Diurnal distribution of ST-segment elevation and related arrhythmias in patients with variant angina: a study by ambulatory ECG monitoring.

Abstract:

:Twenty-four-hour ambulatory ECG recording was performed in 26 patients with variant angina to evaluate the diurnal distribution of ST-segment elevation in relation to chest pain and the incidence of arrhythmias during the episodes. During a recording period of 52 days, 364 ST-segment elevations of 1 mm or greater were observed and 79% were asymptomatic. ST-segment elevation frequently occurred between 0:00 and 9:00 hours (72%) and most frequently between 5:00 and 6:00 hours (13%). Only a few episodes occurred between 10:00 and 18:00 hours. Premature atrial contractions, premature ventricular contractions (PVCs), ventricular tachycardia (VT) and complete atrioventricular block occurred during 12% of the episodes and were more common during painful episodes (32%) than during painless ones (6%). However, VT and severe forms of PVCs (couplets and bigeminy) appeared eight times during painless episodes and nine times during painful ones. Arrhythmias occurred more frequently when the elevated ST segment started to return or was returning to the control level (n = 38) than when the ST segment was rising (n = 8). The incidence of arrhythmias was lower when the daily frequency of ischemic episodes was high. This study shows that episodes of asymptomatic coronary artery spasm predominantly occur early in the morning as symptomatic episodes; complex dysrhythmias appear during the asymptomatic episodes; arrhythmias occur predominantly during a "reperfusion period;" and more arrhythmias accompany infrequent daily episodes of ischemia than frequent ones.

journal_name

Circulation

journal_title

Circulation

authors

Araki H,Koiwaya Y,Nakagaki O,Nakamura M

doi

10.1161/01.cir.67.5.995

subject

Has Abstract

pub_date

1983-05-01 00:00:00

pages

995-1000

issue

5

eissn

0009-7322

issn

1524-4539

journal_volume

67

pub_type

杂志文章
  • Intraoperative detection of myocardial ischemia in high-risk patients: electrocardiography versus two-dimensional transesophageal echocardiography.

    abstract::Because acute segmental wall motion abnormalities (SWMAs) of the left ventricle are highly sensitive and specific indicators of myocardial ischemia, this study compared the incidence and significance of ischemia, as detected by two-dimensional transesophageal echocardiography and surface electrocardiography, during an...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.72.5.1015

    authors: Smith JS,Cahalan MK,Benefiel DJ,Byrd BF,Lurz FW,Shapiro WA,Roizen MF,Bouchard A,Schiller NB

    更新日期:1985-11-01 00:00:00

  • Concealed ventricular parasystole uncovered in the form of ventricular escapes of variable coupling.

    abstract::Exit block from a parasystolic focus is recognized when automatic discharges fail to become manifest during the excitable phase of the ventricular cycle. In the present study, an apparently complete exit block and a persistently concealed ventricular parasystole (VP) resulted from an exit refractory period (ExRP) long...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.64.1.199

    authors: Nau GJ,Aldariz AE,Acunzo RS,Chiale PA,Elizari MV,Rosenbaum MB

    更新日期:1981-07-01 00:00:00

  • Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    abstract::Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has ...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/CIR.0000000000000483

    authors: Forman DE,Arena R,Boxer R,Dolansky MA,Eng JJ,Fleg JL,Haykowsky M,Jahangir A,Kaminsky LA,Kitzman DW,Lewis EF,Myers J,Reeves GR,Shen WK,American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and St

    更新日期:2017-04-18 00:00:00

  • Kinetics of electrophysiologic changes during oral loading of amiodarone and after withdrawal of amiodarone in the unsedated dog.

    abstract::We examined the temporal kinetics of onset and offset of the cardiac electrophysiologic effects of orally administered amiodarone in chronically instrumented, unsedated adult dogs (n = 8). Right atrial (RA), atrioventricular nodal (AVN), and right ventricular (RV) effective refractory period (ERP), and AVN functional ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.72.6.1380

    authors: Tuna IC,Qi AC,Gornick C,Bolman RM 3rd,Benditt DG

    更新日期:1985-12-01 00:00:00

  • Functional consequences of human induced pluripotent stem cell therapy: myocardial ATP turnover rate in the in vivo swine heart with postinfarction remodeling.

