Abstract:
BACKGROUND:It has been suggested that episodes of silent myocardial ischemia (SMI) might influence the prognosis of patients with ischemic heart disease, as its consequences are similar to those of myocardial ischemia accompanied by pain. Ambulatory electrocardiogram (ECG) is generally employed in diagnosis as well as in evaluation of clinical efficacy in patients with SMI, but problems related to its application remain because of the difficulty in differentiating between nonischemic and ischemic ST-segment depressions and because of the absence of data concerning body movement. METHODS AND RESULTS:We developed a method for simultaneously recording onto magnetic tape both the ECG chart and pedometer count, as well as a program which enables semi-automatic analysis of the heart rate (HR)-ST relationship. This new method was employed to record ambulatory ECG along with pedometer count for a total of 70 patients, consisting of 53 with coronary heart disease who were shown to have ischemic heart disease, and 17 with various heart diseases in whom coronary angiography revealed no coronary stenosis. The HR-ST relationship was assessed for periods during which steps were recorded by the pedometer, that is, when patients were confirmed to have been under exertion effort. Patients demonstrating the following findings were diagnosed as true positive for SMI: the ST segment level did not decline until HR increased to a certain threshold, and the rate of change in the ST-segment level noted thereafter was -0.025 mm/beats/min or lower; or the ST-segment depression induced by effort continued even after discontinuation of exercise, after which time HR began to decrease, and the HR-ST loop consequently described a counterclockwise rotation. Evaluation of the HR-ST relationship based on these criteria revealed excellent results, as demonstrated by values of 79.2% for sensitivity and 94% for specificity. CONCLUSION:Our newly developed method of assessment of the HR-ST relationship via analysis of simultaneous data from an ambulatory ECG and a pedometer appears to be time saving, highly objective, and useful with regard to the diagnosis of SMI and evaluation of the therapeutic effect of drugs in patients with ischemic heart disease.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Ino-Oka E,Takahashi T,Sagawa K,Inooka Hdoi
10.1002/clc.4960190605subject
Has Abstractpub_date
1996-06-01 00:00:00pages
467-72issue
6eissn
0160-9289issn
1932-8737journal_volume
19pub_type
杂志文章abstract:BACKGROUND:The presence or absence of collateral circulation to the infarct-related coronary artery in acute myocardial infarction (AMI) significantly impacts on infarct size and resulting left ventricular function. However, the determinants of collateral development have not been clarified. HYPOTHESIS:The purpose of ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960220911
更新日期:1999-09-01 00:00:00
abstract::Primary tumors of the heart are infrequent at all ages. We present a newborn with hypoxia and a heart murmur, in whom an echocardiogram revealed a large tumor filling the right ventricle and the pulmonary annulus. To maintain pulmonary blood flow, the patency of the ductus arteriosus was achieved by infusion of prosta...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110910
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:The efficacy of prophylactic coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery in patients with abdominal aortic aneurysm (AAA) scheduled for open repair surgery remains controversial. HYPOTHESIS:Concomitant coronary artery disease (CAD) ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20335
更新日期:2008-12-01 00:00:00
abstract::There is an apparent benefit with extension of dual antiplatelet therapy (DAPT) beyond 1 year after implantation of drug-eluting stents (DES). Assessment by a Double Randomization of a Conventional Antiplatelet Strategy vs a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation, and of Treatment Interruption ...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22512
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Left ventricular hypertrophy (LVH) on the electrocardiogram (ECG) may be masked in the presence of complete right bundle-branch block (RBBB). Left bundle-branch block on the ECG is associated with LVH at autopsy in 93% of hearts studied. However, RBBB does not predict LVH and the usual ECG criteria applied f...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960210209
更新日期:1998-02-01 00:00:00
abstract::The incidence of inadvertent permanent ventricular pacing from the coronary vein is not known. In a retrospective analysis of 69 patients in whom transvenous pacemakers were implanted between 1979 and 1986, 12 patients were discovered to have right bundle-branch block pattern to the paced complexes on electrocardiogra...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120508
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Iodine-123 metaiodobenzylguanidine (123I-MIBG) concentrates in adrenergic neurons and has been developed for evaluation of the sympathetic nervous system. Recent studies have demonstrated that the normal heart is clearly visualized by 123I-MIBG cardiac scintigraphy, whereas abnormal 123I-MIBG myocardial upta...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
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更新日期:1997-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960230314
更新日期:2000-03-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:1993-05-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2011-06-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:2020-09-01 00:00:00
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更新日期:2019-12-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
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更新日期:1988-02-01 00:00:00
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更新日期:2003-02-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060403
更新日期:1983-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960100704
更新日期:1987-07-01 00:00:00
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doi:10.1002/clc.4960250307
更新日期:2002-03-01 00:00:00
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更新日期:1997-01-01 00:00:00
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更新日期:1978-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 历史文章,杂志文章
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更新日期:1997-04-01 00:00:00
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更新日期:2009-11-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 评论,社论
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更新日期:2010-01-01 00:00:00
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更新日期:2000-05-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:1991-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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更新日期:1992-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2012-06-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20777
更新日期:2010-06-01 00:00:00