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PubMed · 3408622

Angina pectoris treated by ventricular plication.

H H Gray·M Paneth·D G Gibson
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Abstract

Objective analysis of the left ventricular angiogram in a patient with angina but normal coronary arteries showed an appreciable disturbance of regional wall movement. Because of persistent symptoms refractory to medical treatment left ventricular plication was undertaken. This resulted in a return to normal of a series of disturbances of left ventricular wall motion commonly found in patients with obstructive coronary disease, and a striking improvement in the patient's symptoms. The patient remains symptom free five years after operation.

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Angina PectorisCineangiographyHeart VentriclesHumansMaleMiddle AgedMyocardial ContractionCase ReportsJournal Article

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BibTeXRIS

H H Gray, M Paneth, D G Gibson. 1988. Angina pectoris treated by ventricular plication.. https://doi.org/10.1136/hrt.60.1.83

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Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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