    abstract:BACKGROUND:The use of cells derived from human induced pluripotent stem cells as cellular therapy for myocardial injury has yet to be examined in a large-animal model. METHODS AND RESULTS:Immunosuppressed Yorkshire pigs were assigned to 1 of 3 groups: A myocardial infarction group (MI group; distal left anterior desce...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.112.000641

    authors: Xiong Q,Ye L,Zhang P,Lepley M,Tian J,Li J,Zhang L,Swingen C,Vaughan JT,Kaufman DS,Zhang J

    更新日期:2013-03-05 00:00:00

  • Cardiovascular responses to the isoprostanes iPF(2alpha)-III and iPE(2)-III are mediated via the thromboxane A(2) receptor in vivo.

    abstract:BACKGROUND:Isoprostanes (iPs) are free radical-catalyzed products of arachidonic acid that reflect lipid peroxidation in vivo. Several iPs exert biological effects in vitro and may contribute to the functional consequences of oxidant stress. For example, iPF(2alpha)-III (8-iso PGF(2alpha)) and iPE(2)-III modulate plate...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.24.2833

    authors: Audoly LP,Rocca B,Fabre JE,Koller BH,Thomas D,Loeb AL,Coffman TM,FitzGerald GA

    更新日期:2000-06-20 00:00:00

  • Inhaled nitric oxide versus aerosolized iloprost in secondary pulmonary hypertension in children with congenital heart disease: vasodilator capacity and cellular mechanisms.

    abstract:BACKGROUND:Inhaled nitric oxide (iNO) has been used to assess the vasodilator capacity of the pulmonary vascular bed in children with congenital heart disease and elevated pulmonary vascular resistance. Inhaled iloprost is a pulmonary vasodilator for the long-term treatment of pulmonary hypertension (PHT). Because thes...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.103.4.544

    authors: Rimensberger PC,Spahr-Schopfer I,Berner M,Jaeggi E,Kalangos A,Friedli B,Beghetti M

    更新日期:2001-01-30 00:00:00

  • Differential clinical outcomes associated with hypoglycemia and hyperglycemia in acute myocardial infarction.

    abstract:BACKGROUND:In patients with acute myocardial infarction (AMI), hyperglycemia predicts death, but the prognostic significance of hypoglycemia is controversial. METHODS AND RESULTS:We evaluated the prognostic significance of hypoglycemia and hyperglycemia in 30 536 AMI patients in a post hoc analysis of 2 large trials o...

    journal_title:Circulation

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.108.837765

    authors: Goyal A,Mehta SR,Díaz R,Gerstein HC,Afzal R,Xavier D,Liu L,Pais P,Yusuf S

    更新日期:2009-12-15 00:00:00

  • Targeting of apoptotic macrophages and experimental atheroma with radiolabeled annexin V: a technique with potential for noninvasive imaging of vulnerable plaque.

    abstract:BACKGROUND:Apoptosis is common in advanced human atheroma and contributes to plaque instability. Because annexin V has a high affinity for exposed phosphatidylserine on apoptotic cells, radiolabeled annexin V may be used for noninvasive detection of apoptosis in atherosclerotic lesions. METHODS AND RESULTS:Atheroscler...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000105761.00573.50

    authors: Kolodgie FD,Petrov A,Virmani R,Narula N,Verjans JW,Weber DK,Hartung D,Steinmetz N,Vanderheyden JL,Vannan MA,Gold HK,Reutelingsperger CP,Hofstra L,Narula J

    更新日期:2003-12-23 00:00:00

  • Genetic testing for long-QT syndrome: distinguishing pathogenic mutations from benign variants.

