Document Detail


Asynergy in coronary heart disease. Evolving clinical and pathophysiologic concepts.
MedLine Citation:
PMID:  410336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The widespread use of cardiac ventriculography has focused interest on the frequency with which asynergy accompanies coronary heart disease as well as on its clinical and prognostic implications and dynamic nature. Recently, "intervention ventriculography" using nitroglycerin or postextrasystolic potentiation has indicated that asynergic zones may be more accurately classified as reversible (implying viable myocardium) or irreversible (nonviable or scarred myocardium), and thus the ventriculographic definition of aneurysm must reflect not only the severity of asynergy but its contractile reserve. Surface electrocardiogram Q waves, the severity of asynergy, and degree of coronary occlusion all adversely affect the potential for reversibility, whereas coronary collaterals enhance it. Important clinical applications include assessment of the potential utility of coronary bypass surgery in improving asynergy and of vasodilators in the treatment of patients with left ventricular failure. With refractory sequelae of aneurysms (heart failure, ventricular tachyarrhythmias, and systemic emboli) and a discrete aneurysm, surgical resection has been increasingly used with generally good results.
Authors:
R H Helfant; M M Bodenheimer; V S Banka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  87     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1977 Oct 
Date Detail:
Created Date:  1977-11-25     Completed Date:  1977-11-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  475-82     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / physiopathology
Collateral Circulation
Coronary Artery Bypass
Coronary Circulation
Coronary Disease / physiopathology*,  surgery
Coronary Vessels / physiopathology
Electrocardiography
Heart Aneurysm / etiology,  surgery
Heart Conduction System / drug effects,  physiopathology*
Heart Failure / etiology,  therapy
Heart Ventricles / physiopathology
Humans
Ischemia
Myocardial Contraction / drug effects
Nitroglycerin / pharmacology,  therapeutic use
Prognosis
Chemical
Reg. No./Substance:
55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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