| Early morning reduction in ischemic threshold in patients with unstable angina and significant coronary disease. | |
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MedLine Citation:
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PMID: 7671355 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The objective of this study was to investigate in patients with unstable angina and significant coronary stenosis (> 70%) whether or not the morning peak of myocardial ischemia is associated with a reduction in the ischemic threshold. The morning increased incidence of ischemic episodes in stable angina appears to be attributable to a coincidence of several factors. Patients with unstable angina who remain at bed rest, however, also present a similar morning increased incidence of ischemia, but its mechanisms are not completely understood. METHODS AND RESULTS: The ischemic threshold was assessed by atrial pacing at 7 to 8 AM and at 12 to 1 PM in 46 patients. In the 34 with a positive pacing response (ST segment shift > 1.0 mm), ischemic threshold was lower at 7 to 8 AM than at 12 to 1 PM (131 +/- 16 versus 139 +/- 15 beats per minute, P < .001), whereas in the remaining 12 patients, the pacing response was negative. Moreover, 4 patients presented ST segment elevation during pacing in the morning but only 1 at noon and at a higher threshold. Baseline heart rate and diastolic blood pressure were higher at noon than in the morning (81 +/- 16 versus 76 +/- 13 beats per minute, P < .01, and 87 +/- 11 versus 82 +/- 10 mm Hg, P < .05). CONCLUSIONS: The morning lowering of ischemic threshold in the absence of increases in baseline blood pressure or heart rate suggests that a reduced coronary vasodilator capacity or an increased coronary tone may favor the increased incidence of ischemic events during this interval. |
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Authors:
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J Figueras; R M Lidón |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Circulation Volume: 92 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1995 Oct |
Date Detail:
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Created Date: 1995-10-19 Completed Date: 1995-10-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1737-42 Citation Subset: AIM; IM |
Affiliation:
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Unitat Coronària, Hospital General Vall d'Hebron, Barcelona, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina, Unstable
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diagnosis,
physiopathology* Bed Rest Blood Pressure / physiology Cardiac Pacing, Artificial Circadian Rhythm / physiology* Coronary Disease / diagnosis, physiopathology* Coronary Vessels / physiopathology* Electrocardiography Female Heart Rate / physiology Humans Male Middle Aged Myocardial Ischemia / physiopathology* Vascular Resistance / physiology Vasodilation / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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