PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3825928

Total ischemic burden: pathophysiology and prognosis.

P F Cohn
View original source ↗Export metadata ↓

Abstract

Myocardial ischemia is caused by decreased supply (primary ischemia), increased demand (secondary ischemia) or a combination of the two (mixed ischemia). The sum of all episodes--with or without pain--constitutes the total ischemic burden. During out-of-hospital activities, many episodes occur at lower than expected heart rates, suggesting that a vasoconstrictive component is involved in the genesis of such episodes. These silent attacks may be even more important clinically than painful attacks. It has been suggested that silent myocardial ischemia has an adverse impact on prognosis in patients with totally asymptomatic ischemia or asymptomatic postinfarction ischemia. Further, it has been shown that there is a direct relation between the duration and frequency of silent myocardial ischemia and subsequent cardiac events in patients with unstable angina. Therefore, aggressive therapy may be warranted in certain groups of patients in whom silent myocardial ischemia constitutes a significant part of the total ischemic burden.

Explore related subjects

Coronary DiseaseElectrocardiographyHumansMonitoring, PhysiologicPrognosisRadionuclide ImagingJournal ArticleResearch Support, Non-U.S. Gov't

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P F Cohn. 1987-03-09. Total ischemic burden: pathophysiology and prognosis.. https://doi.org/10.1016/0002-9149(87)90188-3

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Update on PPAR agonists: the clinical significance of FIELD and PROACTIVE.

The peroxisome proliferator-activated receptor (PPAR) family of genes plays a major role in metabolic regulation. Unfortunately, the results of two recent, large event trials of PPAR agonists have been mixed. High rates of crossover to statin use confound the interpretation of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial, which found a less than expected reduction in coronary and stroke events with fenofibrate. Of concern, nonsignificant increases in coronary and sudden deaths, thrombotic events, and pancreatitis occurred in the fenofibrate group. The PROspective pioglitAzone Clinical Trial In macroVascular Events (PROACTIVE) also found a reduction in coronary and stroke events with pioglitazone compared with placebo in a population with diabetes and cardiovascular disease, but this benefit was counterbalanced by an increase in congestive heart failure as well as symptomatic edema. Further research is needed to determine the role of PPAR agonists in the prevention of cardiovascular disease.

Coronary Disease↗
PubMed2007

Depressive symptoms and sex affect completion rates and clinical outcomes in cardiac rehabilitation.

Symptoms of depression are often seen in patients with coronary heart disease. Symptoms appear more commonly in women and are negatively associated with measures of cardiovascular health. Using multiple logistic regression analyses, the authors evaluated the independent effects of depression (as measured by the Beck Depression Inventory [BDI-II]) and sex on cardiac rehabilitation (CR) completion. In addition, in those who completed CR, the authors evaluated whether depressive symptoms and sex affected clinical outcomes. Women as well as participants with enrollment BDI-II scores > or =14 had significantly higher rates of CR noncompletion. Patients with BDI-II scores > or =14 who completed CR achieved significant improvements in lipid profile, body mass index, and exercise capacity regardless of sex. Women and individuals with BDI-II scores > or =14 are at risk for CR noncompletion and should be encouraged to complete CR, because cardiovascular benefits comparable to those seen in men and individuals with low BDI-II scores were achieved when these patients completed the CR program.

Coronary Disease↗