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At least 577 records · Page 32Linked to original sources
PubMed1989

[Clinical characteristics and diagnosis of stenocardia in persons with normal coronary vessels].

To date, the clinical pattern and electrocardiographic diagnosis of only one variant of coronary heart disease (CHD) with unchanged coronarogram, Prinzmetal's angina, have been worked out, while the diagnosis of other variants remains undeveloped. Clinical symptoms and possibilities of CHD diagnosis in the presence of intact coronary arteries have been evaluated in 67 coronary patients, the coronarograms being normal in 46 of those. The diagnosis of CHD was verified by means of various instrumental methods, including electrocardiographic tests and myocardial metabolic studies in conditions of frequent atrial stimulations. The results were computerized, using a specifically designed programme. Sets of signs identifying coronary patients with intact coronary arteries at questioning and noninvasive investigation are presented.

Adult↗
PubMed1987

[Effect of fentolamin on the resistance of the coronary vessels and on the frequency of the heart rate].

The effects of phentolamine on coronary resistance and heart rate, as well as the influence of beta 1-adrenoceptor blockade on phentolamine effects were studied on the isolated cat hearts. Phentolamine reduced coronary resistance in 100% of cases (-25.9 +/- 4.4%; p less than 0.001) and increased heart rate only in 31.6% of cases (+9.1 +/- 1.4%); on average the alterations of heart rate were nonsignificant (p less than 0.1). After beta 1-blockade with Cordanum the rate of coronary dilation reduced (p less than 0.001), the changes in coronary resistance being nonsignificant (p greater than 0.1). Basal coronary resistance and tone during phentolamine infusion without or after beta 1-blockade were identical (p greater than 0.1). Thus, the reduction of coronary resistance during phentolamine infusion was due to beta 1-adrenomimetic activity of the drug.

Adrenergic beta-Antagonists↗
PubMed1996

[Comparison of long-term prognosis between medical therapy PTCA and CABG for multiple coronary vessel disease].

Left main trunk disease is mainly treated by CABG, on the other hand, single vessel disease is applied by Simple Medical or PTCA. These concept is widely accepted, but, there were controversies about the treatment for multiple vessel disease. The purpose of this study was to clarify the long-term prognosis of different therapeutic means for multiple vessel diseases. In our center, 3635 consecutive initial coronary angiography were done from September 1977 to December 1989. Of those, 1190 patients of multiple vessel diseases excluding those with left main trunk lesion, previous re-vascularization or acute myocardial infarction were served for this study. Double vessel disease (DVD) was 727 patients, Triple vessel disease (TVD) was 455 patients. We divided these patients into three groups according to their initial therapy. A retrospective analysis was carried out on the follow-up patients from survival rate, cardiac death free rate and cardiac event free survival rate. The cardiac death were due to acute myocardial infarction, congestive heart failure and sudden death. The cardiac event including all death, acute myocardial infarction, PTCA and CABG. The statistical analysis was done by Kaplan-Meier and Cox Proportional Hazard Model. The survival rate in DVD and TVD, Medical was significantly lower than other groups. Survival curves of CABG and PTCA was quite similar. The survival rate at 5 years was 85 (M), 89 (C) and 89% (P), and at 10 years 67,78 and 76%, respectively in DVD, and the survival rate at 5 years was 57,91 and 90%, and at 10-years, 57,77 and 78%, respectively. The cardiac death free rate in DVD and TVD showed same tendency. The cardiac event free survival in DVD, PTCA was significantly lower than other groups. This result was derived from high incidence of re-stenosis after PTCA. The cardiac event free survival rate were at 5 years 79 (M), 86 (C) and 58% (P) and at 10 years 50, 58 and 30%, respectively. In TVD, CABG was significantly higher than other groups. The cardiac event free survival rate were at 5 years 72, 86 and 63% and 10 years 42,64 and 39%, respectively. In Summary, the survival rate and cardiac death free rate of Medical were significantly lower than those of CABG and PTCA. There were no significant differences between CABG and PTCA on the survival rate and cardiac death free rate. The cardiac event free survival rate of CABG was significantly higher than that of PTCA and Medical. In multiple vessel disease, CABG will bring the best long term prognosis. Even though the cardiac events were most frequent in PTCA, it's survival rate was quite similar to CABG. So, PTCA must be thought the second best method of the therapy of multiple vessel disease.

Angioplasty, Balloon, Coronary↗
PubMed1998

Long-term outcome in triple-vessel coronary artery disease in medically treated Japanese patients.