    abstract:BACKGROUND:Genetic testing for long-QT syndrome (LQTS) has diagnostic, prognostic, and therapeutic implications. Hundreds of causative mutations in 12 known LQTS-susceptibility genes have been identified. Genetic testing that includes the 3 most commonly mutated genes is available clinically. Distinguishing pathogenic ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.109.863076

    authors: Kapa S,Tester DJ,Salisbury BA,Harris-Kerr C,Pungliya MS,Alders M,Wilde AA,Ackerman MJ

    更新日期:2009-11-03 00:00:00

  • Sympathoinhibitory effects of atrial natriuretic factor in normal humans.

    abstract::In rats, atrial natriuretic factor (ANF) reduces sympathetic nerve activity (SNA) reflexively by sensitizing cardiac mechanoreceptors with inhibitory vagal afferents. We performed three series of experiments in 26 normal young men to document whether ANF inhibits SNA in humans and if so, to determine potential mechani...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.81.6.1860

    authors: Floras JS

    更新日期:1990-06-01 00:00:00

  • Clinical pharmacokinetics and efficacy of amiodarone for refractory tachyarrhythmias.

    abstract::Using a high-pressure liquid chromatographic assay, we measured serum amiodarone concentrations serially in 122 patients treated with amiodarone for 1.5-53 months (mean 9.3 months) for control of refractory symptomatic atrial or symptomatic and life-threatening ventricular tachyarrhythmias. The atrial tachyarrhythmias...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.67.6.1347

    authors: Haffajee CI,Love JC,Canada AT,Lesko LJ,Asdourian G,Alpert JS

    更新日期:1983-06-01 00:00:00

  • Physical activity and coronary heart disease in men: The Harvard Alumni Health Study.

    abstract:BACKGROUND:The quantity and intensity of physical activity required for the primary prevention of coronary heart disease (CHD) remain unclear. Therefore, we examined the association of the quantity and intensity of physical activity with CHD risk and the impact of other coronary risk factors. METHODS AND RESULTS:We fo...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.9.975

    authors: Sesso HD,Paffenbarger RS Jr,Lee IM

    更新日期:2000-08-29 00:00:00

  • Caval contribution to flow in the branch pulmonary arteries of Fontan patients with a novel application of magnetic resonance presaturation pulse.

    abstract:BACKGROUND:A complete understanding of fluid mechanics in Fontan physiology includes knowledge of the caval contributions to right (RPA) and left (LPA) pulmonary arterial blood flow, total systemic venous return, and relative blood flow to each lung. METHODS AND RESULTS:Ten Fontan patients underwent cine MRI. Three ci...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.9.1215

    authors: Fogel MA,Weinberg PM,Rychik J,Hubbard A,Jacobs M,Spray TL,Haselgrove J

    更新日期:1999-03-09 00:00:00

  • Histopathology of embolic debris captured during transcatheter aortic valve replacement.

    abstract:BACKGROUND:Recent transcatheter aortic valve replacement studies have raised concerns about adverse cerebrovascular events. The etiopathology of the embolized material is currently unknown. METHODS AND RESULTS:A total of 40 patients underwent transcatheter aortic valve replacement with the use of a dual filter-based e...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/CIRCULATIONAHA.112.001091

    authors: Van Mieghem NM,Schipper ME,Ladich E,Faqiri E,van der Boon R,Randjgari A,Schultz C,Moelker A,van Geuns RJ,Otsuka F,Serruys PW,Virmani R,de Jaegere PP

    更新日期:2013-06-04 00:00:00

  • Multiple Arterial Grafting Is Associated With Better Outcomes for Coronary Artery Bypass Grafting Patients.

    abstract:BACKGROUND:Observational studies have shown better survival in patients undergoing coronary artery bypass grafting (CABG) with 2 arterial grafts compared with 1. However, whether a third arterial graft is associated with incremental benefit remains uncertain. We sought to analyze the outcomes of 3 versus 2 arterial gra...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.118.034464

    authors: Rocha RV,Tam DY,Karkhanis R,Nedadur R,Fang J,Tu JV,Gaudino M,Royse A,Fremes SE

