Transient ST-segment depression as a marker of myocardial ischemia during daily life

Deanfield, John; Shea, Michael J.; Ribiero, Paulo; Landsheere, C. De; Wilson, Richard A.; Horlock, Peter; Selwyn, Andrew P.

doi:10.1016/s0002-9149(84)80066-1

Cited by 387 publications

(67 citation statements)

References 16 publications

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“…Some myocardial perfusion studies using radionuclear agents also tend to refute the hypothesis that lesser amounts of myocardium are injured during painless ischemia. 13 Holter monitoring has also proven useful in clarifying pathophysiologic mechanisms during silent ischemia. Early studies of ambulatory ischemia noted that almost 80% of total ischemic episodes were silent and that most of the asymptomatic episodes were short, whereas the symptomatic ones were just as likely to be long as short.…”

Section: Hemodynamic Abnormalities During Silent Ischemiamentioning

confidence: 99%

“…Early studies of ambulatory ischemia noted that almost 80% of total ischemic episodes were silent and that most of the asymptomatic episodes were short, whereas the symptomatic ones were just as likely to be long as short. 13,14 As more and more studies using the Holter monitor have been published, it is apparent that there is a circadian variation in ischemic episodes, with most coming after arousal in the morning, or waking and rising at night. This circadian variation is the same in both men and women.…”

Section: Hemodynamic Abnormalities During Silent Ischemiamentioning

confidence: 99%

See 1 more Smart Citation

Silent Myocardial Ischemia

2003

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Section: Hemodynamic Abnormalities During Silent Ischemiamentioning

confidence: 99%

Section: Hemodynamic Abnormalities During Silent Ischemiamentioning

confidence: 99%

Silent Myocardial Ischemia

2003

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“…Weassessed the clinical efficacy of NTG-TTSbased on two different parameters, the change in frequency of SMIepisodes, a widely used conventional parameter (8), and the SMI index, which includes information about patient activity. The following somewhat inconsistent results were obtained.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with ischemic heart disease associated with episodes of silent myocardial ischemia (SMI) are known to have a poor prognosis similar to, or in some cases rather worse than, that associated with angina pectoris syndrome (1,3,4,8,10,16,25,27,30). Treatment for SMI should be implemented in the case of such patients, and nitrates are expected to be efficacious in this respect (2, 4-6, 8, 10, ll, 16, 22, 31).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Anti-anginal Drugs in the Treatment of Angina Pectoris Associated with Silent Myocardial Ischemia. Importance of Quantitative Holter ECG Data for Patient Activity.

Ino-Oka¹,

Sagawa

Takahashi

et al. 2000

Intern. Med.

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MethodsWe evaluated the clinical efficacy of transdermal nitroglycerin (NTG-TTS), a patch application of a nitrate, in the treatment of 27 patients with angina pectoris who had asymptomatic myocardial ischemic (SMI) attacks, using a double-blind cross-over method. Evaluation was made using Holter ECGand patient activity data.Results In frequency and duration of continuation of SMIepisodes, no significant differences were noted between the observation and placebo treatment periods, while the values of both these parameters were decreased significantly in the active drug treatment period compared with those in the observation and placebo treatment periods. Critical heart rate, the heart rate at the initiation of ST-segment depression, was significantly higher during the period of active drug treatment than during the placebo treatment and observation periods. In SMIfrequency index, which was determined by adjusting the SMIfrequency for the numberof steps taken, there were no significant differences between the 3 periods. The SMI time index was significantly lower in the active drug treatment period than in the observation period. Conclusions These results indicated that the clinical evaluation of the efficacy of anti-anginal drugs against SMI should take into consideration individual patient activity data.

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“…34 '35 We did not have preoperative echocardiograms of these patients. Deanfield et al 36 have shown in patients with active coronary artery disease with and without symptoms of chest pain, that ST ischaemia relates to compromised myocardium as defined by stress thallium and echocardiographic evidence of myocardial dysfunction as evidenced by abnormal wall motion. In our study there was a marked absence of chest pain to accompany myocardial morbidity.…”

Section: Discussionmentioning

confidence: 99%