, total PASS-20, avoidance CAQ, somatization SCL-90, anxiety SCL-90 Conclusion: There is a variety of general factors that may promote the development of cardiophobia. These processes are likely nonspecific in the sense that they increase the chance of negative emotional responding and poor affect regulatory strategies. For persons exposed to cardiac-related illnesses or persons who model the potential dangers of cardiac-related sensations, there may be an enhanced specificity to that general vulnerability.

  18. Effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Liang Wen; Yi Xie; Xian-Jun Wu; Rui-Feng Wang; Jian Cao

    2016-01-01

    Objective:To analyze the effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris. Methods:A total of 98 cases of coronary heart disease patients with stable angina pectoris who received treatment in our hospital from March 2014 to August 2015 were selected as research subjects and randomly divided into observation group 49 cases and control group 49 cases. Control group received conventional clinical treatment, observation group received folic acid adjuvant therapy, and then differences in levels of Hcy, lipid metabolism, endothelial injury and adhesion molecules were compared between two groups after treatment. Results:Hcy, TC, LDL-C and ApoB values of observation group were lower than those of control group while HDL-C and ApoA1/ApoB values were higher than those of control group;Flow-vel and FMD values of observation group after treatment were higher than those of control group;serum E-selectin, ICAM-1, VCAM-1 and sICAM-1 values of observation group after treatment were lower than those of control group. Conclusion:Folic acid adjuvant therapy for coronary heart disease patients with stable angina pectoris can reduce plasma Hcy level and optimize lipid metabolism, further protects vascular endothelium, and has positive clinical significance.

  19. Stable or unstable tear of the anterior cruciate ligament of the knee: an MR diagnosis?

    International Nuclear Information System (INIS)

    To determine the usefulness of magnetic resonance (MR) imaging to distinguish stable from unstable tears of the anterior cruciate ligament (ACL) of the knee. MR images of 97 patients with surgically confirmed ACL tear were retrospectively reviewed. According to arthroscopic and clinical examination, these patients had 36 stable and 61 unstable (9 partial and 52 complete) ACL tears. MR images were interpreted by two blinded reviewers and scored with respect to previously reported primary and secondary MR signs of ACL injury. Based on a comprehensive assessment of all the MR findings, ACLs were categorized as being stable or unstable. MR accuracy was calculated considering only primary MR signs and considering both primary and secondary MR signs of ACL injury, separately. Accuracy of each individual primary and secondary MR sign was calculated. Considering only primary MR signs, sensitivity, specificity, and accuracy of MR were 77, 92, and 82%, respectively. Considering both primary and secondary MR signs, sensitivity, specificity, and accuracy of MR were 59, 81, and 67%, respectively. Of all MR signs, discontinuity and abnormal orientation had highest test accuracy (79 and 87%, respectively). Anterior tibial translation, uncovering of the posterior horn of the lateral meniscus, and hyperbuckled PCL were only seen in unstable ACLs (specificity 100%), but these secondary findings had low sensitivity (23%). Bone contusion around the lateral knee compartment was seen in both unstable and stable ACLs (accuracy 64%). Previously reported MR imaging signs do not allow accurate distinction between clinically stable and unstable ACL injuries. Anterior tibial translation, uncovering of the posterior horn of the lateral meniscus, and hyperbuckled PCL, if present, are helpful signs in the diagnosis of an unstable tear. The presence of bone marrow edema around the lateral knee compartment is not predictive of ACL insufficiency. (orig.)

  20. Stable or unstable tear of the anterior cruciate ligament of the knee: an MR diagnosis?

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    Dyck, Pieter van; Gielen, Jan L.; Parizel, Paul M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Edegem (Belgium); Vanhoenacker, Filip M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Edegem (Belgium); AZ St-Maarten Duffel/Mechelen, Department of Radiology, Duffel (Belgium); Wouters, Kristien [University Hospital Antwerp and University of Antwerp, Department of Scientific Coordination and Biostatistics, Edegem (Belgium); Dossche, Lieven [University Hospital Antwerp and University of Antwerp, Department of Orthopedics, Edegem (Belgium)

    2012-03-15

    To determine the usefulness of magnetic resonance (MR) imaging to distinguish stable from unstable tears of the anterior cruciate ligament (ACL) of the knee. MR images of 97 patients with surgically confirmed ACL tear were retrospectively reviewed. According to arthroscopic and clinical examination, these patients had 36 stable and 61 unstable (9 partial and 52 complete) ACL tears. MR images were interpreted by two blinded reviewers and scored with respect to previously reported primary and secondary MR signs of ACL injury. Based on a comprehensive assessment of all the MR findings, ACLs were categorized as being stable or unstable. MR accuracy was calculated considering only primary MR signs and considering both primary and secondary MR signs of ACL injury, separately. Accuracy of each individual primary and secondary MR sign was calculated. Considering only primary MR signs, sensitivity, specificity, and accuracy of MR were 77, 92, and 82%, respectively. Considering both primary and secondary MR signs, sensitivity, specificity, and accuracy of MR were 59, 81, and 67%, respectively. Of all MR signs, discontinuity and abnormal orientation had highest test accuracy (79 and 87%, respectively). Anterior tibial translation, uncovering of the posterior horn of the lateral meniscus, and hyperbuckled PCL were only seen in unstable ACLs (specificity 100%), but these secondary findings had low sensitivity (23%). Bone contusion around the lateral knee compartment was seen in both unstable and stable ACLs (accuracy 64%). Previously reported MR imaging signs do not allow accurate distinction between clinically stable and unstable ACL injuries. Anterior tibial translation, uncovering of the posterior horn of the lateral meniscus, and hyperbuckled PCL, if present, are helpful signs in the diagnosis of an unstable tear. The presence of bone marrow edema around the lateral knee compartment is not predictive of ACL insufficiency. (orig.)