    更新日期:2018-11-06 00:00:00

  • First clinical results with a new temperature-controlled rate-responsive pacemaker. Comparison of Activitrax and Nova MR pacemakers with VVI/AAI pacing.

    abstract::We examined the cardiopulmonary effects of maximum bicycle ergometer exercise in seven patients with implanted Intermedics Nova MR pacemakers for three types of pacing in a randomized sequence: VVI or AAI at 70 beats/min (SSI 70), rate-adaptive temperature-controlled pacing with the implanted Nova MR, and rate-adaptiv...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Alt E,Völker R,Högl B,MacCarter D

    更新日期:1988-11-01 00:00:00

  • Echocardiography and Doppler ultrasound in the evaluation of pericardial disease.

    abstract::Echocardiography and Doppler ultrasound are useful in evaluating a variety of pathological conditions affecting the pericardium. Cardiac tamponade results in right atrial collapse and right ventricular diastolic collapse detectable by echocardiography. These echocardiographic signs have a high degree of sensitivity an...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Chandraratna PA

    更新日期:1991-09-01 00:00:00

  • Effects of digitalis on resting and isometric exercise myocardial perfusion in patients with coronary artery disease and left ventricular dysfunction.

    abstract::Digitalis has been shown to improve the impaired ventricular function associated with coronary artery disease as well as to increase myocardial oxygen consumption and produce coronary vasoconstriction. To elucidate the net result of these contrasting effects, six patients with coronary artery disease and left ventricu...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.56.3.355

    authors: Vogel R,Kirch D,LeFree M,Frischknecht J,Steele P

    更新日期:1977-09-01 00:00:00

  • Role of ATP-sensitive K+ channel on ECG ST segment elevation during a bout of myocardial ischemia. A study on epicardial mapping in dogs.

    abstract:BACKGROUND:ATP-sensitive K+ channels are activated when the myocardium becomes ischemic. However, the role of the ATP-sensitive K+ current in the emergence of ECG ST changes during ischemia remained unclarified. METHODS AND RESULTS:The left anterior descending coronary artery (LAD) was cannulated and perfused with art...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.88.4.1845

    authors: Kubota I,Yamaki M,Shibata T,Ikeno E,Hosoya Y,Tomoike H

    更新日期:1993-10-01 00:00:00

  • Randomized trial of acupuncture to lower blood pressure.

    abstract:BACKGROUND:Arterial hypertension is a prime cause of morbidity and mortality in the general population. Pharmacological treatment has limitations resulting from drug side effects, costs, and patient compliance. Thus, we investigated whether traditional Chinese medicine acupuncture is able to lower blood pressure. METH...

    journal_title:Circulation

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.106.661140

    authors: Flachskampf FA,Gallasch J,Gefeller O,Gan J,Mao J,Pfahlberg AB,Wortmann A,Klinghammer L,Pflederer W,Daniel WG

    更新日期:2007-06-19 00:00:00

  • Effect of pulse separation between two sequential biphasic shocks given over different lead configurations on ventricular defibrillation efficacy.

    abstract:BACKGROUND:Two sequential biphasic shocks delivered over separate lead configurations markedly improve defibrillation efficacy compared with a single shock alone. We investigated the effect of varying the intershock interval between sequential biphasic shocks on defibrillation. METHODS AND RESULTS:Defibrillation thres...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.85.6.2267

    authors: Johnson EE,Alferness CA,Wolf PD,Smith WM,Ideker RE

    更新日期:1992-06-01 00:00:00

  • Efficacy and Safety of a Pharmaco-Invasive Strategy With Half-Dose Alteplase Versus Primary Angioplasty in ST-Segment-Elevation Myocardial Infarction: EARLY-MYO Trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute

    abstract:BACKGROUND:Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the eff...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/CIRCULATIONAHA.117.030582

    authors: Pu J,Ding S,Ge H,Han Y,Guo J,Lin R,Su X,Zhang H,Chen L,He B,EARLY-MYO Investigators.