The long-term outcome in 198 patients with triple-vessel disease (TVD) treated medically was investigated. The patients, who underwent coronary angiography between September 1973 and February 1984, had significant (75% or more) stenotic lesions in all three major coronary arteries. The mean follow-up period was 8.4 years. The 5- and 10-year survival rates were 80.7% and 64.2%, respectively. Cardiac death occurred in 73 patients (36.9%) and nonfatal cardiac events developed in 60 patients (30.9%) during follow-up. When cardiac death and nonfatal myocardial infarction (MI) were defined as cardiac events, the annual attrition rate was 4.7%. There was no difference in survival with regard to the presence or absence of MI, the site of infarction, or the presence of total occlusion. In the AP group, however, the survival rate decreased as the number of totally-occluded arteries increased. In the MI group, the survival rate was not altered by the number of totally-occluded arteries, but was affected by the ejection fraction (EF). The 5-year survival rate was better in patients with good left ventricular function (EF > or = 60%) than in those with impaired left ventricular function (EF < 60%), although the 10-year survival rate was similarly low in both groups. Revascularization such as PTCA or CABG might improve the long-term outcome in patients with TVD.

Angina Pectoris↗
PubMed1997

Long-term outcome in double-vessel coronary artery disease in Japanese patients.

The long-term (average: 10 years) outcome in 220 patients with double-vessel disease (DVD) treated medically was investigated. The patients underwent coronary angiography between September 1973 and February 1984, and significant (75% or more) stenosis was detected in each of two major coronary arteries. These patients showed relatively good 5-year and 10-year survival rates of 94.5% and 87.4%, respectively. Cardiac death occurred in 31 patients (14.1%) and nonfatal myocardial infarction (MI) developed in 16 patients (7.3%) during follow-up. When these were defined as cardiac events, the annual attrition rate was 3.1%. A comparison of the outcome with regard to the presence or absence of MI revealed worse results for the MI group, but no difference was observed between different sites of infarction. There was also no difference in outcome with regard to the presence or absence of lesions in the left anterior descending artery (LAD). In the MI group, patients with impaired left ventricular function (ejection fraction < or = 40%) had inferior survival to those with good left ventricular function. Thus, DVD associated with good left ventricular function had a relatively good outcome when treated medically, while patients with impaired left ventricular function might benefit from revascularization.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Intramyocardial arterial cushions of coronary vessels in animals and humans: morphology, occurrence and relation to heart disease.

The existence of coronary endoarterial cushions (CEC) in the human heart as nonpathological, functional entities has been debated, and CEC have been sparsely reported in animals. Arterial cushions are localized thickenings that protrude into the lumen of specific arteries. We have identified CEC in the rhesus monkey, dog, sheep, goat, pig, rabbit and rat, and in the human heart. Two distinct types are described: the ovoid CEC arranged singly, in pairs, or in groups of three to four, and the less common polypoid CEC seen primarily in humans. The highest incidence of CEC in rabbits and humans was in the left ventricle in arteries 150-488 microns in diameter. Light and electron microscopy demonstrated intimal location with smooth muscle cells surrounded by ground substance, collagen and elastin fibers in a highly organized pattern. Nerve fibers identified by their immunoreactivity with antiserum to the vasodilatory calcitonin-gene-related peptide contacted the CEC along the tunica media and were occasionally seen within CEC. Arrangement and histological composition of CEC suggest a role in the regulation of local blood flow and myocardial perfusion. In human hearts, the CEC density index correlated highly with the degree of heart disease. In subjects with high heart disease rating, increased connective tissue, lipid-like infiltration and calcification was seen within CEC, and foam cells were present in CEC of obese rabbits. This suggests that CEC in coronary arteries could be predisposed sites of atherosclerosis, and that injured CEC can cause coronary artery spasm and ischemia. We conclude that CEC occur in animals and humans as innervated intimal smooth muscle cushions that might have a role in myocardial perfusion and heart disease.

Adolescent↗
PubMed1992

[Case reports of arteriovenous fistulas of coronary vessels in adulthood].

It is reported on the diagnosis and therapy of arteriovenous fistulae of coronary arteries. With the help of 5 casuistic instances external fistulae could be demonstrated by invasive diagnostic procedures. In three cases the fistulae drained from the left coronary into the pulmonary artery, at the second instance from the right coronary artery into the right ventricle, in the fifth instance from the right coronary artery into the right atrium. In addition to this there were coronary stenoses which needed a bypass. In all cases the tentative diagnoses were confirmed intraoperatively. The indication to operative ligatures of the congenital fistulae is discussed and supported depending upon the picture of the complaint.

Adult↗