    更新日期:2017-10-17 00:00:00

  • Creation of anastomoses between an extracardiac artery and the coronary circulation. Proof that myocardial angiogenesis occurs and can provide nutritional blood flow to the myocardium.

    abstract::The purpose of this investigation was to determine whether blood vessels could develop de novo between an extracardiac artery and a collateral-dependent zone of the heart and to quantify the nutritive blood flow afforded by the new vessels. We also adapted the preparation so that angiogenically active agents could be ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.82.4.1449

    authors: Unger EF,Sheffield CD,Epstein SE

    更新日期:1990-10-01 00:00:00

  • The early posthospital phase of myocardial infarction. Prognostic stratification.

    abstract::Prognostic stratification was carried out on 518 patients less than or equal to 65 years of age who were discharged from the hospital following a definite or probable acute myocardial infarction and followed for four months. The total population was made up of 272 patients hospitalzed in 1973 and 246 patients hospital...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.54.1.58

    authors: Moss AJ,DeCamilla J,Davis H,Bayer L

    更新日期:1976-07-01 00:00:00

  • Congenital heart block in newborns of mothers with connective tissue disease.

    abstract::Of 22 children with congenital complete heart block (CCHB) available for study, 14 (63.6%) were born to 11 mothers with clinical or laboratory evidence of connective tissue disease, primarily lupus erythematosus (LE). Seven mothers had both clinical and laboratory evidence of disease while four had only positive labor...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.56.1.82

    authors: McCue CM,Mantakas ME,Tingelstad JB,Ruddy S

    更新日期:1977-07-01 00:00:00

  • Mechanisms responsible for inhibition of vein-graft arteriosclerosis by fish oil.

    abstract::Favorable changes in lipoproteins, inhibition of platelet aggregation, reduction of serum thromboxane (TX), altered plasma-membrane fluidity, and reduced production of growth factors (mitogens) have all been implicated as possibly being involved in the inhibition of arteriosclerosis by fish oil (FO), which is rich in ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Sarris GE,Fann JI,Sokoloff MH,Smith DL,Loveday M,Kosek JC,Stephens RJ,Cooper AD,May K,Willis AL

    更新日期:1989-09-01 00:00:00

  • Targeted molecular probes for imaging atherosclerotic lesions with magnetic resonance using antibodies that recognize oxidation-specific epitopes.

    abstract:BACKGROUND:Oxidized low-density lipoprotein plays a key role in the initiation, progression, and destabilization of atherosclerotic plaques and is present in macrophages and the lipid pool. The aim of this study was to assess the feasibility of magnetic resonance imaging of atherosclerotic lesions in mice using micelle...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.107.757120

    authors: Briley-Saebo KC,Shaw PX,Mulder WJ,Choi SH,Vucic E,Aguinaldo JG,Witztum JL,Fuster V,Tsimikas S,Fayad ZA

    更新日期:2008-06-24 00:00:00

  • Reciprocating tachycardia using bilateral anomalous pathways: electrophysiologic and clinical implications.

    abstract::A patient who had disabling supraventricular tachycardia showed electrophysiologic evidence of coexistent right and left Kent bundles. The supraventricular tachycardia was accelerated by sequential antegrade and retrograde conduction over the right and left Kent bundles, respectively. Spontaneous blocking of the condu...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.62.3.657

    authors: Cinca J,Valle V,Gutierrez L,Figueras J,Rius J

    更新日期:1980-09-01 00:00:00

  • Prospective temporal analysis of the onset of preinfarction angina versus outcome: an ancillary study in TIMI-9B.

    abstract:BACKGROUND:The timing of onset of angina before myocardial infarction in relation to outcome is unknown. METHODS AND RESULTS:We prospectively determined the importance of the time of onset of preinfarction angina in relation to 30-day outcomes in the TIMI-9B study from standardized forms. Of the 3002 patients entered ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.97.11.1042

    authors: Kloner RA,Shook T,Antman EM,Cannon CP,Przyklenk K,Yoo K,McCabe CH,Braunwald E

    更新日期:1998-03-24 00:00:00